BackgroundTo introduce a modified surgical technique, the “parafoveal multiple curvelinear internal limiting membrane (ILM) peeling”, to preserve epi-foveal ILM in myopic foveoschisis surgery.MethodsConsecutive patients with myopic foveoschisis were enrolled in the present prospective interventional case series. The surgeries were performed using transconjunctival 23-gauge system. The macular area was divided into quadrants. ILM was peeled off in a curvilinear manner centered around the site that was away from the central fovea in each quadrant. Shearing forces were used to control the direction to keep the peeling away from central fovea. ILM at central fovea of about 500 to 1000 μm was preserved by this technique.ResultsThis technique was performed in 20 eyes of 20 consecutive patients. Epi-foveal ILM was successfully preserved in all cases using the technique. Patients were followed up for more than 12 months. The mean postoperative logMAR visual acuity improved from 1.67 ± 0.65 preoperatively to 1.15 ± 0.49 (P = 0.015; paired t-test). Postoperative OCT examinations showed that full-thickness macular holes (MHs) did not developed in any case. Central fovea thickness decreased from 910 ± 261 μm preoperatively to 125 ± 85 postoperatively (P = 0.001; paired t-test).ConclusionFovea sparing ILM peeling using multiple parafoveal curvilinear peels prevents the development of postoperative full-thickness MHs in eyes with myopic foveoschisis.

BackgroundRecently, 25-gauge vitrectomy has become more popular. However, most still perform the surgery in pediatric patients without the use of the trocars and cannulas as in adult vitrectomies.MethodsWe described a simple modification using adult 25-gauge cannulas and 270-silicone watzke sleeves, enabling these instruments to be used in pediatric cases. The sleeve is cut into segments of 2 mm in length, and then introduced up the shaft of the 25-gauge trocar. One is introduced first, and a second one is introduced on top of the first one. This secures the two sleeves on the shaft of the trocar, such that they act as a spacer. The effective shaft of the trocar was then reduced to 2 mm in length.ResultsThis method enabled successful surgery in two cases.ConclusionsThis allows the adaptation of the standard 25-gauge system for pediatric cases with only the slightest modification needed.