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ERM and ILM Removal in Only One Step: 2 Years Follow-up on Anatomical and Functional Results

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...

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Entry Site Hemorrhage: An Uninvited Outsider

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...

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Ocriplasmin for Vitreomacular Traction: Disappointing Results

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...

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Ozurdex Anterior Chamber Migration: What to Do and When to Expect it?

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...

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Intraoperative Suprachoroidal Hemorrhage: Caught on Tape

Introduction: Intraoperative suprachoroidal hemorrhages are a feared complication of ophthalmological surgery. Caused by the rupture of posterior cilliary vessels, its rarity is only matched by its urgent need for immediate action. Although most frequently associated with glaucoma surgery and intra/extracapsular cataract extraction, it may rarely occur in the context of any intraocular procedure. In this paper, the authors present the case...

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Atypical Bilateral Morning Glory Syndrome

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...

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Post-traumatic Anterior Lens Displacement: A Dystocic Labour

Introduction: Ectopia Lentis or lens displacement, may be congenital, developmental or acquired, and the most common cause is trauma. Anterior displacement of the lens is an ophthalmological emergency, due to the risk of absolute pupillary block and irreversible corneal decompensation. Although the history of trauma is usually immediate or recent, it might have happened months or years before the luxation episode. Case Report: The authors...

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A «Cascade» of Retinal Problems After a Complicated Cataract Surgery

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...

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Entry Site Hemorrhage: An Uninvited Outsider

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...

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Idiopathic Macular Hole: A Funny Trick and Different Inverted ILM Flap Techniques

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...

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Intraoperative Suprachoroidal Hemorrhage: Caught on Tape

Introduction: Intraoperative suprachoroidal hemorrhages are a feared complication of ophthalmological surgery. Caused by the rupture of posterior cilliary vessels, its rarity is only matched by its urgent need for immediate action. Although most frequently associated with glaucoma surgery and intra/extracapsular cataract extraction, it may rarely occur in the context of any intraocular procedure. In this paper, the authors present the case...

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Optic Pit Surgical Successful Management: Follow-up of 5 Years

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...

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Macular Hole and VMT in Fellow Eye…How to Approach?

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...

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PDR : Small Gauge Vitrectomy For Complex Cases

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...

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ERM and ILM Removal in One Step – Functional and Morphologic Results

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...

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Bilateral Amaurosis in Patient Medicated with Quinine: A Case Report

Poster David Martins Objective: Description of a clinical case with scientific interest. Introduction: Bilateral amaurosis is a rare complication of the treatment of Plasmodium falciparum malaria with quinine, and can occur with a single therapeutic dose in susceptible individuals. Visual acuity recovery usually occurs, with restricted visual field, but in a few cases amaurosis may be permanent, with optic atrophy. Case Study: 35...

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Unusual Evolution of Idiopathic Macular Holes: A Report of 8 Cases

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...

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My Personal Technique of Peeling Idiopatic Epiretinal Membranes

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...

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Flying Phakic Lens

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...

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A Piece of Steel Removed by 23 Gauge Vitrectomy

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...

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A New and Different Idiopathic ERM Peeling Technique

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...

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Enlarged ILM Peeling in Idiopatic Macular Hole Surgery: A Retrospective Study

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...

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Cystoid ME After Macular Hole Surgical Closure

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...

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