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Varix of the Vortex Vein Ampulla – Intraoperative OCT

Edited Film Ahmed Sallam, Zia Siddiqui, Riley Sanders, USA We present an intra-operative OCT video of a 69-year-old Caucasian patient found to have a varix of the vortex vein ampulla (VVVA) in her right eye during pars plana vitrectomy surgery for symptomatic vitreous opacities, performed under local retrobulbar anesthesia. During surgery, an area of retinal elevation was seen in the patient’s inferonasal mid-periphery and was...

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Visual Outcomes of Primary Versus Secondary Epiretinal Membrane Following Vitrectomy Membrane Peel and Cataract Surgery

Ahmed Sallam, Mohamed K. Soliman, USA Objective: To compare visual outcomes of eyes with primary and secondary epiretinal membranes (ERM) vitrectomy with cataract extraction. Methods: A multi-centre electronic record review was performed. Epiretinal membranes were classified as primary or secondary to: diabetic retinopathy (DR), retinal vein occlusion (RVO), retinal detachment (RD) and uveitis. Change in vision and incidence of...

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Multimodal Imaging in Macular Diseases

Ahmed Sallam, USA, Abdallah Ellabban, United Kingdom & Zofia Michalewska, Poland Multimodal imaging is rapidly evolving, providing unprecedented in-vivo information on the microstructural changes of the retina, and becoming an indispensable tool in the diagnosis and management of many retinal disorders. This course will focus on practical tips that help busy clinicians in making treatment decisions when managing retinal diseases...

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Uveitis

Ahmed Sallam, USA, Mahmoud Soliman, Egypt Structure: Case presentations + surgical videos Topics: – Infective uveitis that need recognition: viral, toxoplasma, syphilis, TB, – Masquerade syndrome – Retinal vasculitis – Postoperative uveitis including retained lens matter – Postsurgery endophthalmitis treatment – Endogenous endophthalmitis treatment – Role of surgery in the management of...

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Subretinal Fluid, Blood, Silicone Oil and More…

Ahmed Sallam, Aman Chandra, USA Video presentation of intraoperative management of subretinal BSS from misdirected vitrectomy infusion cannula, subretinal blood management, subretinal silicone oil and other materials that do not normally belong in the subretinal space! The presentation will focus on how to avoid and manage these problems. Contact Details: Ahmed Sallam UAMS Little Rock United States Cell Phone : +1 501 3982074 Work Phone :...

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Challenging Retina – White Dot Syndrome – Which One ?

Ahmed Sallam, USA A challenging medical retina case for discussion – middle age caucasian female presenting with decreased vision. Presentation supported by color photos, OCT, FA, ICG. ”Note to reviewing committee – the case is: acute retinal pigment epithelitis.” Contact Details: Ahmed Sallam University of Arkansas for medical Sciences Little Rock United States Cell Phone : 001 501 398 2074 Work Phone : 001 501 398...

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Diabetic Delamination Surgery

ABSTRACT Using surgical videos, the authors will present their techniques for diabetic delamination surgery including the use of 27/25g hybrid vitrectomy, bimanual dissection, viscodissection and peri-operative use of intravitreal anti-VEGF and Ozurdex implant. The authors will also defend their view that ‘ less is more’ when undertaking diabetic TRD surgery, as opposed to the classic teaching of attempting to remove all...

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Vitreoretinal Surgery for the Management of Uveitis and Uveitis Complications

ABSTRACT Vitreoretinal surgery in uveitis has both diagnostic and therapeutic indications. Diagnostic indications include vitreous and chorioretinal biopsy for the diagnosis of infection and neoplasia. Therapeutic indications include treatment of certain cases of infections and inflammation as well as uveitis complications such as vitreous opacities and epiretinal membranes. The vitreous can also be used as a reservoir for delivering...

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Intraoperative OCT in Retinal Surgery – Toy or Tool!

ABSTRACT Using surgical videos, the authors will reflect on their experiences discussing the feasibility, limitations and advanatages of the use of intraoperative technology in macular surgery, trauma and other complex retinal surgery. CONTACT DETAILS Ahmed SALLAM*, Sami UWAYDAT University of Arkansas for Medical Sciences Little Rock United States Email : ahmedsallam11@yahoo.com Cell Phone: +15013982074 Work Phone:...

