content top

Subfoveal PFCL Bubbles in Myopic Eye with Posterior Staphyloma

Subfoveal PFCL Bubbles in Myopic Eye with Posterior Staphyloma EDITED FILM ABSTRACT This a case of subfoveal PFCL bubbles complicating 1ry vitrectomy in a myopic eye with posterior staphyloma. Using 41G hydrodissection cannula, BSS was slowly infused into the sub retinal space detaching the retina at the around the fovea. The retina was struck with a soft tip over the PFCL bubble to dislodge them. The sub retinal fluid was aspirated...

Read More

Rhegmatogenous RD Complicating Boston Keratoprosthesis, Type 1, Aphakic Module

Rhegmatogenous RD Complicating Boston Keratoprosthesis, Type 1, Aphakic Module EDITED FILM ABSTRACT The videos is demonstrating difficulties encountered in doing vitrectomy for RRD + PVR occurring in an eye with Boston keratoprosthesis. This is the only eye of 60 year old lady with severe dry eye. She underwent previous reconstruction of the fornices and implantation of Boston keratoprosthesis type 1, aphasic module with postoperative...

Read More

Hinged ILM Flap Technique for Repair of Failed Macular Hole Surgery

Hinged ILM Flap Technique for Repair of Failed Macular Hole Surgery EDITED FILM ABSTRACT This a case of failed macular hole surgery complicated with retinal detachment. Following BB staining, the ILM was found peeled around the hole. The technique involved peeling 2 strips for ILM, from above & below the hole, injection of PFCL bubble to guide the ILM flaps over the hole, detaching the flaps from their bases and brought over the...

Read More

Extensive Subretinal Proliferation Complicating Traumatic RRD

Extensive Subretinal Proliferation Complicating Traumatic RRD EDITED FILM ABSTRACT This a case of perforating trauma complicated with RRD & extensive sub retinal proliferation. Following 23G vitrectomy, posterior hyaloid and ILM peeling, peripheral 360 degrees retinotomy was performed. The retina was inverted and using 2 forceps, the extensive subretinal strand and sheets were dissected. The retinal was attached with PFCL, 360...

Read More

ILM Peeling Across Posterior Staphyloma & ILM Inverted Flap in Myopic MHRD: Technique & Results

ILM Peeling Across Posterior Staphyloma & ILM Inverted Flap in Myopic MHRD: Technique & Results ABSTRACT To evaluate the efficacy of ILM inverted flap & ILM peeling to the edge of the posterior staphyloma in treatment of myopic macular hole RD. Prospective & interventional case series. 32 eyes with myopic MHRD, all with posterior staphyloma & axial length ranging between 28.4 – 34.3 mm. underwent 23/25G...

Read More

Radical Vitrectomy & Extensive ILM Peeling in Complicated Pediatric Rhegmatogenous Retinal Detachment

Radical Vitrectomy & Extensive ILM Peeling in Complicated Pediatric Rhegmatogenous Retinal Detachment ABSTRACT 80 eyes with complicated pediatric RRD were included (congenital myopia, Stickler, Marfan, regressed ROP, trauma, post-IO surgery, congenital retinoschisis, congenital coloboma & Down syndrome). Surgical technique included radical vitrectomy, posterior hyaloid peeling (unimanual or bimanual), radical excision of basal...

Read More

Intravitreal Decorin as an Adjuvant Therapy to Prevent Proliferative Vitreoretinopathy in Perforating Injuries: A Pilot Study

Intravitreal Decorin as an Adjuvant Therapy to Prevent Proliferative Vitreoretinopathy in Perforating Injuries: A Pilot Study ABSTRACT Purpose: To determine the safety, tolerability, and efficacy of human recombinant decorin protein, a transforming growth factor ß (TGFß) inhibitor in preventing proliferative vitreoretinopathy (PVR) in patients with perforating globe injuries. Methods: This is a prospective, single-center,...

