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Advantages of ILM Blue

Before seeing the advantages of the ILM Blue in ERM surgery, compared to the other dyes, we must analyze what we want to dye: ERM is composed on a plaque of posterior hyaloid which is a collagen 2 structure responsible of reflection and metamorphopsia, the ILM (one micron collagen 4 structure) invaded by glial proliferation (astrocytes and Mueller cell end-feet filled with microfibrils of GFAP). ILM peeling works because, when we remove...

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My Way of Using the Coomasie Blue

Coumassie Blue or Brilliant Blue G (BBG) has been introduced as a surgical adjuvant for chromovitrectomy in 2006. This dye was reported to stain the ILM and to have no significant in vivo toxicity. In contrast Triamcinolone Acetonide produces a better vitreous visibility, the crystals of the steroid adhere to the acellular tissue, thereby enabling a clear contrast between the empty vitreous cavity compared to areas with the vitreous...

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Brillant Blue: An Excellent Dye to Peel the ILM

Purpose : To evaluate the potential of brillant blue g (BBG) for intraoperative staining of the inner limiting membrane (ILM) and to compare the different concentration of BBG showing the efficacy to stain. Methods: Review, interpretation and commentary regarding the most relevant stain, showing 2 different concentration of BBG. Results: The cases reviewed included the following diagnoses: epiretinal membrane (2), macular hole (5),...

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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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Advantages of Membrane Blue / Membrane Blue Dual

I use routinely trypan blue since 2002 and operated more than 5000 cases during that time. Trypan blue is a non- specific dye. It stains vitreous, epiretinal membranes and ILM and I find it advantageous to improve visualization of all the tissue with a single dye. Trypan blue is non-toxic. Trypan blue is approved for vitreoretinal surgery. The effectiveness of staining depends on the observation system Different cases. Contact...

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Magnet-assisted Removal of IOFB

Purpose: To evaluate the efficacy of our technique in achieving safe and atraumatic removal of posterior segment magnetic intraocular foreign bodies. Methods: A prospective study carried out at the ophthalmology department, Zagazig university hospitals, Zagazig, Egypt. The study included 45 eyes of 45 patients with posterior segment magnetic intraocular foreign bodies. Eight patients had already undergone primary surgical repair before....

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IOFB

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Repeated Error During Removal of Metal Non Magnetic IOFB: Perseverare Diabolicum

Introduction: In case of magnetic foreign body my safety exit technique is to use always a magnet to immobilize the foreign body that fluctuates in the vitreous or that is stucked on the retina and contemporarily to grab it with a Machmer diamond dusted forceps. More over the magnet allows you to turn the foreign body in the best position for its extraction. In this case you can reduce to the minimum the opening for the extraction both in...

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Surgery in a Hurry with Sudden Visualization of IOFB

The patient after trauma with subacute endophthalmitis due to postponed diagnosis of the foreign body was treated by facoemulsification and 23 G pp-vitrectomy. The lens capsule was left for the further artificial lens implantation, but due to severe vitreous inflammation the lens capsule was removed for more precise peripheral vitreous removal. After core vitrectomy the rupture of the central retina nasally from the disc was diagnosed. The...

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Blunt and Penetrating Trauma Due to Fireworks in a 11 Old Boy

A severe trauma caused by bilateral bulbar explosion in a 11 years old boy came to my attention after 6 months from the trauma . One eye left, no light percetion.The second eye with light percetion and operated with MIVS 23G PPV. A dense Viteous hemorrhage was removed. Tractional RD was managed with the removal of ERM, ILM (blue assisted) final. Heavy Silicone oil tamponade. A visual acuity of 0,1 was achived af ter some weeks. Three...

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PH Dissection for Perforation

Contact Details: Email: jp.berrod@gmail.com Cell Phone:...

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Open Globe Injuries – Surgical Approach to Ruptures

Rupture is the most severe form of open globe injuries after ocular trauma, not only related to the tissue pathologies that occur at the time of injury but also because of the post-injury destruction associated with the body’s normal healing response process. The diagnosis is usually straightforward because the wound is visible, often even to the naked eye. Still, treating it is a big challenge and should be dealt with by an expert...

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Vasalva Retinopathy

SCIENTIFIC POSTER_Miriam Garcia Fernandez_7 Advantages: To report the etiology, treatment and results of 8 patients with Valsalva retinopathy. Methods: Seven patients with sudden visual acuity loss due to Valsalva retinopathy were included in this study. Two patients underwent 20-G vitrectomy, 3 patients were treated with 23-G vitrectomy, in 2 patients no therapy deemed neccessary as the hemorrhage was small and resolved spontaneously after...

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Old Intraretinal IOFB: Remove or Face Siderosis?

Rationale: If a patient is found to have an old, intraretinal, encapsulated IOFB close to the fovea and the eye has full vision, a very difficult dilemma must be faced. Either the IOFB is left in situ or it is to be removed. Leaving it behind saves the patient from all of the possible intraoperative and early postoperative risks, ranging from endophthalmitis to PVR. However, the risk of siderosis will never completely subside, and the...

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Utilization of a New IOFB Forceps

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To evaluate the benefits of a new instrument in removing intraocular foreign bodies. Methods: The new instrument was designed to facilitate removal of intraocular foreign bodies that are too large to fit into the traditional Grieshaber intraocular foreign body forceps. The new design was specifically created to allow better...

