European VitreoRetinal Society a certain philosophy

ABSTRACT Introduction: Suprachoroidal Hemorrhage (SCH) is a potentially devastating complication of both anterior and posterior segment surgery. Although rare, it can occur following corneal transplants, glaucoma or cataract surgery, and vitreoretinal surgery or trauma. SCH may occur when a fragile vessel is exposed to sudden compression and decompression forces. Systemic risk factors include advanced age, arteriosclerosis, hypertension and...

Enzimatic Vitreolysis: Surgical Findings in Unsuccessful Cases EDITED FILM ABSTRACT Introduction: Pharmacologic vitreolysis with ocriplasmin is an effective nonsurgical treatment option for vitreomacular traction (VMT). Ocriplasmin is a truncated plasmin derivative approved as an intravitreal drug for release of focal vitreomacular tractions (<1500 μm), when accompanied by visual symptoms, and/ or closure of macular holes (MH)...

Anterior Hyaloid or Moon Surface? EDITED FILM ABSTRACT The authors present the case of a 45 years old female that presented to our emergency room with left eye acute painless vision loss for two days. The ophthalmological examination revealed a visual acuity of 2/10 and an intraocular pressure of 10 mmHg. The anterior chamber, the iris and the pupil didn’t present any abnormalities. The observation of the retina after dilation of...

Managing Giant Retinal Tears 2 Cases Report ABSTRACT Introduction: Retinal detachments with giant retinal tears (GRT) pose a significant challenge, even to the most experienced vitreoretinal specialists. The extent of the primary lesion complicates management and tamponade choices, carrying the risk of the flap folding over post-operatively and re-detaching the retina. The authors present two cases of a retinal detachment with giant...

CPAP and Vitreoretinal Surgery – Be Aware ABSTRACT Introduction: Obstructive sleep apnea (OSA) is a common chronic disorder that often requires lifelong care. Continuous positive airway pressure (CPAP) and weight loss are the cornerstones of therapy. The use of CPAP therapy has been associated with ocular complications such as dryness and irritation resulting from the air leak from the mask, a higher rate of bacterial...

Ocriplasmin for Treatment of Vitreomacular Traction: Our Real-world Experience ABSTRACT Introduction: Pharmacologic vitreolysis with ocriplasmin is an effective nonsurgical treatment option for vitreomacular traction (VMT). Ocriplasmin is a truncated plasmin derivative approved as an intravitreal drug for release of focal vitreomacular tractions (<1500 μm), when accompanied by visual symptoms, and closure of macular holes (MH)...

ERM and ILM Removal in Only One Step: 2 Years Follow-up on Anatomical and Functional Results ABSTRACT Introduction: Epiretinal membranes (ERM) are fibrocellular proliferations on the surface of the retina, with contractile properties, that cause metamorphopsia and visual loss. ERM surgery is a demanding state-of-the-art procedure, consisting of ERM, and usually internal limiting membrane (ILM) removal. The use of multiple dyes, or the...

Introduction: Full-thickness idiopathic macular holes are foveal anatomic defects with a complete interruption of all retinal layers. This results in a significant visual impact for the patient. Current surgical options are constantly under debate, particularly after the new International Vitreomacular Traction Study Group classification. Various surgical options have been proposed to boost the closure rates in this disorder, namely...

Introduction: Vitreoretinal sutureless surgery has evolved in recent years into a safer, more effective group of procedures. It is, therefore, an unexpected sight to have a vitreous hemorrhage at the end of an otherwise uneventful vitrectomy. A possible cause of such a finding is an external hemorrhage that occurs immediatly after the removal of the trocars, that finds its way inside the vitreous cavity through the sclerotomy. Methods: The...

Introduction: Any surgical pathology presenting with concomitant inflammation presents a dilemma to the eye surgeon, due to the increased risk of post-op complications. On the other hand, a retinal detachment presents an additional challenge to the vitreoretinal specialist in this situation. The authors present a clinical case with both these simultaneous conditions. Case Report: We present the case of a male 75 year-old patient, with a...