Read More

Vitreoretinal Interface Disorders

Vitreoretinal Interface Disorders Pathogenesis of Vitreoretinal Disorders (The Anomalous PVD): 5 min. by Hassan Mortada Epimacular Membranes: 12 min. by Hassan Mortada Lamellar Macular Hole: 12 min. by Jerzy Nawrocki Vitreomacular Traction Syndrome: 12 min. by Hassan Mortada Idiopathic Macular Hole: 12 min. by Jerzy Nawrocki Discussion 7 min. CONTACT DETAILS Hassan Mortada Cairo, Egypt Email: has.mortada@gmail.com Cell Phone:...

Read More

Inverted ILM Flap in Congenital Optic Pit Maculopathy: Technique & Results

Inverted ILM Flap in Congenital Optic Pit Maculopathy: Technique & Results ABSTRACT 5 eyes with congenital optic pit maculopathy underwent inverted ILM flap technique. Visco was used to keep the flap in place under air. Progressive macular flattening & finally reattachment occurred over a period ranging from 6-8 months with improvement in visual acuity in all eyes. CONTACT DETAILS Hassan Mortada Cairo, Egypt Email :...

Read More

Failed Closure of Idiopathic Macular Hole: Causes & Management

Twenty-three eyes with idiopathic macular hole, that failed to close following vitrectomy, were divided into 2 groups: Group 1 (9 eyes) that where operated upon by the author himself, and Group 2 (14 eyes) that were operated by other surgeons and referred to the author because of non-closure. Eyes in Group 1 are known to have undergone posterior hyaloid and ILM peeling. All eyes underwent OCT. The macular hole was found open, enlarged with...

Read More

Tano Scraper for ILM Peeling: Technique & Results

ILM peeling in idiopathic macular hole surgery is crucial to achieve high anatomical and functional success rate. ILM peeling may be done using special ILM forceps or Tano scraper. The purpose of this work is to describe the technique of using the Tanoscraper to start and peel the ILM in eyes with idiopathic macular holes (IMH). 35 eyes with idiopathic macular hole underwent vitrectomy, posterior hyaloid peeling, ILM peeling using the...

Read More

23 Gauge Probe Surgery in Severe Proliferative Diabetic Retinopathy

Technological advances in 23 gauge probe design and vitrectomy machines, allowed the use of the probe to perform many intraoperative techniques and manipulations during complex diabetic vitrectomy. The aim of this work is to describe techniques for using the 23 gauge vitrectomy probe to manage complex diabetic vitrectomy. 120 eyes with severe complications of proliferative diabetic retinopathy were included in this work. They include cases...

Read More

A Novel Episcleral Macular Buckling Technique for Recurrent Macular Hole Retinal Detachment in High Myopic Eyes

The purpose would be to describe and evaluate a novel technique of episcleral macular buckling in postvitrectomy recurrent macular hole retinal detachment in highly myopic eyes. A 7 mm silicone sponge strengthened with a U-shaped 0.5 mm orthodontics stainless steel wire fed along its length and hand-bent to produce L-shaped buckle of appropriate shape and length, is used. The episcleral macular has been performed on 15 highly myopic eyes...

Read More

Diabetic Retinopathy

Introduction: Diabetes mellitus is the most common cause of proliferative vascular retinopathy, which also includes retinal venous occlusive disease, Sickle cell retinopathy and retinopathy of prematurity. The underlying abnormality in these disorders is retinal ischemia, which may ultimately lead to the formation and contraction of proliferative fibrovascular membranes with subsequent vitreous hemorrhage and/or retinal detachment. In...

Read More

Vitrectomy Outcome in Resistent Non-tractional Diffuse DME

Advantages: Diabetic diffuse macular edema not responding to repeated IV injctions of Anti-VEGF and/or Triamcinolone may benefit from vitrectomy and ILM peeling. Vitrectomy helps to remove factors and mediators that may play a role in production of macular edema and/or its no or poor response to IV injections. ILM peeling ensure complete relieve of traction and may stimulate retinal glial cells mainly Muller cells to reactive fibrosis and...

