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Surgical PVD Induction Using Combined Sharp Pick and Active Aspiration

Some cases of retinal detachment particualry in young phakic patients, may not have posterior vitreous detachment (PVD). If operated by PPV, induction of PVD in these cases is mandatory. However, PVD induction by active aspiration of the vitreous cortex over the optic disc margin as usually employed in PPV surgery can be challenging in these eyes because of firmly adherent posterior hyaloid and the absence of counter traction from the...

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A Few More Tips!

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   This is a short presentation demonstrating few surgical tips including the use of the vitreous cutter as a conduit to inject fluids inside the eye during vitrectomy, tips on removing posterior dislocated IOL and explantation of scleral fixated IOL. A different technique for injection of subtenon’s anaesthesia will also be...

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Pick-assisted Diabetic Fibrovascular Membrane Delamination Rediscovered

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: To delaminate posterior pole and macular fibrovascular proliferations in eyes with severe proliferative diabetic retinopathy using a 20G modified blunt curved edged pick. Methods: The use of a 20G blunt edged pick which allows safe delamination of macular fibrovascular membranes, when a bimanual approach is not possible. In...

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Clinical, Biometrical & Refractive Results in Combined Phacoemulsification and 23 Gauge PPV

SCIENTIFIC POSTER_Roslyn Manrique Lipa Advantages: To describe the clinical, biometrical and refractive results in combined phaco-vitrectomy with 23G. Methods: 24 patients were included in this retrospective case series study. We recorded demographical and ophthalmological data which included: ophthalmic exploration before and after surgery, ocular biometric data, surgical technique, spherical equivalence before and after surgery and...

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IOL Positions Comparison Phaco vs PhacoVitrectomy

Purpose: Myopic shift is common after phacovitrectomy. One of the possible reasons is anterior displacement of the intraocular lens. This study evaluates the position of the intraocular lens after phacovitrectomy and compares the results with eyes that received phaco only. Methods: Medical records of patients who received phacovitrectomy in one eye and phaco alone in the fellow eye were analyzed. Patients with significant discrepancy in...

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Phacovitrectomy: My Way

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   I carry out all the steps of phacoemulsification first then proceed to pars plana vitrectomy (PPV). Surgical steps of my combined phacoemulsification PPV technique involve: 1. Clear corneal temporal incisions, 2. Capsulorrhexis, 3. Phacoemulsification, 4. Irrigation/ aspiration, 5. In bag IOL implantation, 6. A single 10/0 nylon...

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Comparison of Success Rate According to the Duration of Prone Positioning After MH Surgery

Poster Young-suk Chang Purpose: To investigate the optimal duration of postoperative prone positioning after macular hole (MH) surgery by the comparison of the anatomical success rate. Methods: The clinical records were reviewed of all patients treated at Kim’s eye hospital between February 1, 2006 and February 28, 201 3, for an idiopathic macular hole. Coexisting ocular disease such as glaucoma, diabetic retinopathy, retinal vessel...

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Differentiated Surgical Tactics for Idiopathic Macular Hole

Poster Ural Altynbaev An algorithm for a differentiated approach to the removal of the ILM and the choice of tamponade in surgery for stage 2 – 4 macular holes. Methods: The study included 110 patients with stage 2 – 4 idiopathic macular holes. All patients received a partial posterior vitrectomy with removal of the posterior hyaloid membrane. Then for patients with MH of up to 500 microns we aspirated fluid of bed of macular...

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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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Short-term Postoperative Non-supine Positioning vs Strict Face-down Positioning in Macular Hole Surgery

Purpose: The purpose of this study was to compare the efficacy of short-term non-supine positioning (NSP) and strict face-down positioning (FDP) in the repair of macular hole (MH). Methods: We retrospectively reviewed all MH repairs over a 27-month period (2008-2010). Inclusion criteria were idiopathic full thickness stage 2-4 MH treated by a single surgeon with 23-gauge pars plana vitrectomy, internal limiting membrane peeling and gas...

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Anatomical and Visual Outcomes of Macular Hole Surgery Using a Non-strict Posturing Regimen: 7-year Data

Purpose: To assess the anatomical and functional outcomes of macular hole surgery with pars plana vitrectomy (PPV), internal limiting membrane peeling and gas tamponade (SF6, C2F6, or C3F8) with a non-strict postoperative posturing regimen. Setting: Gloucestershire Hospitals NHS Trust, United Kingdom. Methods: Clinical and surgical data were prospectively entered into an electronic medical record (Medisoft, Leeds, UK). Data of...