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My Approach to Metallic IOFB

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Introduction: Ocular trauma associated with intraocular foreign bodies (IOFBs) is one of the major causes of visual impairment in young individuals. Various reports indicate that 18-41% of all open globe injuries involve at least one IOFB. IOFBs may become embedded in the retina posing a challenging situation for vitreoretinal...

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Traumatic Cataract – Philosophy and Clinical Practice

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Rationale: Traumatic cataract must not be mindlessly treated as an age-related one. The surgeon must decide preoperatively how to remove the lens without causing additional damage to the already injured eye. The most important two questions to decide are: 1) should vitrectomy instrumentation be utilized and 2) should the lens capsules...

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A Case of Subretinal Tubulation

RETINA PHOTO_Kirk Packo A fascinating case of a patient that underwent successful PVR surgery 13 years ago, that then emergently presents with a new complaint that “something is wrong.” The patient is found to have an unusual “subretinal foreign body” that apparently “appeared” in the macula, although was never before seen during prior postop exams. Amazing clinical photos and OCT’s will be shown,...

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A Coral in the Retina

RETINA PHOTO_Cristina Fonseca Clinical Case: 56-year-old woman evaluated in routine ophthalmology consult for progressive right eye visual deterioration. Best-corrected visual acuity was 20/30 in the right eye and 20/20 in the left eye. Biomicroscopy revealed bilateral mild nuclear sclerosis. Right eye fundoscopy showed the presence of an exophytic, multilobulated whitish rounded neoformation, 2 disc diameters in size, located...

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The Entry Wound as Route for Removal of Retained Metallic IOFB Lodged in the Ciliary Body Area

Poster Manoj Saxena The purpose of this video presentation is to report the innovative use of an entry wound for the removal of a retained metallic IOFB lodged in the ciliary body area. The anteriorly placed retained metallic or non-metallic IOFB, especially in the ciliary body region, has always posed a serious surgical challenge both in location and extraction. Endoscopic vitreoretinal surgery comes in handy in this situation, but what if...

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A Dramatic Complication After Idiopathic MH Surgery: Retinal Phototoxicity

Poster 1 Joaquin Castro Navarro Advantages: To report three cases of retinal phototoxicity caused by Xenon light during idiopathic macular hole surgery. Methods: Three eyes (3 patients), two females and one male with idiopathic macular hole, underwent three-port pars plana vitrectomy (Accurus, ALCON, Fort Worth, Tx, EUA) with internal limiting membrane peeling and fluid-gas exchange and fluid-gas exchange (C3F8) due to the presence of an...

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A Surgeon’s Approach to Prevent PVR

Advantages: Prevention of PVR, whether due to trauma or rhegmatogenous retinal detachment, would eliminate the most common cause of surgical failure. Methods: Destruction using high-powered endodiathermy to destroy the retinal pigment epithelial cells in the area of the injury or retinal break. Effectiveness: In traumatized eyes, the PVR rate dropped from over 65% to below 5%. In RD surgery, the data are still being gathered. Safety: So...

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Bimanual Removal of Large Foreign Bodies with the Use of a Suture Loop, and a New Foreign Body Forceps

Objective / Purpose: IOFBs are common in open-globe injuries and can present in various shapes and sizes. The appropriate instrument for extraction depends on the size, composition, magnetic properties, and location of the IOFB and the presence of associated ocular damage. Although there are several instruments for the removal of IOFBs, including intraocular forceps, and intraocular magnets, they sometimes cannot grasp a large IOFB...

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Use of Entry Wound as Route for Metallic IOFB Removal Lodged in the Ciliary Body

The purpose of this video presentation is to report the innovative use of an entry wound for the removal of a retained metallic IOFB lodged in the ciliary body area. The anteriorly placed retained metallic or nonmetallic IOFB, especially in the ciliary body region, has always posed a serious surgical challenge both in location and extraction. Endoscopic vitreoretinal surgery comes in handy in this situation, but what if it is not handy? A...

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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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Surgical Strategies in Complex Ocular Trauma

Ocular trauma remains an important cause of vision loss. Despite popular belief, many cases can have favourable outcomes if properly addressed. This video illustrates several types of injury and the approach taken to deal with them. The presentation is divided in two parts. Part 1 deals with retinal fibrosis developing as a result of open globe injuries, whereas part 2 introduces techniques which are useful in controlling complications...

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Bimanual Removal of Large Foreign Bodies with a Suture Loop, and a New Foreign Body Forceps

Intaocular foreign bodies (IOFB) can present in various shapes and sizes. Several instruments available can sometimes be of limited use.In this video a suture loop consisting of a 20-gauge angiocatheter and 6-0 polypropylene suture is shown. Its construction is very simple. Also a newly designed IOFB forceps is presented. This suture loop effectively grasps large IOFBs, both metallic and nonmetallic. The use of bimanual technique in which...

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Traumatic Retinal Dialysis: Breaking the Trends

Retinal dialyses cause slowly progressive retinal detachments occurring in young, emmetropic males with no history of preceding trauma. They originate at the ora errate and are asymptomatic until macular involvement occurs and are not associated with posterior vitreous detachment (PVD).  These retinal detachments can be successfully managed in the majority of cases with an external surgical approach in the form of cryotherapy and buckling...

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Phakoanaphylactic Endophthalmitis 67 Years After Trauma

Phakoanaphylactic Endophthalmitis 67 Years After Trauma Fabian Höhn Background and Purpose: Phacoanaphylactic Endophthalmitis is a rare disease that develops infrequently after lens injury or due to a leakage of lens protein through the capsule of a hypermature cataract. It is believed to be caused by an immune reaction to lens protein and constitutes as an autoimmune, granulomatous inflammation centered on lens material. Methods: We...

