Advantages:

In selected cases of VMT, pharmacologic treatment is proposed but the effect is not 100%. The mini MIVS approach obtained complete result but with the risk of surgery and the stimulation of the cataract.

My way is a modification of the Oshima technique using a 27 G approach, reflow strategy, slit lamp illumination and only one pars plana port approach with forceps without vitrectomy in this phakic patient.

Methods:

The use of reflow strategy and one pars plana port approach and only the forceps without vitrectomy allows for sure the removal of vitreomacular traction.

The ‘no vitrectomy’ avoids the stimulation of the cataract in this relatively young phakic patient.

The reflow strategy means standard infusion of 27 G in the anterior chamber: in case of hypotony due to the vitreous manipulation the fluid passes in the vitreous cavity through the zonules. This system compensates for every hypotonic step during the manipulation with the forceps. In this way we avoid corneal folds and the visibility of the vitreomacular traction remains optimal to allow a perfect visibility. We show some cases with this technique with the removal of the vitreomacular traction without vitrectomy and stimulation of cataract.

Effectiveness:

The technique is efficient and using one scleral port the risks are reduced to the minimum while the visibility is assured by the infusion of the anterior chamber (reflow strategy) that compensate the hypotony during manipulation.