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November 1992

Intraoperative Fluorescein Angioscopy in Subretinal Surgery

Arch Ophthalmol. 1992;110(11):1518-1519. doi:10.1001/archopht.1992.01080230016006

To the Editor.  —Recent advances in surgical techniques have made the removal of subretinal membranes and hemorrhages possible.1,2 Although preoperative fluorescein angiography is extremely useful in these cases, intraoperative fluorescein angioscopy can also be very helpful. Large subretinal hemorrhages often preoperatively obscure the source of fluorescein leakage; however, intraoperative angioscopy can be performed immediately after removal of the hemorrhage, to identify choroidal neovascularization and to allow immediate endolaser treatment. We have adapted excitation and barrier filters, made for a fluorescein angiography camera, to fit into an endoilluminator and an operating microscope, respectively. The excitation filter (Spectrotech, Saugus, Mass) is placed into the sliding tray (Fig 1, arrowheads) of a light source. When the fundus is illuminated with the filtered blue light, the fluorescein appears yellow-green. This system is similar to the one described by Charles3 that identifies sources of bleeding during vitrectomy; however, we have greatly enhanced the

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