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Primary, Secondary and Tertiary Prevention in Ocular Trauma

Advantages: Improvements in ocular microsurgery and a new understanding in the intraocular posttraumatic development induced by an injury, new surgical concepts have been developed to reach a much better functional rehabilitation than a few years ago could be imagined (tertiary prevention). Methods: From the mechanism of wound healing the strategical approach of early vitrectomy for severe ocular trauma is derived. Effectiveness / Safety:...

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Post-traumatic Aniridia Open Sky Artificial Iris and Secondary IOL Implantation: One Step Technique

Advantages: Nearby cosmetic IOL and pupillary reconstruction, the artificial iris is a better solution. We show our strategy to suture a foldable IOL on the back surface of the artificial iris to achieve a cosmetic and refractive result on posttraumatic aniridia. Methods: We reviewed 2 eyes with combined anterior and posterior segment injuries. Open-sky surgery technique and mini-invasive 25/23G system was used to repair ocular injuries,...

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Treatment of Retinal Detachment in Osteo-odonto Keratoprosthesis (OOKP)

Treatment of Retinal Detachment in Osteo-odonto Keratoprosthesis (OOKP)

Cesare Forlini, Adriana Bratu, Matteo Forlini, Paolo Rossini, (Ravenna, Italy) The patient of this video was a 21 years old male with an uncertain clinical history of bilateral congenital cataract extraction and multiple surgeries for retinal detachment. One eye was enucleated for bulbar phtisis. His only eye underwent an OOKP implant according to Falcinelli for a corneal decompensation and was not amenable for an ulterior PK. The patient...

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Traumatic Corneal Opacity Developed Endophthalmitis Complicated with Retinal Detachment No Corneal Graft What to Do?

Maha Elshafei (Doha, Qatar) Case of patient who had penetrating trauma by a nail while hammering. Primary repair was done. Two weeks later patient presented with endophthalmitis. Anterior chamber and vitreous samples were taken and intravitreal injection of antibiotics was given. The patient deteriorated, limited vitrectomy was tried due to the bad view caused by the traumatic corneal scar with another sample taken. The patient underwent...

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Retinal Detachment in Eye Trauma: What Can We Do to Avoid Failure?

Miroslav Vukosavljevic (Belgrade, Serbia) Advantages: Ocular trauma may lead to various forms of damage to different parts of the eye, ranging from superficial abrasions to sight-threatening lesions with retinal detachment. Even with all advances in equipment and surgical techniques, as well as in our understanding of pathophysiology and management of eye injuries, there are still many factors, which can affect final outcome. Achieving...

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Anatomic and Functional Prognosis in Patients with Traumatic Retinal Detachment After Close Globe Injury

Ozen Osmanbasoglu, Hülya Güngel, Isil Pasaoglu, Abdurrahman Bascý, Merih Gul (Istanbul, Turkey) Advantages: To assess the anatomical and functional prognosis in patients with traumatic retinal detachment after close globe injury. Methods: The study was a nonrandomised and retrospective chart review of 25 patients who were operated for traumatic retinal detachment after close globe injury. The age, time elapsed before the surgery, the...

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Traumatic Retinal Detachment Associated with Penetrating / Perforating Injuries with Shotgun Pellets: Treatment Technique and Results

Hassan Mortada (Cairo, Egypt) Advantages: Better understanding of wound healing and the advent of vitrectomy resulted in dramatic improvement in the prognosis of open globe injuries. The aim of this work is to present the technique used in dealing with traumatic retinal detachment caused by penetrating/perforating ocular injuries caused by shotgun pellets. Methods: 20 eyes with severe penetrating/perforating injuries caused by shotgun...

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Traumatic Retinal Detachment Following Open Globe Injury

Hülya Güngel, Ozen Osmanbasoglu, Isil Pasaoglu, Abdurrahman Bascý, Ece Kýrandi (Istanbul, Turkey) Advantages: It was the aim of this study to describe the clinical features and surgical outcomes of retinal detachment following open globe injuries. Methods: The study was a retrospective chart review of 11 patients who had undergone surgery for retinal detachment after open globe injury. Effectiveness / Safety: The mean age was 46,18...

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Pole to Pole Surgery in Severe Post-traumatic PVR — The Role of Temporary Keratoprosthesis and Open Sky Surgery

Cesare Forlini, Matteo Forlini, Adriana Bratu, Paolo Rossini (Ravenna, Italy) Purpose: To show the use of temporary keratoprosthesis (TKP, Landers) and of open sky surgery for the visualization of intraocular structures during pars plana vitrectomy in eyes with corneal and retinal pathologies and make possible to manage both in a single surgical procedure. Methods: We reviewed 35 eyes with combined anterior and posterior segment injuries...

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My Way of Managing Traumatic Retinal Detachments: What, When, How, and Why?

Ferenc Kuhn (Hungary / USA) Advantages: An approach based on a careful analysis of what leads to retinal detachment in the severely injured eye promises results superior to those that simply treat the traumatized globe in a -treat-as-you-go fashion. This review lecture lists the author’s personal pearls and caveats. Methods: Pars plana vitrectomy is almost always necessary if the open-globe injury involves the posterior segment. The...

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Prophylactic Chorioretinectomy: A New Weapon to Fight PVR in Open Glove Injuries?

