Triamcinolone-assisted internal limiting membrane peeling during idiopathic macular hole surgery

We have developed a new technique to facilitate internal limiting membrane (ILM) peeling with triamcinolone acetonide during idiopathic macular hole surgery. Twelve eyes of 12 patients with a macular hole, stage 2 to 4 and size 0.12 disc diameters (DD) to 0.39 DD (mean, 0.20 DD), underwent vitrectomy with ILM peeling using triamcinolone. Before ILM peeling, a triamcinolone suspension (8 mg/mL in balanced salt solution) was sprayed around the macular hole, and the triamcinolone in the vitreous cavity was aspirated slowly, making the ILM more visible. Postoperatively, the macular hole was closed in all eyes, and the visual acuity was improved from 20/200 to 20/40 (median, 20/130) to 20/60 to 20/20 (median, 20/40). This technique can facilitate the ILM peeling without any adverse effects in this short-term observation.