content top

25 Gauge Diabetic Vitrectomy: Precise Membranectomy Without Scissors

ABSTRACT Well known are “cosmetic” advantages of small gauge surgery, namely 25ga (shorter procedure, patients´ comfort, less inflammation, no astigmatism), however, more important are the “surgical” advantages (smaller required flow, smaller risk of retina or vitreous incarceration, better surgical accuracy, almost no retinal tears, a single instrument for various manipulations: base dissection, delamination, segmentation...

Read More

Pneumatic Displacement of Submacular Hemorrhage

Pneumatic Displacement of Submacular Hemorrhage ABSTRACT Advantage: Pneumatic displacement of large submacular hemorrhage in hemorrhagic AMD (and similar conditions) using intraocular injection of C3F8 leads to a fast relief, enables blood reabsorption and opens the way to the continuation of AMD treatment. We do not use any additional medicaments as TPA but continue with anti-VEGF therapy in most cases. Method: The pneumatic...

Read More

Vitreous Floaters Not Only in Young Anxious Engineers

Advantages: 1. Vitrectomy helps in all kinds of vitreous opacities. 2. We broke the concept that the typical patient with vitreous floaters is a young anxious engineer. Methods: We analyzed 83 eyes of 63 patients who underwent vitrectomy for vitreous floaters (asteroid hyalosis, PVD, and floaters only) between 2010 and 2015. 47 were male, 36 female eyes. Their mean age was 60 years, ranging from 22 to 82; the median was 61. The mean...

Read More

The Smaller, The Safer

Advantages: The use of 25ga+ and 27ga+ surgery with Constellation enables a more delicate and precise surgical manipulation on the retina surface, making vitrectomy safer. Methods: 1. The duty cycle (Core or Shave) and the fast cutting rate (5000 cpm)  are advantageous namely for beginners, however, it is mainly the smaller flow, thanks to the smaller gauge, which makes the surgery safer. 2. Both the vacuum and the flow can be precisely...

Read More

Eylea in the Treatment of Wet AMD : Comparison of Different Treating Regimens

Advantages: We compared different regimens of aflibercept (EYLEA) injections in patients with wet AMD. Methods: We analyzed 195 eyes of 186 patients with wet AMD, treated between 2013 and 2015 with aflibercept. We assessed BCVA and central retinal thickness and compared these parameters in four subgroups of patients treated using four different regimens: Only three monthly loading doses. Three loading doses followed with individual...

Read More

Small Gauge Surgery is a Real Progress

Advantages: My long time delayed conversion from 20 Gauge to 25 Gauge + surgery in 2012 showed even more benefits than Alcon declared. My trust in a better accuracy of 20 Gauge surgery proved to be wrong and I have operated over 1400 patients with a higher success rate than before. Well known are the “cosmetic” advantages of small gauge surgery (shorter procedure, patients´ comfort, less inflammation, no astigmatism),...

Read More

Efficacy of Idiopathic Macular Hole Retreatment After Primary Pars Plana Vitrectomy

Martina Rubesova_SCIENTIFIC POSTER 2015 Purpose: The aim of this study was to evaluate the efficacy of retreatment of macular hole in patients in whom primary pars plana vitrectomy (PPV) did not lead to the anatomical closure of the full-thickness defect, and to analyse the causes of its failure. Methods: Patients after primary surgical treatment by pars plana vitrectomy with a peeling of internal limiting membrane (IML) and gas tamponade...

Read More

Stimulation Laser in CSCR

Purpose: We use an individualized treatment for CSC based both on traditional procedures and on experimental ones. Laser stimulation therapy can be beneficial even in cases without the typical focus of leakage. In difficult cases without any defined or even anticipated leakage we use experimental therapy with anti-VEGF injections. Even intensive topical steroid therapy, usually strictly rejected, proved to be useful in rare cases. Methods:...

Read More

ALCON Symposium

“Smaller and Faster” in Complicated Vitreoretinal Surgeries Ivan Fiser, Jerzy Mackiewicz, Cesare Mariotti                   Welcome – Opening Remarks – Ivan Fiser My Experience with 25+ Gauge Surgery Technical remarks Cosmetic advantages Surgical advantages Disadvantages My Experience with 27+ Gauge Surgery Advantages Disadvantages Surgical Videos (Ivan Fiser, Jerzy...

