European VitreoRetinal Society a certain philosophy

Advantages: Anti-VEGF agents such as ranibizumab and bevacizumab have revolutionized treatment of wet macular degeneration and diabetic macular edema. Methods: Retrospective study and review of literature. Effectiveness / Safety: Four out of 116 patients (3.45%) developed persistent ocular hypertension following intravitreal injection of ranibizumab (Lucentis) or bevacizumab (Avastin).  The range of preinjection IOP was 8–15 mmHg (mean,...

This video reports an unusual finding in vitreoretinal surgery. A patient with a past history of IOFB, which was successfully removed, suffered a retinal detachment 6 years after the original procedure. In the meantime, the patient had the encircling band removed because of ocular discomfort and repeated inflammation. Examination of the retinal detachment disclosed fixed retinal folds and PVR was suspected but the surgery revealed a...

Introduction: While peeling an idopathic epiretinal membrane with a standard 23-gauge vitrectomy the Infusion port dislocated inadvertently and caused a massive uveal effusion. Methods: By using an additional 20-gauge sclerotomy, it is possible to continue the vitrectomy, peeling the macular pucker and the inner limiting membrane in order to successfully complete the surgery. In this case, the 20-gauge sclerotomy serves as a drainage...

Mehran Masoudnaseri (Odessa, Ukraine) Advantages: This hydraulic device helps to peel the internal limiting membrane (ILM), very quickly and safely. The surgeon can separate the ILM without any hemorrhage, retinal detachment, retinal tear, or macular trauma. Methods:   Hydraulic devices microsurgery Mehran MP-1, (fig 1) can be used safely for ILM peeling during vitrectomy, and in Neurosurgery, for separating microcists, and...

Mehran Masoudnaseri (Odessa, Ukraine) Advantages: To avoid postoperative complications and improve retinal reattachment with Nano Silicon Mehran Lent-1, after scleral buckling. Methods: Scleral buckle by Nano silicon Mehran lent-1, a piece of Nano silicone sponge, rubber, or semi-hard plastic, buckling the sclera. This buckle has 4 pairs of holes at the end of the strip. On one its ends there is a split 1,5 mm, the head of the silicon can...

Mehran Masoudnaseri (Odessa, Ukraine) Advantages:   To treat and avoid postoperative complications with intraocular Nano silicon balloon (antivirus, antibacterial, antifungal) after vitrectomy in aphakic and pseudophakic eyes with large posterior retinal tear after vitrectomy. Methods: After vitrectomy the syringe with silicon oil (fig 1A) with fixed Nano silicon bubble (anti virus, antibacterial, with treatment drugs) on it (v.4-6 mm)...

http://www.evrs.eu/medias/2010/videos/DanielVilaplana_VP6_768K.flv Daniel Vilaplana, Vladimir Poposki, Isaac Alarcon (Sabadell-Barcelona, Spain) Advantages: Macular fold is a very uncommon, but serious pathology. When this complication is repaired a good and comfortable vision is obtained. Methods: A 65-year-old man presented a superior retinal detachment. He underwent surgery with a vitrectomy, perfluorocarbon liquid (PFCL),...

http://www.evrs.eu/medias/2009/congress/How-to-Reduce-Complications.flv Authors: Frank Becquet, Nantes, France Sutureless sclerotomies in microincisional vitrectomy are now widely used, but questions have been raised about self sealing properties of non sutured sclerotomy wounds. Greater risks of hypotony, endophthalmitis and even retinal detachment (due to leakage of vitreous or fluid through the incision) have been pointed out by...

http://www.evrs.eu/medias/2009/congress/How-to-Reduce-Complications.flv Authors: Enrico Bertelli, Stefano Coser, Paolo Pelanda, Veronika Rogger, Bolzano, Italy Advantages: Post-surgical hypotony is a rare but potentially dangerous complication of mini-invasive sutureless vitrectomy. Individual characteristics of the sclera or variables in dynamic and extension of performed vitrectomy may lead to unpredictable selfsealing features of...

http://www.evrs.eu/medias/2009/congress/How-to-Reduce-Complications.flv Author: Klaus Lucke, Bremen, Germany Flow control and audio feedback puts you back in charge Vitrectomy near the retina, particularly a mobile one, remains the big challenge in vitreoretinal surgery. Removing the vitreous in the vitreous base effectively brings on the danger of cutting into the retina inadvertently. The fact that vitreous generally is transparent adds...