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Macular Hole Surgery Without Face-down Positioning Using the Latest Vitreoretinal Techniques

Purpose: To evaluate the success rate of surgical repair of full-thickness macular holes without face-down positioning in a large series. Methods: A retrospective chart review of 81 consecutive patients with idiopathic full-thickness macular holes <750m in diameter were treated with standard surgical techniques by a single surgeon (PET). Surgical technique included 23-gauge pars plana vitrectomy, ICG-assisted peeling of the internal...

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Foveolar Surgery

Introduction: Development of micro invasive technologies expands the indications for surgical treatment of vitreomacular pathology to the point of preventive type of surgeries. Use of mercury light, allows for mechanical detachment of posterior hyaloid (PH) from the internal limiting membrane (ILM) without vitrectomy or staining in the eyes with adhesion of the PH, stage 1 macular hole (Gass classification system). Purpose: To evaluate...

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Significance of PPV with ICG-Assisted ILM Peeling of Idiopathic Macular Holes Stage 4 with Poor Visual Acuity

Introduction: To compare the results of surgery for idiopathic macular hole stage 4 and reduced baseline visual acuity with natural outcome without surgery. Methods: Retrospective, nonrandomized, comparative study of consecutive case series with 19 eyes with idiopathic macular holes stage 4 and baseline visual acuity ≤0.2 (6/30) who underwent pars plana vitrectomy with ICG-stained ILM peeling to compare anatomical and visual outcome...

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Tano Scraper for ILM Peeling: Technique & Results

ILM peeling in idiopathic macular hole surgery is crucial to achieve high anatomical and functional success rate. ILM peeling may be done using special ILM forceps or Tano scraper. The purpose of this work is to describe the technique of using the Tanoscraper to start and peel the ILM in eyes with idiopathic macular holes (IMH). 35 eyes with idiopathic macular hole underwent vitrectomy, posterior hyaloid peeling, ILM peeling using the...

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Temporal Inverted Internal Limiting Membrane Flap for Macular Hole

Advantages: To present a new surgical technique, in which Internal Limiting membrane (ILM) is not removed only in the papillomacular bundle during vitrectomy for macular hole. Methods: This is a prospective study of 80 eyes of 80 patients. 40 eyes with macular holes were operated with the Inverted ILM technique (Group 1). 40 eyes were operated with modification of this technique, in which ILM was removed only on the temporal side of the...

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Reviewing the Main Steps in Macular Hole Surgery

Macular hole surgery has gone through many transformations as our understanding of the possible causes for the disease improved and the outcome of different techniques were compared. From complete posterior hyaloid detachment to face-down positioning, what seems to be really necessary and what is not? This paper tries to find answers to these questions through a rational approach sustained by...

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The Use of Complete Vitrectomy and ILM Peeling Using Infracyanine Dye + 0.8 ml Sf6 and 3 Days Gas Tamponade with Face-down Positioning in the Closure of Idiopathic Macular Hole: Our Experience

Methods: 23g valved trocars, no chandelier lights. Core vitrectomy, creation of PVD using Triamcinolone. Vitrectomy in medium periphery, ERM peeling without dyes, ILM peeling till vascular arcades using Infracyanine dye for 30 sec, confirmation of complete peeling using a second and eventual third dying with Infracyanine. Complete peripheral vitrectomy using Triamcinolone with particular attention at the sclerotomy sites. The peripheral...

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30 Gauge Pars Plana Surgery in Recurrent Vitreous Hemorrhage: The Micro-invasive Technique

Advantage: Recurrent vitreous hemorrhage is common after vitrectomy which needs repeat surgery. Repeat intervention using standard technique is associated with considerable inflammatory response and delayed visual recovery that calls for a less invasive technique. The micro-invasive 30 gauge surgery for recurrent vitreous hemorrhage is safe, and effective. Methods: In this pilot study seven eyes of six patients underwent two-port 30...

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My Personal Technique of Peeling Idiopatic Epiretinal Membranes

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

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27 Gauge One Pars Plana Port Vitrectomy with a Reflow Strategy for Macular Diseases and Beyond

Advantages: To report our results for macular hole using anterior chamber infusion during the reverse zonular flow “Reverse flow“ (personal technique) one port pars plana 27 gauge vitrectomy technique. Methods: A retrospective analysis of 10 eyes which underwent re-flow one port 27 gauge vitrectomy with the infusion in the anterior chamber for macular hole. This technique was used to decrease the turbulence of fluids in the vitreous...