Read More

Threshold Laser for Perifoveal Teleangiectasies

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Macular edema due to perifoveolar teleangiectasies is difficult to treat when the TAE are located close to, or at the border of the FAZ. Advantages: Encouraged by the good results of the stimulation treshold or subtreshold laser in CSC without visible focus (we presented this method at the EVRS meeting in Sevilla), we use this treatment...

Read More

The Most Simple Technique of Gas Tamponade

Advantages:  This very fast technique requires a single injection of undiluted gas without the need of gas mixing. Methods:  After vitrectomy, ILM peeling and fluid/air exchange, the sclera is sutured, or, in sutureless surgery, the cannulas are removed, however, the globe is left slightly hypotonous. The level of hypotony is very easily assessed using a finger. Then, just an injection of 1.5 ml of SF6 is injected using a 30ga needle....

Read More

Atraumatic ILM Peeling Without Forceps

Advantages:  An atraumatic ILM peeling is performed using the vacuum of the vitreous cutter, without a forceps, thus it is not traumatizing the retinal nerve fiber layer. Methods: This technique can be used both in 20 gauge and in 23 gauge, or 25 gauge surgery, in three different modes: either, the ERM is peeled using a traditional forceps; the ILM is usually partly removed, too; after another staining, the ILM is peeled using the...

Read More

Atraumatic ILM Peeling Without Forceps

Advantages:  An atraumatic ILM peeling is performed using the vacuum of the vitreous cutter, without a forceps, thus it is not traumatizing the retinal nerve fiber layer. Methods: This technique can be used both in 20 gauge and in 23 gauge, or 25 gauge surgery, in three different modes: either, the ERM is peeled using a traditional forceps; the ILM is usually partly removed, too; after another staining, the ILM is peeled using the vacuum...

Read More

Individualized Treatment in Macular Edema: Focal vs Diffuse

What I am going to show is that while in focal ME (in CSCh or in NPDR or in TAE etc.), the primary laser treatment is very efficient and almost harmless, thus I recommend laser primarily in these cases. In diffuse edema (as in BRVO, CRVO, DR, Irvine-Gass, uveitis et al), laser coagulation is controversial (often inefficient and even harmful). I will express my embarrassment about the proper choice of the best method of treatment and rather...

Read More

Is There a Universal Technique How to Treat Rhegmatogenous Retinal Detachment?

Ivan Fiser, Petr Bedrich, Frantisek Benda, Martina Rubesova (Prague, Czech Republic) Advantages: We do not have a universal preference in treating RD. We treat each patient individually, according to the finding, to his/her wishes, preferences and abilities, such as the ability of facedown positioning. Methods: We prefer scleral buckling in younger phakic patients while in pseudophakic detachment we more often perform vitrectomy, however,...

Read More

Individualized Therapy in Diabetic Maculopathy

http://www.evrs.eu/medias/2010/congress/Non-Proliferative-Diabetic-Maculopathies.flv Ivan Fiser, Martina Rubesova (Prague, Czech Republic) Advantages: We consider diabetic macular edema a very individual disease, which cannot be treated according to a single template. No doubt that in focal edema the direct laser coagulation of leaking MA brings the best effect. Diffuse edema is more questionable; grid laser is controversial or even...

Read More

Combined Treatment of CME after Branch Retinal Vein Occlusion

http://www.evrs.eu/medias/2010/congress/Branch-Retinal-Vein-Occlusion-Central-Retinal-Vein-Occlusion.flv Ivan Fiser, Martina Rubesova (Prague, Czech Republic) Advantages: In most cases of persisting CME after BRVO we use vitrectomy with ILM peeling which has a good effect in more than 60 % of eyes but. In some patients we start with Avastin that brings a repeated benefit but later recurrences of CME happen. Laser coagulation in edematous...

Read More

Combined Treatment of CME after Central Retinal Vein Occlusion

Ivan Fiser, Martina Rubesova (Prague, Czech Republic) Advantages: CME after CRVO is a typical case where it is very difficult to define which treatment is best to start with. Triamcinolone can be helpful (which was shown in a recent study) but a recurrence can happen. Avastin also has a temporary effect. ILM peeling can be beneficial, too, but we also see recurrences of CME after it. Laser treatment of edematous retina is difficult. We...

