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Role of Endo-diathermy Probe in PDR Surgery

I use the endodiathermy probe as one of two instruments for bimanual dissection of diabetic fibrovascular proliferations. It replaces either the forceps or the vitreous cutting probe and scissors. Forceps Replacement: I identify the surgical planes, by inserting the endodiathermy probe tip underneath the membranes; this allows me to dissect with the vitreous cutting probe under good visulaization. Probe/scissors Replacement: In the...

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Macular Hole in RD PDR

          Giant macular hole in a 13 yo girl after surgery for retinal detachment. Subretinal strands are also visible. Tamponade is silicone oil. Contact Details: Email: parolinibarbara@gmail.com Cell Phone:...

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My Way Treating Diabetic Retinopathy in a Vitrectomized Eye

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   With either diabetic macular edema or with proliferative retinopathy we should ascertain that all retinal laser treatment needed has been done and above all emphasize the importance of a good metabolic control to achieve good results. We certainly should not give up and use anti-angiogenic or corticosteroid intra-vitreal injections as...

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Management of Postvitrectomy Vitreous Hemorrhage in Patients with PDR

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Post vitrectomy vitreous hemorrhage is the main cause of failure in patients with proliferative diabetic retinopathy, the rate of this complication is 25 -65% of cases. Most of surgeon usually perform vitrectomy again, sometimes with gas tamponade for haemostatic effect. We propose to do more easy procedure – outpatient fluid gas...

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Endodiathermy Probe as an Aid to Membrane Delamination in Diabetic Traction RD

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: Eyes with diabetic traction detachment (DTRD) can differ in severity. Systemic control and medication is also very important, which may play a role in the intraoperative and postoperative follow-up. One important complication during surgery is bleeding; when cannot be contolled effectively during pars plana vitrectomy, can...

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Bi-linear Aspiration Flow & Cutting Frequency Control and Segmentation in PDR

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Different techniques have been described for the dissection of proliferative diabetic retinopathy (PDR). When there is a strong adherence between the fibrovascular proliferation and the retinal vessels, segmentation is a safe technique to reduce the risk of bleeding and retinal tear. With the advance of vitrectomy machines, the control...

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Advanced PDR: Surgical Approach

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Methods: Preoperative Avastin 24 hours Always Bimanual approach For dissection I use: a 23G vitreous cutter, Scissors, Fashioned 23G Pick. I use the lower temporal trocar sometimes- in cases with dense fibrovascular proliferations in the upper retina. the working trocars in these cases are the lower temporal and upper nasal The membrane...

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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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Small-gauge Endodiathermy Probe As An Aid to Elevate Tractional Membranes in eyes with Diabetic Traction Retinal Detachment

Purpose: Diabetic traction detachment (DTRD) can differ in severity. Systemic control and medication is very important and may play a role in intraoperative and postoperative follow-up. One important complication during surgery is bleeding; when this cannot be controlled effectively during pars plana vitrectomy, it can cause difficulty in membrane dissection, and even complicate the procedure with retinal tear formation. Preoperative...

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Comparison of Clinical Outcomes of 25 and 23 Gauge Vitrectomy for PDR

Poster Mehmet Onen Purpose: To compare anatomical and functional outcomes of 25 gauge and 23 gauge transconjunctival sutureless vitrectomy (TSV) for treatment of proliferative diabetic retinopathy (PDR). Methods: Retrospective review of 81 consecutive eyes from 81 patients undergoing 25 gauge and 23 gauge TSV with a minimum of 6-month follow-up (vitreous hemorrhage (VH), n=51; tractional retinal detachment (TRD), n=30). Vitrectomy was...

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Clinical Outcomes According to Silicone Oil Removal Timing in PDR

Advantages: To evaluate the visual prognosis and the occurrence of complications after different terms of silicone oil removal (SOR) in proliferative diabetic retinopathy (PDR). Methods: 21 patients who underwent SOR less than 3 months and 12 patients more than 6 months were included in this retrospective study. The length of silicone oil retention in the eye, visual acuity (VA) and intraocular pressure (IOP) prior to the SOR procedure...

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The Appropriate Timing of Pars Plana Vitrectomy After Pretreatment with Intravitreal Bevacizumab for Proliferative Diabetic Retinopathy

Purpose: The purpose of this study was to determine the appropriate timing of pars plana vitrectomy after pretreatment with intravitreal bevacizumab (IVB) for proliferative diabetic retinopathy using histopathological examination of epiretinal membrane biopsies. Material & Methods: This prospective study was conducted in Maghrabi Eye Hospital & Kuwait University Hospital, Sana, between January 2009 – May 2010. Forty...

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23 Gauge Probe Surgery in Severe Proliferative Diabetic Retinopathy

Technological advances in 23 gauge probe design and vitrectomy machines, allowed the use of the probe to perform many intraoperative techniques and manipulations during complex diabetic vitrectomy. The aim of this work is to describe techniques for using the 23 gauge vitrectomy probe to manage complex diabetic vitrectomy. 120 eyes with severe complications of proliferative diabetic retinopathy were included in this work. They include cases...