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Cystoid Macular Edema and Visual Outcome After Pars Plana vitrectomy with Simultaneous Versus Sequential Phacoemulsification Cataract Surgery for Epiretinal Membrane

ABSTRACT Purpose: To audit the frequency of cystoid macular edema (CME) and the level of vision after pars plana vitrectomy (PPV), for idiopathic epiretinal membrane (ERM), and phacoemulsification surgery performed simultaneously or sequentially. Methods: Retrospective extraction and analysis of nationally standardized cataract surgery pathway dataset extracted from 8 hospitals in the UK that used the same electronic medical record (EMR)...

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Endophthalmitis Management: A Uveitis/ Retina Specialist Perspective

Endophthalmitis Management: A Uveitis/ Retina Specialist Perspective ABSTRACT The Endophthalmitis Vitrectomy Study (EVS) has recommended that intravitreal antibiotics should be the standard of care for acute endophthalmitis occurring after cataract surgery and that benefit of early vitrectomy surgery this context is limited. However, with the recent advances in vitrectomy surgery techniques, there has been an increased interest in...

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Management of Rhegmatogenous Retinal Detachment with no Detectable Breaks During Pars Plana Vitrectomy

Management of Rhegmatogenous Retinal Detachment with no Detectable Breaks During Pars Plana Vitrectomy ABSTRACT Management of rhegmatogenous retinal detachment with no detectable breaks during pars plana vitrectomy Successful treatment of rhegmatogenous retinal detachment (RRD) mainly hinges on localizing and closing the causative the causative retinal tear(s). Though in most cases, localizing the retinal tear is usually feasible by...

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Foveal Lucency with Different Gas Tamponades in Surgically Closed Macular Holes

Foveal Lucency with Different Gas Tamponades in Surgically Closed Macular Holes ABSTRACT The presence of foveal lucency (FL), a hyporeflective space underlying the fovea with continuity of the inner retinal layers after surgery – and/or disruption of outer retinal layers such as the ellipsoid layer or the external limiting membrane have been described in the course of the macular hole closure. Given the descriptive nature of...

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Unexpected Intraoperative Events of Sustained Release-corticosteroid Implant When Used in the Context of Pars Plana Vitrectomy Surgery

Unexpected Intraoperative Events of Sustained Release-corticosteroid Implant When Used in the Context of Pars Plana Vitrectomy Surgery ABSTRACT Intravitreal dexamethasone implant (Ozurdex) and fluocinolone acetonide implant (Iluvien®) are FDA approved sustained-release corticosteroid treatments for use in macular edema secondary to diabetic retinopathy. The benefits of Ozurdex implants are also extended to the treatment of retinal...

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Vitrectomy Dyes: The Blues of Vitrectomy !

Many surgeons use dyes during vitrectomy surgery to enhance visualization of intraocular structures such as vitreous, epiretinal membranes and internal limiting (ILM). Several dyes are employed for this purpose including trypan blue, brilliant peel, indocyanin green and some newer Lutein based dyes. Triamcinolone is also used to improve the visualization of the vitreous gel and the posterior hyaloid. In this presentation, we aim to...

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Floaters Surgery

Vitreous floaters could result from vitreous seneresis or as result of vitreoretinal diseases such as intraocular inflammation or vitreous haemorrhage. In the absence of associated vitreoretinal disease, most patients with vitreous seneresis- related floaters learn to live with their symptoms. However, surgery is justifiable in some patients whose quality of vision is compromised because of significant floaters. It is important to carefully...

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Surgical PVD Induction Using Combined Sharp Pick and Active Aspiration

Some cases of retinal detachment particualry in young phakic patients, may not have posterior vitreous detachment (PVD). If operated by PPV, induction of PVD in these cases is mandatory. However, PVD induction by active aspiration of the vitreous cortex over the optic disc margin as usually employed in PPV surgery can be challenging in these eyes because of firmly adherent posterior hyaloid and the absence of counter traction from the...

