Surgical management of a live intravitreal nematode

PURPOSE: To describe a novel surgical technique for the removal of a live intravitreal nematode. OBSERVATIONS: We describe the surgical management of a 35-year-old man with a live intravitreal nematode in his left eye. A 23-gauge pars plana limited core vitrectomy was performed to release the nematode from the surrounding vitreous strands. After creating a peritomy, a 20-gauge full thickness sclerotomy was created with a microvitreoretinal blade. The tip of a 20-gauge angiocath needle was cut obliquely and inserted through the sclerotomy. The external portion of the needle was attached to the viscous fluid extraction tubing for the Constellation vitrectomy machine (Alcon). Gentle aspiration pulled the nematode into the angiocath. The nematode was transferred to a syringe for parasitologic evaluation. CONCLUSIONS AND IMPORTANCE: The novel surgical technique described allows for aspiration of an intravitreal nematode in a controlled fashion. This technique can be used to manage this rare, but visually significant condition.