Table 1 Traditional and novel techniques to deal with issues related to high myopia

Increased axial length

Increased distance between sclerotomies

Ad hoc straight or curved instruments

Use of 20-G instruments

Removal of trocars

Epiretinal tissues visualization

Chromovitrectomy

iOCT

Filters

3D

Dye toxicity

Place a substance over the fovea (e.g. PFCL, sodium hyaluronate, autologous blood)

Devices to inject gently the dye (Drip dropper, SideFlo cannula)

Filters

iOCT

ILM peeling

Start at least 1 DD from the fovea

Diamond Dusted Membrane Scraper

Start from temporal or inferior quadrants

FINESSE Flex loop

Elevate preexisting edge using the back of a needle, a MVR blade or vertical scissors

PFCL bubble to stabilize retina

Lift the flap a bit more than usual

MH closure

ILM non-peeling

Inverted ILM flap (complete, 270° temporal C-shaped variant, 180° superior variant, Viscoat-assisted)

ILM peeling

Injection over the hole of autologous platelet-rich plasma, autologous transplantation of ILM membrane, lens capsular flap, neurosensory retina

Shaving vitreous base in eyes with clear lens

Choice of instruments (valved trocars, small G instruments)

Non-contact wide field viewing systems

Trocar insertion at 4 mm

Ad hoc curved instruments

Peripheral indentation

Brush the peripheral retina (Diamond Dusted Membrane Scraper, FINESSE Flex loop)

Hand switching

Bending of standard instruments

Sclerotomy leakage

Biplanar scleral insertion

Triplanar scleral insertion

Wound construction (Longer tunnel, narrow angle of insertion, parallel to the limbus, bevel-down incision)

27-G instruments

Sclerotomy massage

Other techniques to close the wound (releasable sutures, tissue glue, polyethylene glycol-based hydrogel bandage, conjunctival cauterization

Transconjunctival and transcleral absorbable suture