http://www.evrs.eu/medias/2009/congress/How-to-Reduce-Complications.flv Authors: Barbara Parolini, Grazia Pertile, Verona, Italy Advantages: To report the rate of postoperative retinal detachment in 943 consecutive eyes operated with 23-gauge transconjuctival pars plana vitrectomy. Methods: Single-center, retrospective, noncomparative, interventional case series. Nine hundred and forty-three eyes underwent 23-gauge transconjunctival...

http://www.evrs.eu/medias/2009/congress/How-to-Reduce-Complications.flv Authors: Cesare Forlini, Matteo Forlini, Paolo Rossini, Ravenna, Italy Advantages: Presenting our standard surgical behaviour in the use of 23 g Surgery. Methods: 146 consecutive procedures for macular pucker, macular hole, vitreous hemorrhage, macular edema, RRD. The standard technique is: use of BIOM system and Xenon chandelier light; radical triamcinolone-assisted...

http://www.evrs.eu/medias/2009/congress/How-to-Reduce-Complications.flv Author: Jean-François Le Rouic, Nantes, France Advantages: Introduction: Despite recent improvement in vitrectomy, RD is still a major complication after macular surgery. 23 G sutureless vitrectomy has become very popular and has replaced 20 G vitrectomy in most cases of macular surgery. The aim of the study is to compare the rate of postoperative RD after macular...

Osman Cekic, Mehmet Cakir, Omer F. Yilmaz Advantages: To report the usefulness of serial optical coherence tomography (OCT) follow-up of a case with retinal pigment epithelial (RPE) tear after intravitreal bevacizumab injection for serous pigment epithelial detachment (PED) from neovascular age-related macular degeneration (AMD). Methods: An 80-year-old woman underwent 1.25 mg intravitreal bevacizumab treatment for serous PED secondary to...

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Jonathan M. Holmes, MD (Rochester, MN), Colin A. McCannel, MD (Rochester, MN), David A. Leske, BS (Rochester, MN) PURPOSE: To describe the spectrum of strabismus complications associated with the superior oblique (SO) tendon caused by improper scleral buckle placement, to describe treatment and possible prevention. METHODS: In a retrospective chart review, we identified six cases of vertical and torsional strabismus requiring superior...

http://www.evrs.eu/medias/2006/congress/Incidence-of-Retinal-Detachment-after-Macular-Surgery:-A-Retrospective-Study-of-634-Cases.swf Catherine Creuzot, MD (Dijon, France), Alexandre Guillaubey (Dijon, France), Pierre-Olivier Lafontaine, MD (Dijon, France), Pierre-Olivier Lafontaine, MD (Dijon, France), Isabelle Hubert, MD (Nancy, France), Alain Bron, MD (Dijon, France), Jean-Paul Berrod, MD (Nancy, France) PURPOSE: To evaluate the severe...

Mahmoud Soliman, (Cairo, Egypt) PURPOSE: Evaluation of the Nerve Fiber Layer (NFL) thickness lose following full scatter laser photocoagulation in diabetic patients using Optical Coherence Tomography (OCT) with its correlation to the number of laser shots. METHODS: Twenty eyes of 14 patients legible for full scatter laser photocoagulation were included in this study with an average age of 53 years (range 31-65). Male to female ratio was...

Essam M. Alharthi, MD (Riyadh, Saudi Arabia) PURPOSE: Primary congenital glaucoma is structurally abnormal eye with multiple complications including retinal detachment which lead to poor prognosis. METHODS: Retrospective, case series.Medical records of 34 congenital glaucoma who developed retinal detachment where reviewed. Detailed information of the congenital glaucoma was obtained including date of diagnosis, intraocular pressure,...

http://www.evrs.eu/medias/2006/congress/Untoward-Surgical-Events-in-25-Gauge-Vitreoretinal-Surgery.swf Saad A Shaikh, MD (Orlando, FL), Son Ho, BS (Tampa, FL), Preston P. Richmond, MD, OD (Orlando, FL), Durham Barnes, MD (Orlando, FL), John C. Olson, MD (Orlando, FL) PURPOSE: What is the incidence of adverse surgical events in eyes undergoing 25 gauge vitreous surgery. METHODS: Retrospective, comparative, case series. A chart review of...

http://www.evrs.eu/medias/2006/congress/Use-of-25-gauge-Pars-Plana-Vitrectomy-Surgery-for-Primary-Repair-of-Rhegmatogenous-Retinal-Detachments.swf Amitabh K. Bharadwaj, MD, MSc (Philadelphia, PA), Mariah A. Schumacher, BA (Philadelphia, PA), Michael A. Samuel, MD (Blue Bell, PA), Robert C. Kleiner, MD (North Wales, PA), Carl D. Regillo, MD, FACS (Philadelphia, PA), Carl H. Park, MD (Philadelphia, PA), J. Arch McNamara, MD, FRCS(C)...

