In this episode, my colleague Dr. Kirk Hou demonstrates peeling of the ILM when the macula is detached and with the assistance of PFL. This is a trauma case with a large and irregularly shaped macular hole. Peeling of the ILM when the retina is detached can be challenging due to the lack of counter-traction when attempting to elevate the ILM. PFL can help to stabilize the macula for ILM peeling. If the macula is detached and PFL is not used, peeling the ILM from a nasal to temporal direction (i.e. starting towards the optic nerve and peeling towards the temporal macula) is the preferred approach since the optic nerve serves as a point of counter-traction. This is a beautifully performed case with an excellent anatomic outcome.