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Atraumatic ILM Peeling Without Forceps

Advantages:  An atraumatic ILM peeling is performed using the vacuum of the vitreous cutter, without a forceps, thus it is not traumatizing the retinal nerve fiber layer. Methods: This technique can be used both in 20 gauge and in 23 gauge, or 25 gauge surgery, in three different modes: either, the ERM is peeled using a traditional forceps; the ILM is usually partly removed, too; after another staining, the ILM is peeled using the...

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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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Aspirating Forceps

One of the specifications which can lead to a vitreoretinal incarceration is a high number of entries / exits in the sclerotomy, especially when the anterior vitreous around the sclerotomy is not removed. In order to reduce this risk, the author uses a forceps which contains a tubing connected to the vitrectomy machine pump. This tubing allows: to inject the ILM blue to remove the ILM blue to evacuate small pieces of membrane / ILM just...

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Creative Package for Macular Surgery

I perform macular maneuvers now using the following package: 1. Chandelier illumination. 2. Aspheric macular contact lens 3. 23 gauge needle for creating the ILM flap 4. Clamping the infusion cannula during the BBG stain injection. The chandelier allows for satisfactory illumination with a free second hand that stabilizes the working hand and thus provides stability, precision, control and dexterity. But positioning and redirecting by the...

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Fashioned Instruments for 23 Gauge Vitrectomy

We have to perform our surgical techniques with utmost efficacy, widest safety margin, and least cost. Some instruments can be fashioned oneself in a way that achieves all targets of 23 gauge vitrectomy: 1. Intravitreal triamcinolone acetonide cannula 2. Heavy liquid (PFC) cannula 3. 23 gauge needle pick 4. Silicone oil cannula 5. Non-bent 23 gauge needle for ILM flap creation. By being able to fashion some simple instruments one can t...

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Modification of Vitreoretinal Instruments: Perfection or Complication

Advantages: To reduce the disadvantages of standard vitreoretinal instruments (cannulas and ILM forceps) which arise during the use on eyes with long axial length. Methods: Two types of aspiration cannulas and one ILM forceps for surgery on eyes with long axial length were designed on schematic eye drawing and manufactured. Forty-four eyes with high-grade myopia (axial length 28-33.5 mm) were operated for retinal detachment and macular...

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Limited Surgery in Diabetic Retinopathy

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A New and Different Idiopathic ERM Peeling Technique

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

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Hybrid 27 / 25 Gauge Vitrectomy for Macular Surgery with Flow Control

The authors present  an update of hybrid vitrectomy 27/25 gauge, compared to their previous 25/23 gauge surgery for vitreomacular diseases. It compares parameters with flow control, trying to evaluate maximum possibilities of such a 27/25 gauge system. Flow control appears to be a”must have” for developing such...

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Modified Vitreo Retinal Instruments for Macular Surgery on Eyes with High Myopia

Advantages: To improve certain vitreo-retinal instruments to enhance the accesses to posterior pole and avoid complications during macular surgery in highly myopic eyes. Methods: Modified double bent aspiration 23-gauge cannula with 30.00 mm working part was used during pars plana vitrectomy in highly myopic eyes. The aspiration of residual PFCL or BSS with modified cannula was performed under visual control using different kinds of...

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Video – 25g Sutureless Surgery for Macular Pucker

SYMPOSIUM: SUTURELESS VITRECTOMY Moderator: Anne-Catherine Gribomont Tuesday, June 21, 2005   25g sutureless surgery for macular pucker Author: A. Nikolakopoulos, I. Panidou, E. Fantel, E. Psimenidou, A. Vakalis Abstract : Purpose: To present a new system for 25g sutureless vitrectomy using high vacum for a quicker and safer result. Methods: In our clinic in Thessaloniki we are trying to modify our technique for macular surgery by...

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Congress – The challenge of retinal transplantation.

on SYMPOSIUM: ARMD SURGICAL APPROACH Monday, June 20, 2005 ; 8:30 – 1:15 The Challenge of Retinal Transplantation Author: Peep V. Algvere, M.D., Ph.D., Relya Zivojnovic Award Abstract : Since several retinal diseases and dystrophies exhibit apoptotic cell death of photoreceptors and/or RPE cells, transplantation of young and healthy cells has been most desirable to replace the diseased tissue. A remarkable achievement was the...