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Limited Surgery in Diabetic Retinopathy

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Severe PDR Surgical Strategy

Advantages: Management of severe proliferative diabetic retinopathy is one of the most difficult medical problems of the present time. Methods: We would like to present 10 patients between 25-60 in whom control of diabetes has been unsatisfactory.  Fundus examination, in all of cases showed the final stage of diabetic retinopathy with vitreous hemorrhage, persistent macular edema, new vascular network, huge fibro – vascular...

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Miniinvasive Vitrectomy as a Gold Standard for Severe PDR

Advantages: To examine whether 25 gauge vitrectomy might be a good approach for the treatment of severe proliferative diabetic retinopathy (PDR) and macular edema. Methods: 11 patients with severe PDR and macular edema were randomized to either 23 or 25 gauge vitrectomy. The 25 gauge vitrectomy was performed with bimanual technique, 27 gauge chandelier illumination, Tano diamond dusted scraper. 5 patients underwent 23 gauge vitrectomy...

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Clinical Outcomes of Ultrahigh-speed 23 G with Duty Cycle Control System in the Treatment of PDR Complicated by Tractional RD

Clinical Outcomes of Ultrahigh-speed 23 G with Duty Cycle Control System in the Treatment of PDR Complicated by Tractional RD Jung Ho Lee Advantages:          Dealing with vitreous of detached retina with fibrovascular proliferation and traction complicated by proliferative diabetic retinopathy is a challenge. A higher cutter rate may minimize vitreous turbulence by allowing only small bits of vitreous to enter the port,...

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Preoperative Intravitreal Bevacizumab in Diabetic Tractional Retinal Detachment

Satyen Deka, H Bhattacharjee, H Deka, M J Barman, R Saibum, S M Das (Guwahati, India) Advantages: Preoperative intravitreal bevacizumab in diabetic tractional retinal detachment (TRD) facilitates surgery, decreases the intraoperative bleeding and improves the visual acuity. Methods: In this non comparative interventional case series 10 eyes of 8 candidate diabetic TRD patients received 1.25 mg intravitreal off level bevacizumab 2-7 days...

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Techniques and Results of En Bloc Perfluorodissection for Tractional Retinal Detachment in Proliferative Diabetic Retinopathy

Shaheeda Mohamed*, Tsang Chi Wai (Hong Kong, China) Advantages: Retinal stability during hyaloid removal, better visualization of structures, assists dissection of fibrous membranes, facilitates endolaser of stabilised retina under tamponade, limits and confines blood. Methods: Prospective interventional case series of 13 eyes with tractional retinal detachment using en bloc perfluorocarbon dissection technique. Videos will be...

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Four in One 25 G Vitreoretinal Surgery in Advanced Proliferative Diabetic Retinopathy Treatment

Kh.P. Takhchidi, S.S. Tillyakhodzhaev, A.A. Gorin, A.N. Bessarabov (Moscow, Russia) Surgical treatment of proliferative diabetic retinopathy (PDR) using 25-Ga technology requires the employment of special instruments for epiretinal membrane peeling and dissection of fibro-vascular proliferations – endovitreal spatula, forceps and scissors, but this technique has a lot of disadvantages. The change of instruments requires the...

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Unwanted Effects Following Intravitreal Bevacizumab (Avastin) as an Adjuvant to PRP in Proliferative Diabetic Retinopathy

Dae Young Lee, Suk Ho Moon, Sang Woong Moon, Dong Heun Nam, Hae Jung Paik (Incheon, South Korea) Advantages: To report the unwanted effects after intravitreal Bevacizumab injection as an adjunctive treatment to Panretinal Photocoagulation (PRP) for high-risk Proliferative Diabetic Retinopathy (PDR). Methods: The study was a retrospective chart review of patients with unwanted adverse effects (TRD, vitreous hemorrhage) following...

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Evaluation of Phacoemulsification, Vitrectomy, IOL Implantation for Complications of Proliferative Diabetic Retinopathy

Hussein K. Elgendy (Jeddah, Saudi Arabia) Advantages: To evaluate the effectiveness and safety of combined phacoemulsification, pars plana vitrectomy (PPV), and intraocular lens (IOL) implantation in complicated proliferative diabetic retinopathy (PDR) patients. Methods: The results of combined operation of phacoemulsification pars plana vitrectomy (PPV) and foldable IOL implantation in 38 eyes of 38 patients with cataract and...

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Why Intravitreal Avastin Injections are Useful before Pars Plana Vitrectomy in Diabetic Patient and When

Nabil Abdulghani Taresh Ali, Amin A. Okbah, Ahmed Labib, Basma Alrefaei (Sanaa, Yemen) Purpose: To detect the role of intravitreal Avastin injection before pars plana vitrectomy in diabetic patients and when doing operation after Avastin injection. Material and methods: 40 patients with advanced proliferative diabetic retinopathy with tractional retinal detachment (TRD) and vitreous hemorrhage. Best corrected visual acuity Slit lamp...

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Transconjunctival Sutureless Vitrectomy for the Treatment of Vitreoretinal Complications in Diabetic Patients

Yusuf Akar, K. Cemil Apaydin, Mustafa Unal, Erkan Coban, Koray Demir, Koray Ahat, Meryem Guler, Pinar Tavas (Antalya, Turkey) Advantages: 23 Gauge transconjunctival sutureless vitrectomy appears to be a feasible option in treating vitreoretinal complications in diabetic patients, with the potential benefit of reducing postoperative ocular irritation. Methods: Seventy four eyes of 76 consecutive patients with diabetes mellitus who...