Eric Denion (Caen, France) Advantages: In certain types of open-globe injuries especially intraocular foreign bodies with deep impact, perforating injuries and rupture, cicatricial tissue is liable to proliferate from the wound(s) and invade the adjacent retina. The cicatricial tissue may next contract leading to retinal folds, tractional and then combined tractional-rhegmatogenous retinal detachment. F. Kuhn et al. have coined the term...

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Bilateral Subinternal Limiting Membrane Hemorrhage with Terson Syndrome

Kubilhan Elmas, Özgür Bilen Basaran, Ali Altýnsoy (Ankara, Turkey) Purpose: To report the anatomic location of bilateral dome-shaped posterior pole hemorrhages in a patient with Terson syndrome. Methods: Case report. We performed bilateral vitrectomy for vitreous hemorrhage in a patient with Terson syndrome. After removal of vitreous hemorrhage, the tissue overlying a large discrete hemorrhage in the posterior pole was...

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Chorioretinectomy for Perforating Eye Injuries

Sengul Ozdek*, Erdem Yuksel (Ankara, Turkey) Advantages: Early chorioretinectomy in eyes with perforating eye injury may increase the globe survival rate. Methods: Reports of consecutive eyes with severe perforating injuries treated with chorioretinectomy were examined for surgical technique, VA, formation of postoperative proliferative tissue, PVR, and tractional retinal detachment rate. Effectiveness / Safety: Results of 15 eyes of 15...

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Valsava Retinopathy: Etiology, Treatment and Results

J. Castro-Navarro, C. González-Castaño, M. García-Fernández, A. García-Alonso, M. Fonollá-Gil (Oviedo, Spain) Purpose: To report the etiology, treatment and results of six patients with Valsalva retinopathy. Methods: Six patients with sudden visual acuity loss owing to Valsalva retinopathy, treated in our hospital in the last three years, were selected for this study. Two patients underwent 20-G vitrectomy, three patients were treated...

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Treatment of Retinal Detachment in Osteo-odonto Keratoprosthesis (OOKP)

Cesare Forlini, Adriana Bratu, Matteo Forlini, Paolo Rossini, (Ravenna, Italy) The patient of this video was a 21 years old male with an uncertain clinical history of bilateral congenital cataract extraction and multiple surgeries for retinal detachment. One eye was enucleated for bulbar phtisis. His only eye underwent an OOKP implant according to Falcinelli for a corneal decompensation and was not amenable for an ulterior PK. The patient...

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Outcomes of Eyes with Post-traumatic Endophthalmitis in Open Globe Injuries

Yaprak Banu Ünver*, Ziya Kapran, Nur Acar, Yapar Kucuksumer (Istanbul, Turkey) Advantages: To analyze the microbiological characteristics, anatomical and visual outcomes of eyes with post-traumatic endophthalmitis Methods: Medical records were reviewed of 47 patients with post-traumatic endophthalmitis at a single institution between 2001 and 2011. Pars plana vitrectomy was performed in 34 (72,3%) cases as a first treatment. All eyes were...

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Macular Involvement in Terson Syndrome


http://www.evrs.eu/medias/2010/congress/Hemorrhages.flv Ferenc Kuhn (Birmingham, AL, USA) Advantages: Knowing that hemorrhages can severely impact macular function and recognizing the type of macular pathology involved helps the surgeon deal with the macular complications correctly. Methods: Review of the author’s cases over a period exceeding two decades. Effectiveness / Safety:  Removal of the macular hemorrhages is a simple and...

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Purtscher-Like Retinopathy after Squint Surgery under Local Anesthesia

Hussein K. Elgendy (Jeddah, Saudi Arabia) Advantages: Purtscher retinopathy is a hemorrhagic and vaso-occlusive vasculopathy, which, in 1912, was first described as a syndrome of sudden blindness associated with severe head trauma. Purtscher-like retinopathy is seen in diverse conditions, including acute pancreatitis, fat embolization, amniotic fluid embolization, and vasculitic diseases. Methods: To report a rare case of Purtscher...

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The Yepez Fishnet for Removing Giant Non-Magnetic IOFB

http://www.evrs.eu/medias/2010/videos/JuanBTAYepezM_2_VP6_768K.flv Juan BTA Yepez M, Jazmin Cedeno De Yepez, Maria Cedeno L (Maracaibo, Venezuela) Advantages: 1. Better than other type of tools for removing giant non-magnetic IOFB. 2. Minimize the risk of foreign body drop back. Methods: A 3D video animation was used to demonstrate the “Yepez Fishnet for removing giant non-magnetic IOFB”. Effectiveness / Safety: This new...

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Ocular Traumatology: The Basics

Ferenc Kuhn (Birmingham, AL, USA)   This course covers the basic elements of treating a patient with eye injury. Counseling – the process of communicating with the injured person and his family to achieve maximal cooperation and mutual understanding. Classifying the injury – to make sure that proper information is collected and utilized about the type of trauma encountered. Decision‐making – to decide the optimal route toward...

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Use of Viscoelastic Materials to Protect the Macula During Removal of Large Posterior Segment Intraocular Foreign Bodies

http://www.evrs.eu/medias/2009/videos/ToukaBanaee_VP6_768K.flv Author: Banaee Touka, Mashhad, Iran Advantages: Protection of macula in case a large foreign body is lost from the forceps during removal. Methods: After completion of vitrectomy and before removal of the foreign body, half of the vitreous cavity is filled with viscoelastic material and then the foreign body is removed. The viscoelastic material can effectively reduce the...