Read More

Stimulation Laser in Central Serous Chorioretinopathy

http://www.evrs.eu/medias/2010/congress/Central-Serous-Chorioretinopathy.flv Ivan Fiser (Prague, Czech Republic) Advantages: We use an individualized treatment for CSC based both on traditional procedures and on experimental ones. Laser stimulation therapy can be beneficial even in cases without the typical focus of leakage. Intensive topical steroid therapy, commonly strictly rejected, proved to be useful in some cases. Methods:...

Read More

Age-Related Peripheral Degeneration

http://www.evrs.eu/medias/2010/congress/Non-Age-Related-Macular-Degeneration-Nor-Diabetes-Neovascularization.flv Ivan Fiser (Prague, Czech Republic) Advantages: Peripheral choroidal neovascularization (CNV) is not a rare condition in patients in the age group of Age Related Macular Degeneration (ARMD). Extramacular CNV can be far away from the macula, although the clinical appearance of the posterior pole may mimic the classic exudative...

Read More

Macular Drusen, Atrophic AMD and Progression into Wet AMD

http://www.evrs.eu/medias/2010/congress/Age-Related-Macular-Degeneration-2.flv Ivan Fiser (Prague, Czech Republic) Advantages: 1. We find useful to carefully follow up eyes with atrophic AMD and macular drusen. Not only the drusen, but also the fading of drusen, and the conversion to geographic atrophy can be a prologue to CNV. The combination of OCT and FA, together with other usual examination methods, can distinguish between...

Read More

Tailored Avastin in Wet ARMD

http://www.evrs.eu/medias/2010/congress/Age-Related-Macular-Degeneration.flv Ivan Fiser, Frantisek Benda (Prague, Czech Republic) Advantages: Therapy with Avastin, fully tailored to the finding, can reduce the number of injections. The “saturation phase” of the traditional treatment scheme consisting of three monthly injections is not necessary in all cases. We always adapt the treatment to the course of the disease and keep the...

Read More

Laser Coagulation in Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Ivan Fiser (Prague, Czech Republic) Advantages: We should never stop warning against too extensive and destructive laser treatment in PDR. Modern lasers enable an effective coagulation of the RPE, still favoring the neuroretina. We have a suspicion that too extensive treatment with heavy burns can even cause an inflammation that stimulates the VEGF and the...

Read More

Coats Disease, Teleangiectasies and Angiomas

http://www.evrs.eu/medias/2010/congress/Vascular-Pathologies-in-Young-Patients.flv Ivan Fiser (Prague, Czech Republic) Advantages: In Coats´ disease and Coats-like retinal telangiectasia and aneurysms connected with exudation, we primarily treat the ectatic lesion with laser photocoagulation, rarely with cryopexy. Encouraged by good results, we treat even some perifoveal telangiectasies. In cases where the exudation stimulates an ERM...

Read More

Trypan Blue Staining Pro

http://www.evrs.eu/medias/2009/congress/Controversial-Techniques.flv Authors: Ivan Fiser, Ivan Kolin, Prague, Czech Republic Advantages: Trypan blue stains not only the ILM but also the vitreous, the “ERM” (i.e. the layer of posterior hyaloid) and enables to distinguish between them. It facilitates the identification of the posterior hyaloid and the surgical PVD. It prevents from confusing the leaf of vitreoschisis for...

Read More

My Way in Viewing the Eye

http://www.evrs.eu/medias/2009/congress/Viewing.flv Author: Ivan Fiser, Prague, Czech Republic Advantages: For retinal detachment, diabetic complications, or trauma, I prefer the BIOM, mostly with the classical endoillumination, rarely with the chandelier system. The classical endoillumination is still very practical; it best enables to illuminate the area of surgical interest. Bimanual surgery can be performed using special instruments...