Harinderjit Singh, MD (Augusta, Georgia), Dennis M. Marcus, MD (Augusta, GA), Micah Manning, MD (Columbia, SC), Jasleen Singh, BS (Augusta, Georgia) PURPOSE: To report short-term outcomes and complications from the first 100 eyes undergoing 23-gauge transconjunctival sutureless vitrectomy (Dutch Ophthalmics). METHODS: Forty eight females and 52 males, average age of 65 years (range 29-94 years), underwent 23-gauge vitrectomy by two surgeons...

http://www.evrs.eu/medias/2006/congress/23-Gauge-Vitrectomy-as-an-Effective-and-Safe-Alternative-for-Sutureless-Vitreous-Surgery.swf http://www.evrs.eu/medias/2006/congress/23-Gauge-Vitrectomy-as-an-Effective-and-Safe-Alternative-for-Sutureless-Vitreous-Surgery.flv Keith A. Warren, MD (Overland Park, KS) PURPOSE: To evaluate the safety and effectiveness of the 23-gauge vitrectomy system (DORC) as a treatment modality for a variety of...

http://www.evrs.eu/medias/2006/congress/Complications-of-25-Gauge-Vitrectomy-Surgery.swf Robert A. Mittra, MD (Minneapolis, MN), David F. Williams, MD, MBA (Minneapolis, MN), Edwin H. Ryan, MD (Minneapolis, MN) PURPOSE: To assess the incidence of major complications of 25-gauge vitreous surgery. METHODS: The records of all eyes undergoing 25g vitrectomy for ERM, vitreous opacity, and MH from 6/03–12/05 were retrospectively reviewed. Data...

http://www.evrs.eu/medias/2006/congress/25-Gauge-Vitrectomy:-Outcomes-and-Complications.swf Carl D. Regillo, MD, FACS (Philadelphia, PA),* Omesh Gupta, MD (Philadelphia, PA), Allen C. Ho, MD (Wyndmoor, PA), Richard S. Kaiser, MD (Wyndmoor, PA), Mitchell S. Fineman, MD (Cherry Hill, NJ), James F. Vander, MD (Wyndmoor, PA), J. Arch McNamara, MD, FRCS(C) (Wyndmoor, PA) PURPOSE: To report surgical outcomes and both intraand postoperative...

http://www.evrs.eu/medias/2006/videos/25-Gauge-Macular-Surgery:-Results-and-Complications.flv Fabio Patelli, MD (Milan, Italy), Paolo Radice, MD (Rome, Italy), Giulio Zumbo, MD (Rome, Italy), Giuseppe Fasolino, MD (Rome, Italy) PURPOSE: To report the safety and surgical outcome of 25-gauge transconjunctival sutureless vitrectomy (TSV) for macular pathologies. METHODS: 160 eyes of 150 patients underwent 25-gauge TSV for different macular...

http://www.evrs.eu/medias/2006/congress/Reoperation-after-Diabetic-Vitrectomy:-Rate,-Indications,-Visual-Outcomes,-and-Complications-in-an-Urban-Academic-Medical-Center.swf Julie L. Gasperini, MD (Detroit, MI), Dean Eliott, MD (Los Angeles, CA) PURPOSE: To identify the rate, indications, visual outcomes, and complications in patients requiring reoperation(s) for the sequelae of proliferative diabetic retinopathy. METHODS: Retrospective...

http://www.evrs.eu/medias/2006/videos/Anatomical-Mechanics-of-Intravitreal-Injection.flv Ahmad M. Mansour, MD (Beirut, Lebanon), Rola Nazih Hamam, MD (Boston, MA) SYNOPSIS Retinal damage with 30/27 G 13 mm needle occurs with injection posterior to 4 mm from limbus, contralateral subretinal injection in hypotonous eyes & detached retina, hitting a high buckle, & nanophthalmic eye with anterior retinal insertion. Lenticular damage...

Ubeyt Inan Umit, MD (Ayfon, Turkey), Berrin Avci, MD (Bursa, Turkey), Tuncay Kusbeci, MD (Afyon, Turkey), Berkant Kaderli (Bursa, Turkey), Remzi Avci, MD (Bursa, Turkey) PURPOSE: Choroidal neovascular membrane, proliferative retinopaties and retinal vascular occlusions are caused by microvascular disability stimulated mainly with vascular endothelial growth factor (VEGF). Bevacizumab, as a full-length anti-VEGF, has been one of the...