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Retinal Detachment Surgery Needs to Be Individualized – Vitrectomy Surgery Is Not the “One Size Fits All™” Treatment

Rhegmatogenous retinal detachment (RD) surgery is the most common indication for vitreoretinal surgery. Pars plana vitrectomy (PPV) and scleral buckle (SB) are the most commonly used techniques, with the proportion of patients undergoing SB significantly decreased over the last decade in the US and worldwide. There is agreement that PPV is the surgery of choice for complex RD and in pseudopakic eyes. However, SB remains a valid option for...

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Endophthalmitis – Immediate Intravitreal Antibiotic Therapy Only is What We Should Do

The Endophthalmitis Vitrectomy Study (EVS) has recommended that intravitreal antibiotics should be the ‘‘standard of care’’ for acute endophthalmitis occurring after cataract surgery and that the benefit of early vitrectomy surgery is limited. However, with recent advances in vitrectomy surgery techniques, there has been an increased interest in performing early vitrectomy surgery to treat endophthalmitis in...

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CSCR or Not CSCR? This is the Question

Purpose: Whilst the diagnosis of central serous chorioretinopathy (CSCR) is usually straightforward to make, diagnostic challenges do exist. In this presentation, I will discuss several cases that either had CSCR with atypical features or another underlying diagnosis masquerading as CSCR. Contact Details: Email: ahmedsallam11@yahoo.com Cell Phone:...

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Gloucestershire Model for Treating Neovascular ARMD – An Industrial Production Line!

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   The management of patients with neovascular age related macular degeneration (nAMD) forms a large and increasing proportion of hospital eye service activity worldwide, particularly since the introduction of intravitreal anti-VEGF therapy. The delivery of anti-VEGF therapy has created substantial service pressures on ophthalmology...

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A Few More Tips!

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   This is a short presentation demonstrating few surgical tips including the use of the vitreous cutter as a conduit to inject fluids inside the eye during vitrectomy, tips on removing posterior dislocated IOL and explantation of scleral fixated IOL. A different technique for injection of subtenon’s anaesthesia will also be...

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Patients Demographics, Ocular Co-pathology & Results for RVO with ME Treated with Ozurdex

The purpose of this work is to describe patients’ demographics, existing ocular co-pathology and treatment procedures for patients treated with Ozurdex for macular oedema due to branch and central retinal vein occlusion in the UK National Health Service (NHS). A multicenter national database study of prospectively collected anonymized data within an electronic medical record system (Medisoft). Data from participating 15 NHS centres across...

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Pneumatic Retinopexy: The Frowned upon Retinal Re-attachment Procedure!

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Background/aim of the work: Pneumatic retinopexy is a recognized, simple, procedure for the treatment of rhegmatogenous retinal detachment (RRD). However, this technique is not widely practiced in UK in particular and Europe in general. This is due to several factors including limited range of indications and lower success rate...

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Anatomical and Visual Outcomes of Macular Hole Surgery Using a Non-strict Posturing Regimen: 7-year Data

Purpose: To assess the anatomical and functional outcomes of macular hole surgery with pars plana vitrectomy (PPV), internal limiting membrane peeling and gas tamponade (SF6, C2F6, or C3F8) with a non-strict postoperative posturing regimen. Setting: Gloucestershire Hospitals NHS Trust, United Kingdom. Methods: Clinical and surgical data were prospectively entered into an electronic medical record (Medisoft, Leeds, UK). Data of...

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Macular Hole Surgery: Does C3F8 Provide Better Anatomical and Functional Outcomes than SF6 and C2F6?

Purpose: To assess differences in anatomical and functional outcomes when using C2F6, SF6 or C3F8 gas tamponade in macular hole surgery with pars plana vitrectomy, internal limiting membrane peeling and a non-strict postoperative posturing regimen. Setting: Gloucestershire Hospitals NHS Trust, UK. Methods: Clinical and surgical data were prospectively entered into an electronic medical record (Medisoft, Leeds, UK). Data of consecutive...

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Retinal Detachment Surgery Tips / Tricks

Pars plana vitrectomy (PPV) is a commonly used surgical technique in the management of rhegmatogenous retinal detachment. Surgeons on many occasions do not have an assistant who can do scleral indentation to facilitate vitreous removal from around, or drainage from a peripheral retinal tear. Retinal detachment surgery can be regarded as a retinal tear surgery and subretinal fluid (SRF) can be left behind as long as retinal breaks have been...

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Success Rate of Primary Retinal Detachment Surgery

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