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Congress – One Port VPPV for the treatment of Epimacular disorders: Slit Lamp and new Anterior Chamber Maintain

SYMPOSIUM:MACULA POT POURRI Moderator: Khaled El-Rakhawy Sunday, June 19, 2005 One port VPPV for the treatment of epimacular disorders: Author: Cesare Forlini, MD, Paolo Rossini, MD, Giuseppe Giunchiglia, MD, Barbara Campanini, MD, Department of Ophthalmology – Ravenna Hospital Viale V. Randi, 5 48100 Ravenna, Italy Abstract : Purpose: This presentation shows a personal technique of one port VPPV for the treatment of epiretinal...

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Electronic System for Postoperative Monitoring of Patient’s Head Position after Vitreoretinal Surgery

Radek Girgle, Igor Vicha, Eva Vlkova, Jiri Rozman, Martin Cizek, Jiri Dlouhy (Brno, Czech Republic) Advantages: Team of ophthalmologists and bioengineers presents the final version of a three-year development of a new electronic system helping the patients to keep the head in optimal position after vitrectomy. A head mounted device continually monitors the head position and immediately warns the patient whenever the position of the head...

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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...

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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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The Effect of Mydriatics on Posterior Synechia after Combined Pars Plana Vitrectomy, Phacoemulsification, and Intraocular Lens Implantation

Kim, Jung-Yeul Purpose: To evaluate the postoperative frequency and severity of posterior synechia after combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation in different groups using long-acting and short-acting mydriatics. Design: Prospective, randomized, controlled trial. Participants: A total of 69 eyes in 69 patients with rhegmatogenous retinal detachment and cataracts. Methods: All patients underwent...

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A New Electronic System for Postoperative Monitoring of Patient Head Position

Igor Vicha, Eva Vlkova, Radek Girgle (Department of Ophthalmology, Masaryk University and University Hospital, Brno, Czech Republic), Jiri Rozman, Martin Cizek, Jiri Dlouhy (Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, University of Technology, Brno, Czech Republic) Advantages: A new electronic system helps patients to keep their heads in optimum position after vitrectomy (firstly with gas). A...

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Interface Vitrectomy

http://www.evrs.eu/medias/2006/congress/Interface-Vitrectomy.swf Steve T. Charles, MD (Memphis, TN)* PURPOSE: To demonstrate that all vitreoretinal surgery techniques can be performed under air, PFO or silicone oil and that this is often advantageous. METHODS: Retrospective review of charts, operative notes, and surgical videos. Prospective, consecutive series of medium term PFO use and surgery under silicone will be discussed. Critical...

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Learning Curve for Scleral Buckling Operation: Lessons from the First 80 Cases

Woo Hyok Chang, (Daegu, South Korea) PURPOSE: To provide an insight into the learning curve of ophthalmologist in fellowship course associated with scleral buckling procedure and to determine risk factors affecting outcomes during this period. METHODS: Prospective data were collected on 80 consecutive scleral buckling operations alone performed by author over a 22-month period, beginning with his first year fellowship course. All patients...

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Surgical Management of Vitreo-retinal Proliferation

http://www.evrs.eu/medias/2006/videos/Surgical-Management-of-Vitreo-retinal-Proliferation.flv Jeroni Nadal, MD (Barcelona, Spain) SYNOPSIS Techniques and surgical manoeuvres are presented in the management of proliferative vitreo-retinophaty (PVR) including unimanual and bimanual surgery. Special procedures like peeling under perfluoro-carbon, use of biological stains to visualize the different proliferative menbranes, and viscosurgery to...

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New Devices for Vitreoretinal Surgery

Carl C. Awh, MD (Nashville, TN)* PURPOSE: To demonstrate the efficacy of new devices for vitreoretinal surgery, including the following: an improved chandelier illuminator, “one-step” insertion cannulas for 23- and 20-gauge vitrectomy, an intraocular fluid micro-injector, and an improved endoillumination source. To compare these devices to previously existing devices. METHODS: The following devices were used during a variety of...

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25-gauge Vitrectomy (from the Outside…)

Luiz Eduardo de Aguiar Marques, MD (Irvine, CA), Faisal Jehan, MD (Irvine, CA), Bogdan Alexandrescu, MD (Irvine, CA), Baruch D. Kuppermann, MD, PhD (Irvine, CA)* SYNOPSIS We show 25-gauge surgeries with an emphasis on external aspects and our technique of tunnelled incisions. We also demonstrate situations that may occur during surgery (cannulas coming out, suturing…). Internal limiting peeling in a diabetic patient, aqueous...