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Intravitreal Avastin Prior to Vitrectomy and Removal of Advanced Diabetic Tractional Membrane

http://www.evrs.eu/medias/2010/videos/AhmedIbrahim_1_VP6_768K.flv Ahmed Ibrahim (Jeddah, Saudi Arabia) Advantages: Intravitreal Avastin Injection one Week prior to Vitrectomy and Removal of Advanced Diabetic Tractional Membrane Make It Easy to Sissect, Peel and Bleeding is less. Methods: Intravitreal Avastin injection done. And after one week 20 Gage pars plana vitrectomy performed with use of 23 Gauge curved needle and scissors to peel,...

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Pars Plana Vitrectomy and Epiretinal Membrane Peeling in Cases of Vitreous Hemorrhage with Tractional Retinal Detachment

http://www.evrs.eu/medias/2010/videos/MohamedElDeeb_1_VP6_768K.flv Mohamed El-Deeb (Cairo, Egypt) Advantages: This video shows the classic surgical steps for management of cases of diabetic vitreous hemorrhage with tractional retinal detachment. If the surgeon masters these steps, he will achieve very satisfactory surgical results. Methods: This video shows the classic surgical steps for management of vitreous hemorrhage with tractional...

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25 Gauge Vitrectomy – An Effective Method for Sutureless Diabetic Vitrectomy

http://www.evrs.eu/medias/2010/videos/AbhijitChattopadhyay_VP6_768K.flv Abhijit Chattopadhyay, Chirag Bhatt, Soumen Mandal, Shubhankarsri Paul (Kolkata, India) Advantages: 25 Gauge sutureless methods allow early ambulation and quick recovery. This system also helps in better maintenance of intra-ocular pressure thus reducing the intra-operative bleeding. The hospital staying time also got reduced remarkably. The lid swelling and...

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Bimanual Vitrectomy – A Safer Way to Manage Severe Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/videos/ChiragBhatt_1_VP6_768K.flv Chirag Bhatt, Aniruddha Maiti, R. C. Paul, P. K. Chatterjee, Aditya Kelkat, Abhijit Chattopadhyay (Kolkata, India) Advantages: Diabetic retinopathy is one of the leading causes of blindness in the world. Vitrectomy may not only remove vitreous hemorrhage but also prevent or relieve traction on the retina from contraction of the fibrovascular membranes that characterize severe...

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23 Gauge for Proliferative Diabetic Retinopathy: It Has to Be!

http://www.evrs.eu/medias/2010/videos/EnricoBertelli_VP6_768K.flv Enrico Bertelli, Paolo Pelanda (Bolzano, Italy) Advantages: 23 Gauge transconjunctival vitrectomy is a minimally invasive vitreoretinal technique that offers the advantages of sutureless surgery combined with the benefits of a sturdy instrumentation, this latter feature making it potentially suitable for a large number of indications. Methods: The video highlights the ample...

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25 Gauge Vitrectomy Techniques for Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/videos/FlorianBalta_VP6_768K.flv Florian Balta (Bucharest, Romania) Advantages: Reduction of the surgically induced trauma to the ocular tissue and reduction of the operative time. Methods: Removal of the membranes in proliferative diabetic retinopathy (PDR) using 25 Gauge instruments: the vitreous cutter is used at 5000 cuts / min (Constellation Alcon) either alone or combined with an intraocular forceps in...

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Proliferative Diabetic Retinopathy: Principles and Techniques of Vitreoretinal Surgery

Hassan Mortada (Cairo, Egypt) Introduction: Diabetes mellitus is the most common cause of proliferative vascular retinopathy which also includes retinal venous occlusive disease, sickle cell retinopathy and retinopathy of prematurity. The underlying abnormality in these disorders is retinal ischemia, which may ultimately lead to the formation and contraction of proliferative fibrovascular membranes with subsequent vitreous hemorrhage and...

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Vitrectomy with ILM Peeling vs without ILM Peeling for Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Dominik Odrobina, Sławomir Cisiecki, Krzysztof Dzięgielewski, Zbigniew Pikulski, Janusz Michalewski, Zofia Michalewska, Jerzy Nawrocki (Lodz, Poland) Advantages: To analyze the effect of internal limiting membrane (ILM) peeling on the anatomical and functional outcomes in patients undergoing vitrectomy for proliferative diabetic retinopathy with vitreous...

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Results of Combined Phacoemulsification, IOL Implantation and 23 Gauge Vitrectomy for Complications of Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Mushfig Karimov (Baku, Azerbaijan) Purpose: Data of 12 patients (12 eyes) with diabetes mellitus, who underwent phacoemulsification, IOL implantation and 23 Gauge pars plana vitrectomy for complications of proliferative diabetic retinopathy were analyzed. Follow-up ranged from 3 to 9 months. Results: Overall, visual acuity improved in 11 of 12 eyes (91.7%), in 9...

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25 Gauge Vitrectomy as the Gold Standard for Severe PDR

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Cesare Forlini (Ravenna, Italy), Matteo Forlini (Modena, Italy), Adriana Bratu (Ravenna, Italy), Paolo Rossini (Ravenna, Italy) Advantages: To examine whether 25 Gauge vitrectomy might be a good approach for treatment of severe proliferative diabetic retinopathy (PDR) and macular edema. Methods: 31 patients with severe PDR and macular edema were randomized to...