Read More

Vitrectomy Outcome in Traction Diffuse DME

Advantages: In eyes with diffuse diabetic macular edema and OCT evidence of tangential and/or anteroposterior traction, Vitrectomy techniques allow complete release of traction, restoration of normal or near normal retinal architecture, and functional improvement. Methods: 65 eyes with traction diabetic diffuse macular edema underwent 23 gauge vitrectomy. All eyes underwent preoperative FA and OCT. Vitrectomy was combined with...

Read More

Vitreoretinal Interface Abnormalities Associated with Diffuse DME: Diagnosis and Management

Advantages: Diabetic diffuse macular edema may be associated with multiple vitreoretinal interface abnormalities as epimacular membranes, vitreomacular traction syndrome, lamellar macular hole and full thickness macular hole. Vitrectomy combined with ILM peeling is effective in dealing with interface disorders with encouraging anatomical and functional results. Methods: Vitrectomy combined with ILM peeling was used to deal with...

Read More

Vitreo-Macular Interface Disorders: Diagnosis & Management

Hassan Mortada (Cairo, Egypt); Jerzy Nawrocki (Lodz, Poland) Introduction The vitreo-retinal interface has 2 components, the posterior cortical vitreous (collagen type II) and the internal limiting membrane (collagen type IV). Several pathological entities may take place at the Vitreomacular interface including: idiopathic macular hole, lamellar macular hole, Epimacular membrane, Vitreomacular traction syndrome and myopic traction...

Read More

Recent Trends in Management of Proliferative Vitreoretinopathy (PVR), Complicating Rhegmatogenous Retinal Detachment (RRD)

Hassan Mortada (Cairo, Egypt), Grazia Pertile (Verona, Italy) Introduction: PVR is a clinical entity characterized by migration and proliferation of cells, mainly retinal pigment epithelium, glial cells and inflammatory cells, with subsequent formation of non-vascularized membranes on both retinal surfaces, vitreous base and vitreous gel, after a RRD. The cells have contractile properties and can exert traction directly on the retina or...

Read More

Management of Adherent Posterior Hyaloid During Vitrectomy in Eyes with Rhegmatogenous RD

Hassan Mortada (Cairo, Egypt) Advantages: Peeling of adherent cortical vitreous during primary vitrectomy in eyes with rhegmatogenous RD is crucial in achieving complete mobilization of the retina, to remove the scaffold for further proliferation and to achieve long-term retinal stability. The posterior hyaloid may be loosely or strongly adherent or may show vitreoschisis. The aim of this work is to present the behavior of adherent...

Read More

A Novel Episcleral Macular Buckling Technique for Recurrent Macular Hole Retinal Detachment in Highly Myopic Eyes (Preliminary Results)

Hassan Mortada (Cairo, Egypt) Advantages: Factors acting in the production of macular hole RD in highly myopic eyes may include traction exerted by partially detached posterior hyaloid, altered ILM, potent retinal arterioles and progression of posterior staphyloma. Vitrectomy techniques with peeling of posterior hyaloid and ILM and internal tamponade with long acting gas or silicone oil, can eliminate traction exerted by the first 3...

Read More

Strategy for Management of Giant Retinal Tears Retinal Detachment, Technique & Results

Hassan Mortada (Cairo, Egypt) Advantages: Giant retinal tear retinal detachment entails many controversial issues including: whether or not to use scleral buckle, management of the crystalline lens, choice of internal tamponade and methods to prevent posterior slippage of posterior retinal flap. The technique used in this study includes: no scleral buckle, removal of the crystalline lens using phacoemulsification and PCIOL, radical...

Read More

Primary Vitrectomy, Without Buckling, for Rhegmatogenous RD of Intermediate Severity: Technique & Results

Hassan Mortada (Cairo, Egypt) Advantages: The advantages of primary vitrectomy include direct relieve of vitreoretinal traction, removal of inflammatory mediators & cells, intraoperative complete retinal reattachment, choice of the appropriate tamponade and avoiding the complications associated with scleral buckling. This work presents the technique & results of primary vitrectomy without buckling in dealing with RRD of...