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Bilateral Globe Rupture, Loss of Intraocular Content and 330º Retinal Dialysis

http://www.evrs.eu/medias/2009/videos/MarioAlfaiate_VP6_768K.flv Authors: Mário Alfaiate, Paula Magro, João Figueira, Sérgio Leal, Joaquim Carvalho, Coimbra, Portugal Methods: We present a surgical video of a case with traumatic bilateral globe rupture, loss of all vitreous content, retinal dialyses in about 330º and incarceration of the retina in the wound. The globes were closed on the day of the accident. Vitrectomy, extraction of...

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Predictive Value of Ocular Trauma Score (OTS) in Terrorism-Related Open-Globe Injuries

http://www.evrs.eu/medias/2009/congress/Trauma.flv Authors: Güngör Sobaci, Ismail Halili, Hakan Durukan, Cüneyt Erdurcan, Atilla Bayer, Fatih Mehmet Mutlu, Üzeyir Erdem, Yusuf Uysal, Suat Karagül, Ankara, Turkey Advantages: To predict the visual outcomes in eyes with open-globe injury caused by acts of terrorism. Methods: The charts of patients with open-globe injury presenting to the tertiary referral center during the past 17...

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Outcomes of Partial Pars Plana Vitrectomy in Open Globe Injuries Involving the Posterior Segment

http://www.evrs.eu/medias/2009/congress/Trauma.flv Authors: Francesco Boscia, Luigi Sborgia, Nicola Recchimurzo, Claudio Furino, Gianluca Besozzi, Bari, Italy Advantages: OGI involving PS is usually treated by radical PPV, in order to remove scaffold for future traction. However, radical PPV has several complications. This paper evaluates efficacy and safety of P-PPV in selected cases of OGI involving PS. Methods: Nine eyes (9 patients)...

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Pole to Pole Surgery in Trauma Cases and “Dancer” Philosophy

http://www.evrs.eu/medias/2009/congress/Trauma.flv Authors: Cesare Forlini, Matteo Forlini, Paolo Rossini, Ravenna, Italy Advantages: Presenting the “pole to pole” surgical strategy as a reconstruction in trauma cases using multiple procedure surgery all in a single operation. It is important for the ophthalmologist to develop strategic thinking so that it can be used systematically in different cases. Methods: The introduction of...

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Management of Traumatic Corneal Tissue Loss

http://www.evrs.eu/medias/2008/congress/Management-of-Traumatic-Corneal-Tissue-Loss.flv Grazia Pertile, Barbara Parolini Advantages: Some trauma cases may present with corneal tissue loss. In those cases, a simple corneal suture, while may be used as emergency treatment, is not adequate to restore anatomy and function. The use of a scleral patch to replace the lost corneal tissue allows to perform a corneal transplantation. If necessary,...

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Cosmetic IOL in Trauma Cases: Role of Iris Surgery and Endoscopy

http://www.evrs.eu/medias/2008/congress/Cosmetic-IOL-in-Trauma-Cases:-Role-of-Iris-Surgery-and-Endoscopy.flv Cesare Forlini, Paolo Rossini, Antonio Aversano (Department of Ophthalmology, “S. Maria delle Croci” Hospital, Ravenna, Italy), Matteo Forlini (Eye Clinic, University of Modena, Italy) Advantages: Show the combined use of cosmetic scleral-fixed cosmetic IOL, iris surgery and endoscopy in the treatment of post-traumatic aphakia...

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Save the Iris

http://www.evrs.eu/medias/2008/congress/Save-the-Iris.flv Cesare Forlini, Paolo Rossini, Antonio Aversano (Department of Ophthalmology, “S. Maria delle Croci” Hospital, Ravenna, Italy), Matteo Forlini (Eye Clinic, University of Modena, Italy) Advantages: Show the importance to try to save the iris tissue and to restore the pupil, in severe ocular trauma. Methods: Several cases of severe ocular trauma with iris rupture, iris dialysis,...

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Management of Intraretinal IOFBs: My way

http://www.evrs.eu/medias/2008/congress/Management-of-Intraretinal-IOFBs:-My-way.flv Ferenc Kuhn, Adrien Solt Advantages: The “comprehensive” – rather than reflex-based – approach to the management of the injured eye allows to surgeon to carefully plan the operation and aim for the best possible outcome. Methods: The surgical strategy involves consideration of not only the intraocular abnormalities already present,...

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Surgical Prevention of PVR in Serious Ocular Trauma

http://www.evrs.eu/medias/2008/congress/Surgical-Prevention-of-PVR-in-Serious-Ocular-Trauma.flv Ferenc Kuhn, Wolfgang Schrader, Robert Morris, Viktoria Mester Advantages: Prevention of the development of proliferative vitreoretinopathy is crucial in preserving vision in the injured eye. Since pharmacologic methods have largely been unsuccessful, a new surgical approach is attempted. Methods: Prophylactic chorioretinectomy is performed...

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Comparison of External Magnet and Intraocular Forceps for Intravitreal Foreign Body Extraction (IVFB)

http://www.evrs.eu/medias/2008/congress/Comparison-of-External-Magnet-and-Intraocular-Forceps-for-Intravitreal-Foreign-Body-Extraction-(IVFB).flv Masoud Soheilian Advantages: The data from this study suggest no preference between external magnet and intraocular forceps for the extraction of magnetic intraravitreal foreign bodies (IVFB). However, the use of external magnet for the extraction of IVFB may offer several advantages, including...