Read More

Tailored Anti-VEGF for ARMD

http://www.evrs.eu/medias/2009/congress/Anti-VEGF-Alone.flv Authors: Ivan Fiser, Frantisek Benda, Prague, Czech Republic Advantages: Tailored therapy with Avastin is an effective treatment of wet AMD. It can reduce the number of applications and save the patients´ money, thus enables more patients to be treated. There are potential super responders to Avastin in whom a single injection is a sufficient treatment. Methods: 274 eyes of 270...

Read More

ILM Peeling in DME

http://www.evrs.eu/medias/2009/congress/Diabetes.flv Author: Ivan Fiser, Prague, Czech Republic Advantages: The ILM peeling has a beneficial effect in DME in which laser treatment is ineffective (MA in FAZ, CME, diffuse DME). Methods: Forty eyes of 35 patients 17 male, 18 female, mean age 60.2 ± 14.8)were operated using the ILM peeling with the help of trypan blue. Effectiveness / Safety: Anatomical finding (foveal thickness, lipids)...

Read More

One-Needle Technique for Air-Gas Exchange

http://www.evrs.eu/medias/2008/congress/One-Needle-Technique-for-Air-Gas-Exchange.flv Ivan Fiser, Ivan Kolin (Cornea Lexum Eye Clinic) Advantages: This technique simplifies the air-gas exchange, making it the shortest and the cheapest possible. Methods: The exchange is performed on a closed eye, even after the conjunctival suture. A single 30ga needle is introduced, the required volume of air is removed using one 2ml syringe and the same...

Read More

The Use of Glucose-Diluted Trypan Blue in Membrane Peeling

http://www.evrs.eu/medias/2008/congress/The-Use-of-Glucose-Diluted-Trypan-Blue-in-Membrane-Peeling.flv Ivan Fiser, Ivan Kolin Advantages: It improves the adherence of trypan blue to the retina surface. It enables distinction between the posterior hyaloid, vitreoschisis, the ERM and the ILM. It makes the surgery faster and cheaper. Methods: The trypan blue, diluted with 10% glucose, makes the stain more viscous. It adheres better to the...

Read More

Tailored Therapy with Avastin Helps Patients with AMD to Save Money

http://www.evrs.eu/medias/2008/congress/Tailored-Therapy-with-Avastin-Helps-Patients-with-AMD-to-Save-Money.flv Ivan Fiser, Nikola Toskova, Cornea Lexum Eye Clinic, Prague, Czech Republic Advantages: For senior patients even the cheapest therapy with three monthly injections of Avastin, followed with three-month check-ups, can exceed their financial limits. The tailored therapy, based on the application of a single injection, followed by a...

Read More

Vitrectomy Session – Peeling

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

Read More

Vitrectomy Session – Infusion Line

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

Read More

Bets on Fortune: A Step-by-step Repair of a Lacerated Globe and the OTS

http://www.evrs.eu/medias/2006/videos/Bets-on-Fortune:-A-Step-by-step-Repair-of-a-Lacerated-Globe-and-the-OTS.flv Ivan Fiser, MD (Prague, Czech Republic), Petr Novak, MD (Prague, Czech Republic), Pavel Kuchynka, Prof. MD (Prague, Czech Republic) SYNOPSIS We will correlate the OTS prognosis with surgical results in a seriously damaged eye. A video will show four surgical procedures for a penetrating injury caused by broken glasses. The OTS...

Read More

Vitrectomy with ILM Peeling for Diabetic Macular Edema

Ivan Fiser, Renata Handlova Purpose: To evaluate the anatomical and functional benefit of the ILM peeling for the diabetic macular edema. Methods: Retrospective review of 20 consecutive eyes undergoing vitrectomy with ILM peeling. All eyes were operated for CSME only; eyes with vitreous hemorrhage or TRD were excluded. Membrane Blue was used in all eyes for the ILM visualization. Results: The average follow-up time was 6 (1-12)months. The...

Read More

Vitrectomy for dislocated lenses

Ivan Fiser, Zdenek Dominek Prague,Czech Repub The purpose of our study was to evaluate the results of surgery for various types of posterior lens dislocation. We performed a retrospective chart review of 150 patients who had a surgical management of posteriorly dislocated lenses at our clinic during the 6-year period from January 1996 to March 2002. Our group was rather heterogenic as it included dislocated lenses of all kinds: iatrogenic...

Read More
content top