Tamer Macky, MD (Cairo, Egypt), Dina Helmy, MD (Cairo, Egypt), Nihal El Shazly, MD (Cairo, Egypt) PURPOSE: To assess rabbit retinal toxicity to triamcinolone acetonide vehicle, benzyl alcohol, when injected intravitreally. METHODS: This prospective comparative experimental study included 24 pigmented rabbits assigned into 2 groups; group 1 (experiment, n=12) received intravitreal 0.1ml of benzyl alcohol (BA), and group 2 (control, n=12)...

Carlos Mateo, MD (Barcelona, Spain), Borja Corcostegui, MD (Barcelona, Spain) SYNOPSIS Dry macular folds are a rare complication after vitreoretinal surgery. Most reported associated conditions are: superior bullous retinal detachment repair, giant breaks retinal detachment repair and recently limited macular translocation. When affecting the fovea dry macular folds cause a dense linear scotoma with metamorphosia with a very unpleasant...

Adiel Barak, MD (Tel Aviv, Israel), Anat Loewenstein, MD (Tel Aviv, Israel) PURPOSE: To report an episode of toxic anterior chamber syndrome that occured 8 days after uneventful cataract extraction and IOL implantation. METHODS: Retrospective study evaluated an episode of 7 cases of postoperative inflammation that occurred 8 days after cataract extraction with placement of the posterior chamber IOL. RESULTS: Eight patients (out of 13...

Ferenc Kuhn, MD, PhD (Birmingham, AL), Zsuzsanna Szijarto, MD (Pecs, Hungary), Gyongyi Kiss, MD (Pecs, Hungary) PURPOSE: Intravitreal triamcinolone acetate injection has become very popular for treating a variety of conditions ranging from macular edema to age-related macular degeneration. Its complication rate, however, needs to be closely evaluated. METHODS: A prospective study was undertaken to evaluate the postoperative complications of...

Eric R. Holz, MD (Houston, TX), Thomas A. Albini, MD (Houston, TX), Muhammad M. Abd- El-Barr, (Houston, TX), Petros E. Carvounis, BM, BCh (Houston, TX), Mohan N. Iyer, MD (St. Petersburg, FL), Rohit R. Lakhanpal, MD (Houston, TX), Mark E. Pennesi,(Houston, TX), Patricia Chevez-Barrios, MD (Houston, TX), Samuel M. Wu, PhD (Houston, TX) PURPOSE: To investigate whether IVTK produces histological or electroretinographic changes in the rabbit...

Lihteh Wu, MD (San Jose, Costa Rica), Maria A. Martinez- Castellanos, MD (Mexico City, Mexico), Hugo Quiroz-Mercado, MD (Mexico City, Mexico), J. Fernando Arevalo, MD, FACS (Caracas, Venezuela), Michel Eid Farah, MD, PhD (São Paulo, Brazil), Maria H. Berrocal, MD (Santurce, PR), Jose A. Roca, MD (Lima, Peru), Francisco J. Rodriguez, MD (Bogota, Colombia), Mauricio Maia, MD (São Paulo, Brazil), Teodoro Evans, MD (San Jose, Costa Rica), Pan...

Clement K. Chan, MD (Palm Springs, CA), Carsten H. Meyer, MD (Marburg, Germany), Jeffrey G. Gross, MD (Columbia, SC), Prema Abraham, MD (Rapid City, SD),* Steven G. Lin, MD (Palm Springs, CA), Asha S.D. Nuthi, DO (Palm Springs, CA) PURPOSE: To report a case series of retinal pigment epithelial (RPE) tears after off-label intraocular bevacizumab (Avastin) for neovascular age-related macular degeneration. Acute RPE tears are known to occur...

Howard F. Fine, MD (New York, NY), Richard F. Spaide, MD (New York, NY), Reza Iranmanesh, MD (New York, NY), Diana Iturralde, MD (Pamplona, Spain) PURPOSE: Twenty-five gauge vitrectomy systems possess several advantages over 20-g methods including improved wound healing, conjunctival sparing, and patient comfort. Newer 23-g systems were introduced to improve instrument bore size and rigidity while retaining sutureless technique. The...