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Vitrector vs Bimanual Technique for the Surgical Treatment of Proliferative Diabetic Retinopathy: Is the New Always the Best?

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Barbara Parolini, Grazia Pertile (Verona, Italy) The new gauges and vitrectomy machines are leading to a wider use of the vitrectomy probe for various and finer surgical steps. The 23, 25, and 27 Gauges seem to be able to substitute the scissors for peeling and cutting membranes in PVR and PDR. However this talk is designed to present some surgical scenarios of...

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Microincision Vitrectomy Surgery (MIVS) to Treat Complications of Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Vito Primavera, Isabella Turco, Francesco Prascina, Nicola Delle Noci (Foggia, Italy) Advantages: To compare the effectiveness and safety of 25+  (Alcon, CONSTELLATION® Vision System) and 23 Gauge (Alcon, Accurus® Surgical System) MIVS in the management of vitreoretinal complications in patients with diabetic retinopathy. Methods: 34 consecutive patients...

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The Advantages of 20 Gauge Vitrectomy in Advanced Proliferative Diabetic Retinal Detachments

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Theodoros Potamitis, Yianna Antoniou (Limassol, Cyprus) Advantages: Although 23 Gauge and 25 Gauge vitrectomy systems have recently revolutionized our surgical techniques in many retinal pathologies, in our most complicated cases of tractional retinal detachments the advantages conferred by the use of 20 Gauge instruments outweighs the benefits of smaller gage...

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New Vitrectomy Technique in PDR

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Carl Claes (Antwerp, Belgium) Advantages: A new technique is presented to perform vitrectomy under stable intra-ocular conditions, within 2mmHg variation. This is very useful in cases with neovascularization and a high bleeding tendency intra-operatively, as in proliferative diabetic retinopathy. Methods: New, one step valved 23 Gauge trocars are used in...

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24 Hours Preoperative Intravitreal Bevacizumab (Avastin) for Repair of Retinal Detachment in Eyes with Active Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Hassan Mortada (Cairo, Egypt) Advantages: Preoperative intravitreal Avastin injection produces significant reduction of retinal neovascularization. This dramatic effect may be related to its activity against all isoforms of VEGF. However, intravitreal Avastin injection is not without complications. It may lead to contraction of the fibrovascular tissue with...

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Efficacy of Intravitreal Triamcinolone Acetonide Injection in Treating Refractory Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Arwa Azmeh, Judi Abdin (Damascus, Syria) Advantages: To evaluate the efficacy of intravitreal triamcinolone acetonide injection (IVT) in causing regression of new vessels activity in proliferative diabetic retinopathy (PDR) refractory to pan retinal photocoagulation (PRP). Methods: 11 eyes of 10 patients with type 2 diabetes and active PDR refractory to PRP...

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Efficacy of Intravitreal Bevacizumab in Treating Refractory Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Arwa Azmeh, Wafi Maihoub (Damascus, Syria) Advantages: To evaluate the efficacy of intravitreal Bevacizumab  (IVB) injection in causing regression of new vessels activity in patients with proliferative diabetic retinopathy (PDR) refractory to pan retinal photocoagulation (PRP). Methods: 32 eyes of 23 patients with type 2 diabetes and active PDR refractory to...

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Laser Coagulation in Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Ivan Fiser (Prague, Czech Republic) Advantages: We should never stop warning against too extensive and destructive laser treatment in PDR. Modern lasers enable an effective coagulation of the RPE, still favoring the neuroretina. We have a suspicion that too extensive treatment with heavy burns can even cause an inflammation that stimulates the VEGF and the...

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Is Surgery of Late Complex Proliferative Diabetic Retinopathy Always Justified?

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Majed Bakjaji, Abdelouahed Amraoui, Adil Mchachi (Casablanca, Morocco) Advantages: Reduced risk of development of neovascular glaucoma, recurrent vitreous hemorrhage, tractional retinal detachment, combined tractional rhegmatogenous retinal detachment, and severe fibrovascular proliferation, improved visual outcome. Methods: Two groups of patients with late...

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Recurrent Diabetic Vitreous Hemorrhage: The Best Time for Anti-VEGF Injection to Avoid Recurrent Postoperative Hemorrhages

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Mario R. Romano, C. Costagliola, P. Vinciguerra (Milan, Italy) Advantages: Intravitreal Bevacizumab is efficacious as pre-operative adjuvant treatment rather than intra-operative, for the management of recurrent postoperative hemorrhages in patients with advanced proliferative diabetic retinopathy (PDR). Methods: The patients were divided in two groups: Group A...

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The System of Dynamic Follow-Up and Treatment Tactics of Late Post-Vitrectomy Vitreous Hemorrhages in Diabetic Patients

http://www.evrs.eu/medias/2010/congress/Proliferative-Diabetic-Retinopathy.flv Sergey V. Nosov, Victor N. Kazaikin (Ekaterinburg, Russia) Advantages: The developed system of dynamic follow-up and treatment tactics including choice of additional operation techniques in patients with late post-vitrectomy diabetic vitreous hemorrhages (PVDVH) takes into consideration the character of sclerotomies healing and course of diabetes. Methods: The...