Read More

23 G Transconjunctival Vitrectomy Techniques in Complicated Retinal Detachment

Hassan Mortada (Cairo, Egypt) Advantages: To evaluate the efficacy of using only 23g transconjuntival sutureless vitrectomy in management of complicated retinal detachment over the past 3 years. The preservation of the integrity of the conjunctiva and sclera in these cases is of crucial importance, as these cases frequently need more than one operation, at least to remove silicone oil. This is a major advantage of 23G over 20G. The...

Read More

Traumatic Retinal Detachment Associated with Penetrating / Perforating Injuries with Shotgun Pellets: Treatment Technique and Results

Hassan Mortada (Cairo, Egypt) Advantages: Better understanding of wound healing and the advent of vitrectomy resulted in dramatic improvement in the prognosis of open globe injuries. The aim of this work is to present the technique used in dealing with traumatic retinal detachment caused by penetrating/perforating ocular injuries caused by shotgun pellets. Methods: 20 eyes with severe penetrating/perforating injuries caused by shotgun...

Read More

Recurrent Retinal Detachment in Silicone Oil Filled Eyes

Hassan Mortada (Cairo, Egypt) Advantages: Recurrent RD in silicone oil filled eyes may occur early due to persistent retinal traction not adequately relieved or missed breaks, or late due to reproliferation. The aim of the present study is to describe the pathogenesis and management of recurrent Rd, following vitrectomy and silicone oil tamponade in eyes with RRD complicated with PVR. Methods: 180 silicone oil filled eyes, with recurrent...

Read More

Vitrectomy for Tractional Diabetic Macular Edema

http://www.evrs.eu/medias/2010/congress/Non-Proliferative-Diabetic-Maculopathies.flv Hassan Mortada (Cairo, Egypt) Advantages: PPV, with or without ILM peeling relieves traction at the vitreoretinal interface, improves trans-vitreal oxygenation of the retina and removes growth factor reservoir in the premacular hyaloid. Methods: 46 eyes with tractional diffuse diabetic macular edema underwent PPV: 12 eyes with taut adherent posterior...

Read More

Peripheral Temporal Retinotomy for the Evacuation of Submacular Blood Clots Secondary to Retinal Arterial Macroaneurysms

http://www.evrs.eu/medias/2010/congress/Hemorrhages.flv Hassan Mortada (Cairo, Egypt) Advantages:  One hundred and eighty degree peripheral temporal retinotomy, just posterior to the ora serrata allows free access to the sub-retinal space.  It allows complete removal of unabsorbed sub macular blood clot secondary to retinal arterial macroaneurysms.  Peripheral retinotomies are associated with less risk of epiretinal proliferation than...

Read More

Full Macular Translocation for CNVM Secondary to ARMD, Not Responding to Anti-VEGFs

http://www.evrs.eu/medias/2010/congress/Age-Related-Macular-Degeneration-2.flv] Hassan Mortada (Cairo, Egypt) Advantages: Full macular translocation (FMT) has the advantages of complete removal of CNVMs not responding to repeated anti-VEGF intravitreal injections, reposition of the macular area over healthy retinal pigment epithelium and choriocapillaris and restoration of the normal macular configuration and function. Methods: The last...

Read More

Proliferative Diabetic Retinopathy: Principles and Techniques of Vitreoretinal Surgery

Hassan Mortada (Cairo, Egypt) Introduction: Diabetes mellitus is the most common cause of proliferative vascular retinopathy which also includes retinal venous occlusive disease, sickle cell retinopathy and retinopathy of prematurity. The underlying abnormality in these disorders is retinal ischemia, which may ultimately lead to the formation and contraction of proliferative fibrovascular membranes with subsequent vitreous hemorrhage and...

Read More

24 Hours Preoperative Intravitreal Bevacizumab (Avastin) for Repair of Retinal Detachment in Eyes with Active Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Hassan Mortada (Cairo, Egypt) Advantages: Preoperative intravitreal Avastin injection produces significant reduction of retinal neovascularization. This dramatic effect may be related to its activity against all isoforms of VEGF. However, intravitreal Avastin injection is not without complications. It may lead to contraction of the fibrovascular tissue with...