Introduction: Retinal detachments with giant retinal tears pose a significant challenge, even to the most experienced vitreoretinal specialists. The extent of the primary lesion complicates management and tamponade choices, carrying the risk of the flap folding over post-operatively and re-detaching the retina. The authors present one case of a macula-on retinal detachment with multiple giant tears. Case report: The authors present the...

Introduction: Epiretinal membrane surgery is a demanding, state-of-the-art procedure. Vitreoretinal surgeons continuously seek to perfect their results, maximizing results and reducing complications and toxicity. Based on our belief and experience of the benefits of combined ERM and ILM peeling when removal of the former is indicated, we present our technique that we believe is both effective and safe. Methods: We present our adopted...

Introduction: Macular edema is the main cause of visual loss in diabetic patients. In spite of the ample choice of therapeutic modalities, chronic macular edema management is a challenge to this date. Aside from laser and intravitreal therapies, the newest proposal by some authors has been vitrectomy with ILM peeling as a possible solution for many therapy-resistant cases, or even naive cases. Reducing traction, increasing retinal...

Introduction: Vitreous hemorrhages during vitrectomy are not an uncommon event, particularly in diabetic patients. However, intraoperative vitreous hemorrhages resulting from conjunctival and/or episcleral hemorrhages, after the successful closure of 23G scleral ports, is a rare finding, never before experienced by our surgical team. The authors present the case of a young man undergoing vitrectomy for persistent vitreous haze, that had a...

Introduction: Ocriplasmin is a truncated plasmin derivative, with vitreolytic enzymatic activity. Following the MIVI-TRUST study, it was approved as a therapeutic option for focal (<1500μm) VMT (Vitreomacular Traction), when accompanied by visual symptoms and/or a macular hole < 400μm. Although few complications have been reported, a few authors report on the unpredictability of the results of this treatment. The authors...

Introduction: Intravitreal dexamethasone implants are currently an opti on for chronic macular edema due to diabetes, non-infectious uveitis and retinal vein occlusion. Anterior chamber migration is a rare event, occurring mostly in vitrectomized patients without posterior capsule integrity. This condition is associated with persistent corneal edema and ocular hypertension, therefore requiring intervention. The few cases published suggest...

Pedro Neves_SCIENTIFIC POSTER 2015 Introduction: Morning Glory Syndrome is a non-hereditary optic nerve malformation, most frequently unilateral and in women, rarely affecting black patients. The optic disk is abnormally excavated and funnel-shaped, with an hypopigmented neuroretinal rim and radially-oriented vessels. Up to one third of patients present with a retinal detachment, and this syndrome may be associated with other craniofacial...

Introduction: Nowadays cataract surgery is the most frequent eye procedure overall the world. In an experienced hand the complications are very limited. Neverthless, they happen and can even induce blindness. Clinical Case: The authors present one case of a patient with a cataract that was submited to a phaco with introduction of an I.O.L. in the posterior chamber. The procedure was complicated with posterior capsule rupture and vitreous...

Introduction: Vitreous haemorrhages during vitrectomy are not an uncommon event, particularly in diabetic patients. However, intraoperative vitreous haemorrhages resulting from conjunctival and/or episcleral haemorrhages, after the successful closure of 23G scleral ports, is a rare finding, never before experienced by our surgical team. The authors present the case of a young man undergoing vitrectomy for persistent vitreous haze that had...

Introduction: Idiopathic full thickness macular holes are foveal anatomic defects with interruption of all neurosensory retinal layers, resulting in visual and functional alterations with significant impact on the patient’s quality of life. Currently, the best therapeutic approach for macular holes is still being debated, after the new classification by the International Vitreomacular Study Group. Several surgical methods have been...

SCIENTIFIC POSTER_Pedro Neves Introduction: Optic pits are congenital anomalies of the optic disc of unknown pathophysiology. About 45% are associated with either macular retinoschisis or serous retinal detachments. Peripapillary vitreous traction has been proposed to be involved and vitrectomy is reported as an effective therapy, with induction of posterior vitreous detachment even without gas tamponade or laser photocoagulation. Case...