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The Value of an Intraocular Electromagnet in Removing Iron Foreign Bodies in the Posterior Segment

B. Rysanek, M. Robert, C. Billotte Advantages: The use of an intraocular magnet may improve the extraction of an intraocular metallic foreign body smaller than 10mm. Methods: During three-port vitrectomy, the electromagnet is introduced through one port allowing to gently draw the foreign body back from the retina. At the same time, the vitrectomy hand piece is used to release all the vitreous adherences still holding the foreign body in...

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PPV in Patients with Intraocular Foreign Body.

Anita Lyssek-Boron, Edward Wylęgała, Slawomir Teper (OSK Hospital in Katowice, Department of Ophthalmology) – Head: Prof. Edward Wylęgała Aim of the Study: To present and compare treatment results in patients who underwent PPV due to intraocular foreign body (IFB) with or without previous electromagnet IFB extraction. Material & Methods: Retrospective analysis of IFB patients – with IFB in the vitreous or on the retinal...

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Pneumatic Displacement in the Diagnosis and Treatment of Valsavia Retiopathy in a Case with Premacular Hemorrhage

Eylem Yaman Pinarci, Berna Demirel, Hulya Gungel Advantages: Instillation of Intravitreal gas is very easy and helpful to make a differential diagnosis and also treatment in premacular haemorrhagia Methods: 0.3 cc pure C3F8 gas was instilled intravitreally with the aim of pneumatic displacement in order to make a differential diagnosis for the Valsalva retinopathy and haemorraghia due to SMD to a 72 year-old male patient who had scar...

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Removal of Foreign Body with 23 Gauge: Case Report

I. Turco, V. Primavera, G. Schiena, G. Querques, A. de Giglio, C. Iaculli, N. Delle Noci Advantages: To use 25 gauge vitrectomy to remove little intra-ocular foreign body Methods: Ocular trauma is a major cause of permanent visual loss or blindness in young adults in the western world. We report a case of a 46 year-old man hospitalized for a penetrating wound, after accidental entry of a foreign body. Ultrasound and CT, preferably with...

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Combined Pars Plana Vitrectomy, Phacoemulsification and Intraocular Lens Implantation with Foreign Body Extraction

Deniz Oygar Baylancicek, Hulya Gungel, Isil Basgil Purpose: To evaluate the results of combined pars plana vitrectomy (PPV), phacoemulsification with IOL in eyes with intraocular foreign body (IOFB). Methods: Ten eyes of 10 patients were included in this retrospective study. All the foreign bodies were metallic. PPV with phacoemulsification and foldable IOL with PMMA haptics implantation were performed to all patients. First...

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The Using of Microendoscopy in the Surgical Treatment of Posttraumatic Alterations of the Eyeball

http://www.evrs.eu/medias/2008/congress/The-Using-of-Microendoscopy-in-the-Surgical-Treatment-of-%20Posttraumatic-Alterations-of-the-Eyeball.flv Shkvorchenko D.O., Kislitsina N.M., Sharafetdinov I.H., Takhchidi Kh.P., Uzunyan D.G. Advantages: The ciliary body and the peripheral part of the retina are difficult for diagnostic assessment and intraoperative visualization. The necessity of visualization of intraocular foreign body and...

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Macular Hole Due to Terson’s Syndrome

Willemine De Vries Knoppert, MD (Amsterdam, The Netherlands), Peter Ringens, MD, PhD, PURPOSE: To report a case of a macular hole as a result of Terson’s syndrome and to postulate a new hypothesis regarding the mechanism of macular hole development. METHODS: A case report with clinical and surgical findings. RESULTS: A 57-year-old woman developed a subarachnoid haemorrhage with a subinternal limiting membrane (ILM) haemorrhage in the...

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The Use of New Surgical Strategies in Dealing with Ocular Trauma

The Use of New Surgical Strategies in Dealing with Ocular Trauma

Giampaolo Gini, MD (Prato, Italy), Vincent S. Reppucci, MD (New York, NY) SYNOPSIS New techniques and devices are helping us deal successfully with complex trauma cases. Drainage implants have proved reliable where no other option for controlling IOP is available. Posterior hyaloid identification with Triamcinolone and its consequent removal accounts for fewer mid- and long-term retinal complications. Finally, the laser-assisted corneal...

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The Effect of Blue Light on Vascular Endothelial Growth Factor

Kourous A. Rezai, MD (Harvey, IL), Kasra Attaran Rezaei, MD (Chicago, IL), Elzbietta Gasyna, MS (Chicago, IL), Lili Farrokh-Siar, MD (Chicago, IL) PURPOSE: Vascular endothelial growth factor (VEGF) plays an important role in AMD. Further it has been suggested that exposure to blue light may also affect the progression of AMD. In this study we analyzed the effect of blue light on the production of VEGF in human retinal pigment epithelial...

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Extended Use of Small-gauge Vitrectomy: New Insights

Joao Luiz Lobo Ferreira, MD (Florianopolis, Brazil) SYNOPSIS The extended use of small-gauge vitrectomy with the need to convert one of the sclerotomies to 20-gauge has been described for the use of phacofragmentation for dislocated lens into the vitreous (IVDL), removal of intra-ocular foreign body (IOFB), and for silicone oil (SiO) infusion. New techniques for scleral fixation of IOL, phacocrush for removal of IVDL, removal of IOFB –...

