Modern vitreous surgery has been greatly facilitated, if not made possible, by the intraocular fiberoptic light pipe. In its current state, the light pipe is a straight, bright illuminator that allows direct visualization of what it shines on.1 This is limiting when used with small opacities that have a refractive index similar to their surroundings and for use with subtle vitreoretinal adhesions. In these instances, relationships can be difficult to discern by direct illumination.
We have found that these shortcomings can be largely overcome by bending the light pipe (Figure) and taking advantage of the indirect illumination that results. This is not unlike the added visualization afforded by indirect and retroillumination in slit-lamp biomicroscopy, and it has allowed us to better appreciate the insertion of the vitreous base and the location of the posterior hyaloid face. By highlighting the presence and direction of anteroposterior and tangential vitreous traction, this
Kertes PJ, Peyman GA. A Light Pipe With a Twist. Arch Ophthalmol. 1996;114(6):777-778. doi:10.1001/archopht.1996.01100130769040