ABSTRACT
In 1991, the first report of the successful removal of subfoveal choroidal neovascularization (CNV) in two patients with ocular histoplasmosis ushered in the modern era of submacular surgery. A sclerotomy should be placed so that the CNV can be reached directly without going over a previous laser scar or risking extensive manipulation under the fovea. Membrane dissection begins with passing the pick over the entire surface of the CNV to verify that no anterior connections to the retina exist. If pressure from the pick fails to break the remaining adhesions, then horizontal sub-retinal scissors are introduced through the retinotomy and the tissue is cut close to the membrane surface. The forceps are slowly opened to grasp full-thickness membrane at its elevated edge or to grasp the ingrowth stalk beneath the CNV. The CNV is either removed from the eye through the pars plana or cut and aspirated with the vitrectomy instrument.
