Posterior Vitreous Separation by a Combination of Triamcinolon and Fluid Jet

The advantage of triamcinolone  in the context of the creation of posterior vitreous separation is to better visualize the hyaloid.  Being able to directly see the hyaloid may help to improve the effectiveness of detaching the hyaloid via the cutter and helps to realize a beginning separation. But triamcinolone does not directly interfere with vitreo-retinal adhesion. A jet of fluid, BSS, applied through a small glass capillary pipette however can sever and weaken vitreo-retinal adhesions and facilitate the hyaloid detachment by the subsequent cutter aspiration as shown here. Too strong a jet of fluid however can perforate the retina an create a accidental retinal bleb.