A 68-years-old patient,female,with loss of vision in the right eye (count fingers) and symptoms of deterioration visual acuity and distorted vision in the left eye. The OCT showed a full thickeness macular hole in the right eye and a vitreomacular traction in the left eye. The issue in discussion is: The aproach to the right eye. Wich are the options of treatment for the left eye??: Vitrectomy?? Pharmacologic Vitreolysis?? The authors...

Advantages: Small-Gauge transconjunctival Vitrectomy is a minimally invasive surgical technique. The recent advances in instrumentation have helped to improve the safety and efficacy of surgical technique for Diabetic Retinopathy for Complex Cases. Methods: The video we present, highlights the various spectrum of surgical techniques we can use to treat severe Proliferative Diabetic Retinopathy. The video shows our experience and the...

Epiretinal membranes are avascular, fibro-cellular membranes that proliferate on the surface of the retina. These membranes have contractile properties and patients may present with metamorphopsia and visual changes because of their effect on the underlying retina. Epiretinal membrane surgery usually implies pulling the ERM itself and commonly the internal limiting membrane, exerting forces on the retina that may easily damage and...

Objective: Description of 8 idiopathic macular holes that had an unusual evolution. Introduction: Macular hole is the absence of macular retinal layers. Most idiopathic macular holes have a good outcome after surgery, which is vitrectomy, ILM peeling and gas tamponade. However, some unusual cases are still challenging the actual management of this pathology. Cases: (1) Surgical closure of macular hole with macular edema development...

Purpose: To understand the postoperative evolution of BCVA and macular thickness with this technique and to conclude the benefits or not of it. Methods: Most of the surgeons use different dyes to visualize the posterior hyaloid, the ERM and the ILM and peel them in several steps. We decided to peel the ERM and the ILM only in one step using brilliant blue G or MEMBRANEBLUE-DUAL. We present the first 10 cases with this technique and their...

Introduction: Phakic refractive lenses may get dislocated into the vitreous cavity and retina. When placed on both eyes, it may occur in only one of them, causing anisometropy. Subject and methodology: The patient was a 46 year old female who had undergone refractive surgery for high myopia in 2002. Two Phakic Refractive Lenses were introduced. In June 2012 the patient was sent to our Retinal Surgery Department, at the Ophthalmology Service...

An intraocular foreign body (IOFB) must be excluded in all cases of eye perforation. An IOFB may traumatize the eye mechanically, introduce infection or cause other toxic effects (i.e.: siderosis) on the intraocular structures. Once in the eye, the foreign body may lodge in any of the structures (in the antherior chamber, in the angle, in the lens, in the vitreous or on the retina).Some of them are inert but an intraocular ferrous foreign...

Surgery is the common therapy for  idiopathic epiretinal membranes when the visual acuity is changed and the macular thickness is increasing disturbing the vision quality. The procedure usually follows some steps: (23 gauge; 25 gauge; 27 gauge) Pars Plana Vitrectomy, posterior hyaloid detachment, ERM peeling and ILM peeling with the use of different dyes. Many Surgeons use triamcinolone for the vitrectomy and for the posterior hyaloid...

Optic Pits are congenital excavations of optic nerve “head” that may be associated with other optic nerve and peripapillary retina anomalies. They occur in 1/10.000 people, both male and female. More than two thirds of patients develop serous macular detachment with loss of vision. There is controversy about the etiology and nature of maculopathy in these cases. Clinical Case: Female patient observed due to painless loss of...

Enlarged ILM Peeling in Idiopatic Macular Hole Surgery A Retrospective Study Claudia Bacalhau Objective: To evaluate the morphological and functional success of vitrectomy with enlarged internal limiting membrane peeling for full-thickness macular hole. Method: Retrospective study, including 18 patients with full-thickness macular hole that were submitted to vitrectomy with enlarged peeling of internal limiting membrane (until the...

Cystoid ME After Macular Hole Surgical Closure Claudia Bacalhau Objective: Description of a clinical case with scientific interest. Introduction: Macular hole surgery has now very high successful morphological and functional rates, with few postoperative complications associated. We describe a case with development of clinically significant macular edema treated effectively. Case Study: 65 year-old patient with full thickness macular...