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Chronic and Hemorragic Retinal Detachment im Proliferant Diabetic Retinopathy

http://www.evrs.eu/medias/2009/videos/DanielVilaplana_2_VP6_768K.flv Authors: Daniel Vilaplana, Vladimir Poposki, Isaac Alarcon, D. Martin, M. Castilla, Barcelona, Spain Advantages: A 65-year-old homeless man with hand movements vision in his left eye for a long period (the patient was unaware of this). He has been recently diagnosed with advanced diabetes mellitus. He suffered from high-risk proliferation with a chronic and haemorrhagic...

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Pars Plana vitrectomy Results in Proliferative Diabetic Retinopathy

Authors: Zeliha Yazar, Nil Irem Ucgun, Mehmet Onen, Turan Kayik, Ankara, Turkey Advantages / Purpose: The evaluation of pars plana vitrectomy (PPV) surgery results on proliferative diabetic retinopathy (PDR) cases. Methods: One hundred and sixteen eyes of 90 PDR cases were examined retrospectively. Their age was between 20 and 83; 51 were females (56%) and 39 were males (44%). Their ocular features, pre and postoperative visual acuity and...

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Vitreous Cavity Hemorrhages and Fibrovascular Ingrowth after Primary 25 Gauge Vitrectomy in Diabetic

http://www.evrs.eu/medias/2009/congress/Proliferative-Diabetic-Retinopathy.flv Authors: Sergey V. Nosov, A.N. Varaksin, Yekaterinburg, Russia Advantages: Multiple investigators reveal fibrovascular ingrowth (FVIG) and anterior hyaloidal fibrovascular proliferation (AHFVP) at UBM of former sclerotomy sites after primary vitrectomy in diabetic patients. It is considered that FVIG and AHFVP are the reason of postvitrectomy diabetic vitreous...

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New Generation 25 Gauge Vitrectomy for Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2009/congress/Proliferative-Diabetic-Retinopathy.flv Authors: Vito Primavera, Isabella Turco, Giuseppe Schiena, Francesco Prascina, Nicola Delle Noci, Foggia, Italy Advantages: To compare the feasibility and efficacy between bimanual membrane peeling technique vitrectomy (group 1) and new generation 25 gauge vitrectomy system (group 2) for treating traction retinal detachment (TRD) secondary to severe...

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Anti-VEGF (Bevacizumab) Before Vitrectomy in Severe Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2009/congress/Proliferative-Diabetic-Retinopathy.flv Authors: Stanislav Rodin, Veronika Aslanova, Nikolai Umanetz, Odessa, Ukraine Advantages: Intravitreal injection of bevacizumab before VE for severe PDR reduced hemorrhage risk and allowed to perform more effective surgery with complete and safe neovascularized ERM removal. Methods: The results of treatment of 17 patients (18 eyes) (20-67 y/o, 7 males, 10...

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Avastin in Complicated Diabetic Retinal Detachments

http://www.evrs.eu/medias/2009/congress/Proliferative-Diabetic-Retinopathy.flv Author: Maria H. Berrocal, San Juan, Puerto Rico Advantages: Preoperative Avastin reduces intraoperative complications and surgical time in complex diabetic retinal detachments. Methods: In this prospective study, 48 eyes undergoing pars plana vitrectomy for tractional (Group 1) and combined tractional and rhegmatogenous (Group 2) retinal detachment secondary to...

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The Results of 20 Gauge and 23 Gauge Vitrectomy Combined with Phacoemulsification after Intravitreal Bevacizumab Injection in Tractional Retinal Detachment with Proliferative Diabetic Reinopathy

http://www.evrs.eu/medias/2009/congress/Proliferative-Diabetic-Retinopathy.flv Author: Hulya Gungel, Istanbul, Turkey Advantages: To reduce intraoperative bleeding. Methods: Forty-nine patients with tractional retinal detachment were studied retrospectively. To 23 patients 20 G PPV, to 26 patients 23 G MIVS combined with phacoemulsification were applied. They had tractional retinal detachment with macular involvement, rhegmatogenous retinal...

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New Molecules Involved in Progression of Diabetic Retinopathy – Biochemical Analysis of Human Vitreous

L Kotilova, B Kalvodova (Dept. of Ophthalmology, General Teaching Hospital in Prague, Czech Rep), M Kalousova, H Benakova, T Zima (Dept. of Biochemistry and laboratory Diagnostics, General Teaching Hospital in Prague, Czech Rep), A Kubena (Faculty of Pharmacy, Charles University, Prague, Czech) Advantages: Vitreous is currently used for clinical research assessing the vitreoretinal interface. Increased vascular permeability and breakdown...

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Intravitreal Avastin and 25 Gauge Vitrectomy in Treating Active Form of Proliferative Diabetic Retinopathy

Bikbov M.M., Altynbaev U.R. Purpose: To study anatomic and functional findings of 25G vitrectomy combined with preoperative intravitreally injected Avastin in patients with active form of proliferative diabetic retinopathy (PDR). Material & Methods: 9 patients (10 eyes) with PDR accompanied with expressed retinal neovascularization were included into investigation. Tractional retinal detachment was found in 8 cases, tractional and...