Read More

ILM Peeling for Management of Idiopathic Epimacular Membranes

http://www.evrs.eu/medias/2009/congress/Is-ILM-Peeling-Mandatory.flv Author: Hassan Mortada, Cairo, Egypt Advantages: Systematic ILM peeling in eyes with idiopathic epimacular membranes ensure complete removal of epiretinal membrane, thus ensure complete relief of tangential traction with subsequent better restoration of the normal macular contour and better visual results. It also reduces the incidence of recurrence of epimacular...

Read More

Relaxing Retinotomy / Retinectomy for Recurrent Retinal Detachment in Silicone Oil – Filled Eyes

http://www.evrs.eu/medias/2009/congress/Silicone.flv Author: Hassan Mortada, Cairo, Egypt Advantages: Recurrent retinal detachment in silicone oil – filled eyes is most commonly due to persistent or recurrent retinal traction 2ry to periretinal proliferation or retinal shortening. Adequate circumferential retinotomy is effective in relieving anteroposterior and/or circumferential shortening, removing subretinal proliferation as well as...

Read More

Strategy for Management of Giant Retinal Tear Retinal Detachment

http://www.evrs.eu/medias/2009/congress/Giant-Tear.flv Author: Hassan Mortada, Cairo, Egypt Advantages: My strategy for management of giant retinal tear retinal detachment is lens removal using phacoemulsification and implantation of PCIOL, no encircling scleral buckle, 20 gauge PPV, meticulous excision of basal vitreous gel and excision of anterior flap, mobilization of the retina and posterior flap through dissection of epiretinal...

Read More

Primary Vitrectomy without Scleral Buckling, for Management of Uncomplicated Retinal Detachment

http://www.evrs.eu/medias/2009/congress/Systematic-Primary-Pars-Plana-Vitrectomy-vs-Only-in-Selected-Cases.flv Author: Hassan Mortada, Cairo, Egypt Advantages: Primary vitrectomy detect all retinal breaks, directly relieves traction on retinal breaks, removes attached posterior cortical vitreous, smoothly attach the retina through PFCL injection and provides internal tamponade with air or gas for all retinal breaks. Primary vitrectomy...

Read More

Full Macular Translocation for Massive Submacular Hemorrhage Secondary to Neovascular AMD

http://www.evrs.eu/medias/2009/congress/Hemorrhages.flv Author: Hassan Mortada, Cairo, Egypt Advantages: In eyes with massive submacular hemorrhage secondary to neovascular AMD, perform full macular translocation (FMT) remove the submacular hemorrhage, excise the neovascular membrane and translocate the macula to an area with healthier RPE/CC complex. This results in improvement of both distant and reading vision and prevents recurrence of...

Read More

Temporal Peripheral Retinotomy for Evacuation of Submacular Hemorrhage Secondary to Arterial Macroaneurysm

http://www.evrs.eu/medias/2009/congress/Hemorrhages.flv Author: Hassan Mortada, Cairo, Egypt Advantages: Evacuation of submacular hemorrhage, secondary to arterial macroaneurysm, through a peripheral temporal retinotomy ensure rapid and complete removal of the submacular hemorrhage. This helps to prevent the toxic effect of the blood on photoreceptors with subsequent preservation of visual acuity. Experience from full macular translocation...

Read More

Management of PVR with Severe Retinal Contraction and Shortening

http://www.evrs.eu/medias/2008/congress/Management-of-PVR-with-Severe-Retinal-Contraction-and-Shortening.flv Hassan Mortada Advantages: Retinal contraction and shortening in eyes with rhegmatogenous retinal detachment complicated by PVR is managed with a relaxing retinotomy. This video presents recurrent retinal detachment following 2 vitrectomies and an inferior 180 degrees relaxing retinotomy in a single eye patient. Methods: Following...