Nur Acar, MD (Istanbul, Turkey), Ziya Kapran, MD (Istanbul, Turkey), Yaprak Banu Unver, MD (Istanbul, Turkey), Tugrul Altan, MD (Istanbul, Turkey), Sezin Ozdogan, MD (Istanbul, Turkey) PURPOSE: To evaluate the safety and efficacy of 25-gauge transconjunctival sutureless vitrectomy (TSV) for the treatment of a variety of vitreoretinal diseases. METHODS: In this retrospective, interventional clinical trial, 64 consecutive eyes that underwent...

Flavio A Rezende, MD, PhD (Rio de Janeiro, Brazil), Luiz Gustavo T. Regis, MD (Rio de Janeiro, Brazil), Mônica Kickinger, MD (Rio de Janeiro, Brazil), Simone Alcântara, MD (Rio de Janeiro, Brazil) PURPOSE: To report 2 cases of ocular decompression retinopathy after 25-gauge transconjunctival sutureless vitrectomy (TSV-25) for retained lens fragments after complicated phacoemulsification. METHODS: We present case reports of 2 patients...

Lidmila Prochazkova, MD (Ústí Nad Labem, Czech Republic), Martina Závorková, MD (Ústí Nad Labem, Czech Republic) PURPOSE: To study the occurence of secondary glaucoma after pars plana vitrectomy (PPV). The secondary glaucoma is a strongly unpleasant complication following the PPV. It can be an open-angle glaucoma or an angle-closure glaucoma. types of secondary glaucoma: hemolytic, steroid, neovascular and, pupillary...

http://www.evrs.eu/medias/2006/congress/A-2006-Update-on-the-Risks-Associated-with-Intravitreous-(IVT)-Injection-and-Guidelines-for-Safe-Administration.swf Emmett T. Cunningham, MD, PhD, MPH (South San Francisco, CA) PURPOSE: IVT injections are increasingly being used as a means of administering therapeutic agents to the posterior ocular segment, which allows one to achieve high ocular levels while minimizing systemic exposure. In fact, the...

David S. Dyer, MD (Kansas City, MO),* Brandon L. Davis, MD (Kansas City, KS), Blake A. Cooper, MD (Kansas City, MO),* Gregory M. Fox, MD (Kansas City, MO)* PURPOSE: To review post-operative examinations and complications of 25g vitrectomies. METHODS: A retrospective review of visual acuity, IOP and complications of 25 g vitrectomies performed on 610 eyes by 3 retina specialists. Snellen visual acuity (VA) and IOP were recorded for pre-op,...

http://www.evrs.eu/medias/2006/videos/BEST-OF-SHOW-Managing-Dry-Macular-Folds-after-Vitreoretinal-Surgery.flv Carlos Mateo, MD (Barcelona, Spain), Borja Corcostegui, MD (Barcelona, Spain) SYNOPSIS Dry macular folds are a rare complication after vitreoretinal surgery. Most reported associated conditions are: superior bullous retinal detachment repair, giant breaks retinal detachment repair and recently limited macular translocation. When...

Sophie J Bakri, MD (Cleveland, OH), J.D. Cameron, MD (Rochester, MN), Jose S. Pulido, MD (Rochester, MN), Colin A. McCannel, MD (Rochester, MN), Ronald Marler, DVM, PhD (Scottsdale, AZ) PURPOSE: To evaluate the retinal toxicity of intravitreal bevacizumab in an animal model. METHODS: Bevacizumab was injected into the vitreous of one eye of each of 8 Dutch-belted rabbits; the other eye served as a control. Four rabbits received a dose of...

Dong Heun Nam, MD (Incheon, Korea), Jee Woong Jeung, MD (Incheon, Korea), Kyung Hwan Shyn, MD, PhD (Incheon, Korea) PURPOSE: This study was performed to ascertain the complication, intraocular pressure(IOP) elevation and cataract formation, arisen after 4.0 mg triamcinolone (TA) is injected into vitreous cavity in curing retinal diseases, and to analyze the influential factors. METHODS: The 289 patients and 325 eyes traced for over 6...

Baruch D. Kuppermann, MD, PhD (Irvine, CA), Raja Narayanan, MD (Irvine, CA), Saurabh Luthra, MD (Irvine, CA), L. E. Marques, MD (Irvine, CA), Aneesh Neekhra, MD (Irvine, CA), Maria C. Kenney, MD (Irvine, CA) PURPOSE: To study the toxicity of the steroids triamcinolone acetonide (Kenalog®), preservative free triamcinolone (PFTA), dexamethasone, betamethasone, and methyl prednisolone acetate (Depomedrol®) on retinal pigment epithelial...