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My Way of Treating Proliferative Simultaneous Diabetic Retinopathy and Diffuse Diabetic Macular Edema in Young Patients: Triple Therapy

Pina Marin Begoña, Escobar Barranco José Juan, Fernández Bonet Manel Advantages: Sequenced triple therapy with anti Vascular Endothelial Growth Factor (antiVEGF) followed by complete photocoagulation and intravitreal triamcinolone allows treating diffuse diabetic macular edema, the most important factor regarding final visual acuity, without neglecting the treatment of neovascularization, the primary responsible of ocular integrity;...

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Cryotherapy of Sclerotomy Sites May Increase the Risk of Late Post-Vitrectomy Diabetic Hemorrhage

http://www.evrs.eu/medias/2008/congress/Cryotherapy-of-Sclerotomy-Sites-May-Increase-the-Risk-of-Late-Post-Vitrectomy-Diabetic-Hemorrhage.flv Morteza Entezari, Alireza Ramezani, Hamid Ahmadieh, Pejman Bakhtiari, Mehdi Yaseri (Ophthalmic Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran) Advantages: To present the disadvantages of cryotherapy of sclerotomy sites in prevention of late (after 4 weeks)...

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Dissection of Proliferative Diabetic Retinopathy Using the Vitreotome with Flow Control

http://www.evrs.eu/medias/2008/congress/Dissection-of-Proliferative-Diabetic-Retinopathy-Using-the-Vitreotome-with-Flow-Control.flv Jean-François Le Rouic, Frank Becquet, Didier Ducournau Advantage: The precise aspirating flow control of recent vitrectomy machines and the reduction of the vitreotome port allow for a selective grasping and cutting of preretinal proliferations. This technique reduces the need for iterative exits through the...

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Evaluation of Air as a Retinal Tamponade During Vitrectomy in Eyes with Diabetic Tractional or Combined Tractional Rhegmatogenous Detachment

Ashraf Shaarawy, MD (Alexandria, Egypt) PURPOSE: To determine wether air is an efficient retinal tamponade to treat either iatrogenic or rhegmatogenous breaks during diabetic vitrectomy.Air has a short duration of retinal tamponade. However, the use of intravitreal triamcinilone(TAAC) and intraoperative BIOM had improved our ability to completely remove the posterior hyaloid,vitreoschisis and fibrovascular proliferation and all the exerted...

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Microelements in Eyes with Proliferative Diabetic, Traumatic Retinopathy and Detached Retina

Andriy Sergienko, MD (Kiev, Ukraine) PURPOSE: To evaluate role of microelements in development of proliferative retinopathy of different pathogenesis. METHODS: Seventy seven eyes with retinal detachment, 51eyes with proliferative diabetic retinopathy and 25 eyes traumatic retinopathy were included in this study. Thirty postmortem human eyes served as a control. Intraoperatively taken vitreous and subretinal fluid was used for the...

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Subthreshold Diode Micropulse Panretinal Photocoagulation for Proliferative Diabetic Retinopathy

Jeffrey K. Luttrull, MD (Ventura, CA), David C. Musch, PhD (Ann Arbor, MI),* Charles A. Spink, CRA (Ventura, CA) PURPOSE: To report the visual and clinical outcomes of a pilot study of subthreshold diode micropulse (SDM) panretinal photocoagulation (PRP) for treatment of diabetic retinopathy. METHODS: A retrospective chart review of all patients undergoing PRP for complications of diabetic retinopathy between April 2000 and February 2003...

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Use of Perfluorocarbon Liquid During Diabetic Vitrectomy

Janice C. Law, MD (Detroit, MI), Dean Eliott, MD (Los Angeles, CA) PURPOSE: The use of perfluorocarbon liquid (PFCL) has facilitated the treatment of complex retinal detachments. The purposes of this study were to evaluate the indications for PFCL use and the anatomic and functional outcome after PFCL use during pars plana vitrectomy for proliferative diabetic retinopathy. METHODS: Retrospective review of 520 consecutive diabetic...

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Perfluorodissection in Vitreoretinal Surgery: A Novel Technique

http://www.evrs.eu/medias/2006/videos/Perfluorodissection-in-Vitreoretinal-Surgery:-A-Novel-Technique.flv J. Fernando Arevalo, MD, FACS (Caracas, Venezuela), Juan G. Sanchez, MD (Caracas, Venezuela) SYNOPSIS Improvement in surgical techniques has led to improved anatomic and functional success rates following surgery for severe complications of proliferative diabetic retinopathy (PDR) and uveitic vitreo-retinal complications. We found that...

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Efficacy of Intravitreal Bevacizumab for Severe Nonproliferative, Proliferative Diabetic Retinopathy and Active Photocoagulated Retinopathy

Jans Fromow-Guerra, MD, PhD (Mexico City, Mexico), Elizabeth Reyna-Castelán, MD (Mexico City, Mexico), Juan Manuel Jimenez- Sierra, MD (Mexico City, Mexico), Adriana Solis-Vivanco, MD (Mexico City, Mexico), Jose Luis Guerrero-Naranjo, MD (Mexico City, Mexico), Maura Abraham-Marin, MD (Mexico City, Mexico), Myriam Lucia Hernández-Rojas, MD (Mexico City, Mexico), Griselda Alvarez-Rivera, MD (Mexico City, Mexico), Maria Ana Martinez-...