Read More

Management of Myopic Macular Hole Retinal Detachment

http://www.evrs.eu/medias/2008/congress/Management-of-Myopic-Macular-Hole-Retinal-Detachment.flv Hassan Mortada Advantages: Drainage of the subretinal fluid through the macular hole during fluid air exchange in myopic macular hole retinal detachment has several disadvantages. It traumatizes the edge of the hole and may result in enlargement of small holes in case of viscous subretinal fluid. The present work presents a technique for...

Read More

Vitrectomy and Posterior Hyaloid Peeling for Myopic Foveoschisis

http://www.evrs.eu/medias/2008/congress/Vitrectomy-and-Posterior-Hyaloid-Peeling-for-Myopic-%20Foveoschisis.flv Hassan Mortada Advantages: It is still uncertain which technique is most effective in management of myopic foveoschisis. This work presents the technique and results of vitrectomy combined with posterior hyaloid peeling, without internal limiting membrane peeling, in management of myopic foveoschisis. Methods: Twenty highly...

Read More

Outcome of Vitrectomy for Lamellar Macular Hole

http://www.evrs.eu/medias/2008/congress/Outcome-of-Vitrectomy-for-Lamellar-Macular-Hole.flv Hassan Mortada Advantages: The diagnosis, pathogenesis and the best therapeutic approach for lamellar macular hole is still unclear. This work describes the surgical technique used for management of these cases and the postoperative anatomical and functional results. Methods: Sixteen eyes with symptomatic lamellar macular hole underwent 20-gauge (6...

Read More

Medical & Surgical Strategy Session

http://www.evrs.eu/medias/2007/videos/medicalandsurgicalstrategy.flv

Read More

Vitrectomy Session – IOFB

http://www.evrs.eu/medias/2007/videos/vitrectomysession-iofb.flv

Read More

Vitrectomy Session – Lenses

http://www.evrs.eu/medias/2007/videos/vitrectomysession-lenses.flv

Read More

Vitrectomy Session – Peeling

http://www.evrs.eu/medias/2007/videos/vitrectomysession-peeling.flv

Read More

Vitrectomy Session – Silicone

http://www.evrs.eu/medias/2007/videos/vitrectomysession-silicone.flv

Read More

Posterior Retinal Detachment and Retinoschisis without a Macular Hole in Highly Myopic Eyes: Clinical Findings and Management

http://www.evrs.eu/medias/2006/congress/Posterior-Retinal-Detachment-and-Retinoschisis-without-a-Macular-Hole-in-Highly-Myopic-Eyes:-Clinical-Findings-and-Management.swf http://www.evrs.eu/medias/2006/congress/Posterior-Retinal-Detachment-and-Retinoschisis-without-a-Macular-Hole-in-Highly-Myopic-Eyes:-Clinical-Findings-and-%20Management.flv Hassan Mortada (Cairo, Egypt) PURPOSE: To describe the clinical and OCT findings as well as the...

Read More

Patterns of Posterior Cortical Vitreous Attachment in Myopic Macular Hole Retinal Detachment (RD)

Hassan A. Mortada, MD Purpose: To show the patterns of posterior cortical vitreous attachment in eyes with myopic macular hole retinal detachment (RD). Methods: Triamcinolone Acetonide (TA)-assisted vitrectomy was performed on 36 eyes with myopic macular hole retinal detachment. After excision of the central core and posterior vitreous gel, an attached posterior cortical vitreous was visualized as a white gel or membrane highlighted by TA....

Read More

Full Macular Translocation for Massive Submacular Haemorrhage Secondary to Exudative Age-Related Macular Degeneration

Hassan A. Mortada, MD Purpose: To report the results of full macular translocation (FMT) in management of massive subretinal haemorrhage secondary to age-related macular degeneration (ARMD). Methods: FMT with 360 peripheral retinotomy was used to treat 4 eyes (4 patients) presenting with massive submacular haemorrhage secondary to exudative ARMD. The duration of the haemorrhage ranged between 15 – 30 days and the preoperative visual...

Read More
content top