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Surgical Management in Acute Endophthalmitis

Fréderic Rouberol, MD (Lyon, France), Christophe Chiquet, MD (Grenoble, France) SYNOPSIS Treatment of acute endophthalmitis includes intravitreal injection of antibiotics, and pars plana vitrectomy. The surgery is looked at from several angles: removal of inflammatory debris or membranes in the anterior segment, obtaining intraocular specimens sampling, different modes of visualization of the fundus during surgery. After presenting the...

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Anatomical Mechanics of Intravitreal Injection

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...

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Heavy Silicones in Severe Vitreoretinal Diseases

Heavy Silicones in Severe Vitreoretinal Diseases

Cesare Forlini, MD (Ravenna, Italy), Paolo Rossini, MD (Ravenna, Italy) SYNOPSIS To describe the usefulness of new heavy silicone oils in the management of complex cases of vitreoretinal surgery: a severe penetrating trauma, a macular trans-location for large paramacular hole in previous vitrectomy for CNV removal, and a closed trauma in previous PK patient with iris and lens expulsion.   VIDEO not communicated Sorry for the...

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Posttraumatic Endophthalmitis: Microbiology and Visual Outcomes

Emad B. Abboud, MD (Riyadh, Saudi Arabia), Abdulrahman. M Alomran, MD (Riyadh, Saudi Arabia), Ahmed Mokhtar Abuelasrar, MD, PhD (Riyadh, Saudi Arabia) PURPOSE: To identify the microbiological spectrum and establish the visual prognosis of posttraumatic endophthalmitis. METHODS: This is a retrospective, consecutive, interventional case series. The medical records were reviewed of all 67 consecutive patients with positive intraocular culture...

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No Light Perception (NLP) Vision After Injury: Don’t Give Up!

http://www.evrs.eu/medias/2006/videos/No-Light-Perception-NLP-Vision-After-Injury:-Don-t-Give-Up.flv Ferenc Kuhn, MD, PhD (Birmingham, AL) SYNOPSIS Over 90% of NLP eyes are enucleated, although vision often could be improved with timely reconstruction. This film is on an 80-year-old lady with an occult rupture after falling. Vision was NLP (confirmed at the slit lamp); the lens was under the conjunctiva and she had a retinal detachment....

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No Light Perception Vision After Injury: Don’t Give Up!

No Light Perception Vision After Injury: Don’t Give Up!

Ferenc Kuhn, MD, PhD (Birmingham, AL) SYNOPSIS Over 90% of NLP eyes are enucleated, although vision often could be improved with timely reconstruction. This film is on an 80-year-old lady with an occult rupture after falling. Vision was NLP (confirmed at the slit lamp); the lens was under the conjunctiva and she had a retinal detachment. Comprehensive reconstruction (wound closure, removal of extruded tissues, vitrectomy, silicone oil...

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Pole to Pole Sugery in Trauma Case: The Dancer

Pole to Pole Sugery in Trauma Case: The Dancer

Cesare Forlini, MD (Ravenna, Italy), Paolo Rossini, MD (Ravenna, Italy), Stefano Dolce, MD (Ravenna, Italy), Antonio Aversano, MD (Ravenna, Italy), William Gualtieri, MD (Ravenna, Italy) SYNOPSIS Complex cases of ocular traumatology, which involve different sectors of the eyeball. A “pole to pole” surgical strategy has been chosen, developing a global surgical strategy, putting aside the traditional distinctions between anterior and...

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The Use of New Surgical Strategies in Dealing with Ocular Trauma

http://www.evrs.eu/medias/2006/videos/The-Use-of-New-Surgical-Strategies-in-Dealing-with-Ocular-Trauma.flv Giampaolo Gini, MD (Prato, Italy), Vincent S. Reppucci, MD (New York, NY) SYNOPSIS New techniques and devices are helping us deal successfully with complex trauma cases. Drainage implants have proved reliable where no other option for controlling IOP is available. Posterior hyaloid identification with Triamcinolone and its consequent...

Read More

Heavy Silicones in Severe Vitreoretinal Diseases

Cesare Forlini, MD (Ravenna, Italy), Paolo Rossini, MD (Ravenna, Italy) SYNOPSIS To describe the usefulness of new heavy silicone oils in the management of complex cases of vitreoretinal surgery: a severe penetrating trauma, a macular trans-location for large paramacular hole in previous vitrectomy for CNV removal, and a closed trauma in previous PK patient with iris and lens expulsion.

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Management of Traumatic Retinal Detachment Associated with Open Globe Injuries

http://www.evrs.eu/medias/2006/congress/Management-of-Traumatic-Retinal-Detachment-Associated-with-Open-Globe-Injuries.swf http://www.evrs.eu/medias/2006/congress/Management-of-Traumatic-Retinal-Detachment-Associated-with-Open-Globe-Injuries-1.flv http://www.evrs.eu/medias/2006/congress/Management-of-Traumatic-Retinal-Detachment-Associated-with-Open-Globe-Injuries-2.flv Giampaolo Gini, MD (Prato, Italy) PURPOSE: How far have surgical...

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Intraocular Foreign Body Removal

http://www.evrs.eu/medias/2006/videos/Intraocular-Foreign-Body-Removal.flv Eric D. Weichel, MD (Philadelphia, PA) SYNOPSIS Surgical video of intraocular foreign body removal from soldiers injured in Operation Iraqi Freedom. The video shows  preoperative, intraoperative and postoperative cases of intraocular foreign bodies secondary to combat ocular trauma.