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Three-port Bimanual 25-gauge Vitrectomy in Severe Diabetic Traction Retinal Detachment

Nur Acar, MD (Istanbul, Turkey), Ziya Kapran, MD (Istanbul, Turkey), Yaprak Banu Unver (Istanbul, Turkey), Tugrul Altan (Istanbul, Turkey), Bulut Ocak (Istanbul, Turkey) SYNOPSIS In this video, three-port bimanual 25-gauge transconjunctival sutureless vitrectomy (TSV) technique is demonstrated in eyes with severe diabetic traction retinal detachments. 25-gauge illuminated infusion cannula is used for bimanual surgery. Membrane delamination...

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Phacoemulsification-PPV Versus PPV Alone in Proliferative Diabetic Retinopathy

Yavuz Bardak, MD (Isparta, Turkey), Osman Cekic, MD, PhD (Isparta, Turkey), Ufuk Sahin Tig, MD (Isparta, Turkey), Aykut Arslan Yildiz, MD (Isparta, Turkey), Fadime Kendir, MD (Isparta, Turkey), Mustafa Muhterem Ekim, MD (Isparta, Turkey) PURPOSE: To investigate effectiveness and safety of combined phacoemulsification (PE) and pars plana vitrectomy (PPV) in diabetic patients. METHODS: One hundred seventeen eyes of the 117 diabetic (type II)...

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Vitreous Surgery for Recalcitrant NVG in PDR

Guruprasad S. Ayachit, MS (Hubli, India), Paul E. Tornambe, MD (Poway, CA) PURPOSE: When transpupillary laser ablation is not feasible, does direct retinal ablation by endolaser and cryotherapy result in regression of NVI, control of IOP and preservation of vision? Is the surgery fraught with any risks? METHODS: A prospective, interventional, noncomparative case series. 14 patients with PDR with no previous laser and recalcitrant NVG were...

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Intravitreal Bevacizumab (Avastin) for Proliferative Diabetic Retinopathy

J. Fernando Arevalo, MD, FACS (Caracas, Venezuela), Lihteh Wu, MD (San Jose, Costa Rica), Juan G. Sanchez, MD (Caracas, Venezuela), Mauricio Maia, MD (Sao Paulo, Brazil), Mario J. Saravia, MD (Buenos Aires, Argentina) PURPOSE: To study the effects of intravitreal bevacizumab (Avastin) on retinal neovascularization (RN) in patients with proliferative diabetic retinopathy (PDR). METHODS: Retrospective study of patients with RN due to PDR who...

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Reoperation after Diabetic Vitrectomy: Rate, Indications, Visual Outcomes, and Complications in an Urban Academic Medical Center

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...

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Pars Plana Vitrectomy Using a 25-gauge System in Patients with Proliferative Diabetic Retinopathy

John P. Denny, MD (Decatur, GA), G. Baker Hubbard, MD (Atlanta, GA) PURPOSE: Pars plana vitrectomy (PPV) is commonly performed to treat the ocular complictations of proliferative diabetic retinopathy (PDR). Recently, 25-gauge systems for PPV have been reported to decrease postoperative recovery time. This study investigates the safety and efficacy of PPV performed via a 25-gauge trocar system in a group of patients with proliferative...

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Diabetic Traction Detachment Treated with Bimanual 25g Sutureless Surgery (Is Silicon Oil Necessary?)

Athanasios Nikolakopoulos, MD (Thessaloniki, Greece), Ifigenia Panidou (Thessaloniki, Greece), Elie Fantel (Thessaloniki, Greece), Apostolos Reptsis (Thessaloniki, Greece), Dimitris Kirodimos (Thessaloniki, Greece), Nikoletta Leventi (Thessaloniki, Greece) PURPOSE: Traction diabetic retina detachments and especially the table tops with the attached vitreous have the higher incidence of iatrogenic retina tears that reduce the rate of success...

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25 Gauge Vitrectomy for Advanced Proliferative Diabetic Retinopathy: A Consecutive Case Series Including Complex Retinal Detachments

http://www.evrs.eu/medias/2006/congress/25-Gauge-Vitrectomy-for-Advanced-Proliferative-Diabetic-Retinopathy:-A-Consecutive-Case-Series-Including-Complex-Retinal-Detachments.swf Firas M. Rahhal, MD (Los Angeles, CA)* PURPOSE: The author hypothesizes that with recent advances in technology, instrumentation, and experience, 25g pars plana vitrectomy (PPV) is safe and effective for the treatment of both simple and complex cases of advanced PDR....

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Injection of Intravitreal Avastin Before Vitrectomy Surgery in the Treatment of Severe Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2006/congress/Injection-of-Intravitreal-Avastin-Before-Vitrectomy-Surgery-in-the-Treatment-of-Severe-Proliferative-Diabetic-Retinopathy.swf http://www.evrs.eu/medias/2006/congress/Injection-of-Intravitreal-Avastin-Before-Vitrectomy-Surgery-in-the-Treatment-of-Severe-Proliferative-Diabetic-Retinopathy.flv Stanislao Rizzo, MD (Pisa, Italy), Federica Genovesi-Ebert, MD (Pisa, Italy), Emanuele Di Bartolo, MD (Pisa,...