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Pitfalls in the Management of Ocular Trauma

http://www.evrs.eu/medias/2006/videos/Pitfalls-in-the-Management-of-Ocular-Trauma.flv Hazem El Sabagh, MD (Damman, Saudi Arabia) SYNOPSIS The film present three ocular trauma cases in which improper management and / or improper timing of intervention has affected the anatomical and visual outcomes of surgery.

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Comprehensive Reconstruction of a Phthisical, Disorganized Eye after Trauma

http://www.evrs.eu/medias/2006/videos/Comprehensive-Reconstruction-of-a-Phthisical-Disorganized-Eye-after-Trauma.flv Ferenc Kuhn, MD, PhD (Birmingham, AL) SYNOPSIS An 11-year-old boy ruptured an eye that was abandoned after the first, unsuccessful reconstruction. He had LP vision, no pupil (dragged iris), extensive anterior scarring, total retinal detachment with subretinal strands, and severe hypotony. Surgery at 4 months included...

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A frequent cause for retinal detachment occur-ring in open globe injuries is retinal incarceration. The boundary between which cases are operable and which are not has been moved forward as new surgical tech-niques and materials have become available through the years. Aim of this video is to illustrate some of these concepts as we consider a first case in which the boundary of operability has been stretched forward and a second case in which there is a happy ending for a severe injury.

Ferenc Kuhn, MD, PhD (Birmingham, AL) SYNOPSIS Over 90% of NLP eyes are enucleated, although vision often could be improved with timely reconstruction. This film is on an 80-year-old lady with an occult rupture after falling. Vision was NLP (confirmed at the slit lamp); the lens was under the conjunctiva and she had a retinal detachment. Comprehensive reconstruction (wound closure, removal of extruded tissues, vitrectomy, silicone oil...

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Retinal Incarceration Associated with Open Globe Injuries

http://www.evrs.eu/medias/2006/videos/Retinal-Incarceration-Associated-with-Open-Globe-Injuries.flv Giampaolo Gini, MD (Prato, Italy) SYNOPSIS A frequent cause for retinal detachment occur-ring in open globe injuries is retinal incarceration. The boundary between which cases are operable and which are not has been moved forward as new surgical tech-niques and materials have become available through the years. Aim of this video is to...

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Pole to Pole Surgery in Trauma Case: “The Dancer”

http://www.evrs.eu/medias/2006/videos/Pole-to-Pole-Surgery-in-Trauma-Case:-The-Dancer.flv Cesare Forlini, MD (Ravenna, Italy), Paolo Rossini, MD (Ravenna, Italy), Stefano Dolce, MD (Ravenna, Italy), Antonio Aversano, MD (Ravenna, Italy), William Gualtieri, MD (Ravenna, Italy) SYNOPSIS Complex cases of ocular traumatology, which involve different sectors of the eyeball. A “pole to pole” surgical strategy has been chosen, developing a...

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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...

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A Simple Snare Instrument for Intraocular Foreign Bodies

http://www.evrs.eu/medias/2006/videos/A-Simple-Snare-Instrument-for-Intraocular-Foreign-Bodies.flv Tansu Erakgun, MD (Izmir, Turkey) SYNOPSIS Intraocular foreign bodies (IOFB) often produce injuries to a variety of ocular structures in a complex array of patterns and form a risk for infection, retinal detachment and metallosis. Here I report a simple snare instrument formed of a vascular catheter and a prolene suture, used for the removal...

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Microbial Isolates and Sensitivities in Posterior-segment Intraocular Foreign Body (IOFB) Injuries: A 10-year Review

http://www.evrs.eu/medias/2006/congress/Microbial-Isolates-and-Sensitivities-in-Posterior-segment-Intraocular-Foreign-Body-(IOFB)-Injuries:-A-10-year-Review.swf Samuel B Barone, MD (New York, NY), Sean C. Lalin, MD (New York, NY), Mahendra Shah, MS (New York, NY), Steven A. McCormick, MD (New York, NY), Richard B. Rosen, MD (New York, NY), Ronald C. Gentile, MD (New York, NY) PURPOSE: Evaluate the incidence of endophthalmitis and/or...

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Results of Surgery in Traumatic Macular Holes

http://www.evrs.eu/medias/2005/congress/Results-of-Surgery-in-Traumatic-Macular-Holes.swf Tugrul Altan, Mehmet Çakir, Ziya Kapran, Irfan Perente, Nur Acar, Yaprak B. Ünver, Zerrin Bayraktar, Canan Aslı Utine Purpose: To evaluate the anatomical and functional success of pars plana vitrectomy (PPV) in traumatic macular holes. Methods: The records of 5 eyes of 5 patients who underwent PPV due to traumatic macular hole between September 2001...

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Hemorrhagic Macular Cysts in Terson Syndrome

Ferenc Kuhn, Robert Morris, Viktoria Mester Purpose: To present the incidence, clinical appearance, surgical management, and prognosis of hemorrhagic macular cysts (HMC). Methods: Retrospective case series. Results: The incidence of HMC among patients with Terson syndrome was 42% (15 out of 36). In 11 eyes (73%) the cyst was submembranous (under the internal limiting membrane [ILM]). All cysts were removed without complication, and vision...

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Surgical Slit Lamp Advantages for Macular Surgery

Didier Ducournau Numerous advantages are provided by using the slit microscope and tilted five to seven degrees from the axis. The fact that the surgeon’s second hand is free, allowing him to stabilise forceps, enables a better precision. The fact the light is close to the axis increases the membrane reflex visualisation. The two advantages allow the surgeon not to use colouring agents. This decreases the global price of the procedure...

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