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Intravitreal Bevacizumab (Avastin) in the Treatment of Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2006/congress/Intravitreal-Bevacizumab-(Avastin)-in-the-Treatment-of-Proliferative-Diabetic-Retinopathy.swf http://www.evrs.eu/medias/2006/congress/Intravitreal-Bevacizumab-(Avastin)-in-the-Treatment-of-Proliferative-Diabetic-Retinopathy.flv Robert L. Avery, MD (Santa Barbara, CA),* Dante J. Pieramici, MD (Santa Barbara, CA),* Alessandro A. Castellarin, MD (Santa Barbara, CA), Ma-an A. Nasir, MD (Santa Barbara,...

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Pegaptanib Sodium in Diabetic Retinopathy: Improvements in Diabetic Macular Edema, Retinal Neovascularization, and Severity of Diabetic Retinopathy

http://www.evrs.eu/medias/2006/congress/Pegaptanib-Sodium-in-Diabetic-Retinopathy:-Improvements-in-Diabetic-Macular-Edema,-Retinal-Neovascularization,-and-Severity-of-Diabetic-Retinopathy.swf Victor Hugo Gonzalez, MD (Mcallen, TX) PURPOSE: Preclinical data indicate that pegaptanib, an aptamer targeting VEGF165, can reverse diabetesinduced blood-retinal barrier breakdown; clinical trials demonstrate pegaptanib’s efficacy in treating...

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Bimanual Surgery as the Golden Standard in PDR

Bimanual Surgery as the Golden Standard in PDR

Giampaolo Gini, MD (Prato, Italy) SYNOPSIS Proliferative diabetic retinopathy continues to be a major cause of blindness throughout the world. Removal of fibrovascular tractions on the retina while avoiding the possibile iatrogenic damage deriving from such manouvers, requires both a good understanding of the anatomical variations involved in each specific case as well as the possibilty of using a bimanual technique. Aim of the video is to...

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“Trimming” Technique for Advance Proliferative Diabetic Retinopathy

Arturo Santos, MD, PhD (Guadalajara, Mexico), Enrique A. Roig-Melo, MD PhD (Guadalajara, Mexico), Miguel Castellanos, MD (Guadalajara, Mexico), Iban Flores, MD (Guadalajara, Mexico), Ramon Flores-Fuentes, MD (Guadalajara, Mexico), Monica A. Ayala, MD (Guadalajara, Mexico) SYNOPSIS Performing surgery in a case of diabetic retinopathy with extensive fibrovascular tissue is a challenge and demands surgical skills and a wide variety of...

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Bimanual Surgery as the “Golden Standard” in Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2006/videos/Bimanual-Surgery-as-the-Golden-Standard-in-Proliferative-%20Diabetic-Retinopathy.flv Giampaolo Gini, MD (Prato, Italy) SYNOPSIS Proliferative diabetic retinopathy continues to be a major cause of blindness throughout the world. Removal of fibrovascular tractions on the retina while avoiding the possibile iatrogenic damage deriving from such manouvers, requires both a good understanding of the anatomical...

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Preoperative Bevacizumab in the Management of Diabetic Retinal Detachments

http://www.evrs.eu/medias/2006/videos/Preoperative-Bevacizumab-in-the-Management-of-Diabetic-Retinal-Detachments.flv Maria H. Berrocal, MD (Santurce, PR) SYNOPSIS Preoperative Bevacizumab (Avastin) combined with viscodissection and high-speed cutter vitrector reduces operative time and complications in cases of traction and traction and rhegmatogenous retinal detach-ments. Several cases are presented using this technique.

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Pre-operative Bevacizumab (Avastin) as a Surgical Adjuvant in the Treatment of Proliferative Diabetic Retinopathy

http://www.evrs.eu/medias/2006/videos/Pre-operative-Bevacizumab-(Avastin)-as-a-Surgical-Adjuvant-in-the-Treatment-of-Proliferative-Diabetic-Retinopathy.flv Robert L. Avery, MD (Santa Barbara, CA)* SYNOPSIS Preoperative Avastin is shown to be very helpful in decreasing the vascularity of PDR membranes thereby reducing the intra-operative bleeding.

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Clinical Outcome after Vitrectomy with or without Internal Limiting Membrane Peeling in Proliferative Diabetic Vitreoretinopathy Patients with Macular Edema

L. O. Hattenbach, P. N. Jentzmik, J. Puchta, Y. Sinangin, F. Koch – Klinik für Augenheilkunde, Netzhaut- und Glaskörperchirurgie, Klinikum der Johann Wolfgang Goethe Universität, Frankfurt am Main, Germany Purpose: To investigate visual recovery and clinical outcome after pars plana vitrectomy with or without internal limiting membrane (ILM) peeling in patients with macular edema associated with proliferative diabetic vitreoretinopathy...

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Management of Thick Fibrovascular Membrane with Plasma Blade

Indu Singh, MS Purpose: Management of thick fibrovascular membranes involving macular area with the present techniques lead to haemorrhage. In this paper I will talk about my experience of using Plasma blade in tackling such membranes. Methods: Plasma blade is a cutting device which utilises fourth state of matter „Plasma“. After doing pars plana vitrectomy we remove the Tractional bands with Plasma blade. The technique will be...

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