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Lost in Vitrectomy. South of the Border Approach!

http://www.evrs.eu/medias/2006/videos/Lost-in-Vitrectomy-South-of-the-Border-Approach.flv Virgilio Morales-Canton, MD (Mexico City, Mexico) SYNOPSIS This video shows different techniques that can be used on some surgical steps of the vitrectomy proce-dure. What to do with small pupils when you don’t have iris hooks? How to survive and have a successful case when the instrumentation is not the best?

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A New Surgical Approach in the Management of Posteriorly Dislocated Intraocular Lenses

http://www.evrs.eu/medias/2006/videos/A-New-Surgical-Approach-in-the-Management-of-Posteriorly-Dislocated-Intraocular-Lenses.flv Tansu Erakgun, MD (Izmir, Turkey) SYNOPSIS I herein report on one patient a new surgical technique in the management of dislocated PCIOLs consisting retrieval from the vitreous cavity, followed by repositioning of the intraocular lens with minimal tissue damage and complications. The instrument used consists of a...

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Managing Dry Macular Folds after Vitreoretinal Surgery (Best of Show)

Managing Dry Macular Folds after Vitreoretinal Surgery (Best of Show)

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

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Vitrectomy for Dummies

Vitrectomy for Dummies

Virgilio Morales-Canton, MD (Mexico City, Mexico) SYNOPSIS Vitrectomy techniques have evolved greatly during the last decade thanks to improvements in technology. Wide-angle visualization, and better instrumentation offers better surgical outcomes. This video describes important considerations during surgery that facilitates the maneuvers giving better results, and that’s why can be considered “a reference for the rest of...

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Bimanual Vitreous Surgery Using Xenon Light Illuminated Translucent Forceps and Illuminated Infusion Line

http://www.evrs.eu/medias/2006/videos/Bimanual-Vitreous-Surgery-Using-Xenon-Light-Illuminated-%20Translucent-Forceps-and-Illuminated-Infusion-Line.flv Ching J. Chen, MD (Jackson, MS), Michael C. Palmer, MD (Jackson, MS), Hussein Wafapoor, MD (Jackson, MS), Charles G. Sherwood, MD (Jackson, MS) SYNOPSIS This film will demonstrate a practical way to conduct a bimanual membrane dissection. Xenon light was connected to the Duo-Mode infusion...

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A New Microscope with Wide Angle Viewing System without Endoillumination

A New Microscope with Wide Angle Viewing System without Endoillumination

Murat Oncel, MD (Istanbul, Turkey) SYNOPSIS This film demonstrates the technique of using a new microscope observation system for vitrectomy procedures that does not require the use of fiber optic illumination. Without fiber optic illumination, the surgeon is able to perform bimanuel surgery. A 40D non-contact lens provides a wide-angle viewing. ...

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Method of Safe Vitrectomy Technique

Andriy Sergienko, MD (Kiev, Ukraine), Alexander Filipchuk, MD (Kiev, Ukraine) PURPOSE: To evaluate efficacy of the method developed for safe vitrectomy manipulations. METHODS: A design of the developed instrument is supplied with thin irrigation tube which is fixed near a tip of the vitreo-cutter. The water jet from the tube allows to prevent capture of the retina and to control removal of vitreous. Initial trial of the instrument was...

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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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Lost in Vitrectomy: South of the Border Approach

Lost in Vitrectomy: South of the Border Approach

Virgilio Morales-Canton, MD (Mexico City, Mexico) SYNOPSIS This video shows different techniques that can be used on some surgical steps of the vitrectomy proce-dure. What to do with small pupils when you don’t have iris hooks? How to survive and have a successful case when the instrumentation is not the best? ...

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Pars Plana Vitrectomy with Binocular Indirect Ophthalmoscope

Daniel Ochoa-Contreras, MD (Mexico City, Mexico), Maura Lucy Abraham Marin, MD (Mexico City, Mexico), Carlos Fernando Cortes Luna, MD (Bogota, Colombia), Ricardo Agurto Rivera, MD (Santiago, Chile), Mitzy Torres Soriano, MD (Mexico City, Mexico),Lidia Griselda Alvarez-Rivera, MD (Mexico City, Mexico), Virgilio Morales-Canton, MD (Mexico City, Mexico) PURPOSE: Describe our experience with two-port vitrectomy, using binocular indirect...

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A New Microscope with Wide Angle Viewing System without Endoillumination

http://www.evrs.eu/medias/2006/videos/A-New-Microscope-with-Wide-Angle-Viewing-System-without-Endoillumination.flv Murat Oncel, MD (Istanbul, Turkey) SYNOPSIS This film demonstrates the technique of using a new microscope observation system for vitrectomy procedures that does not require the use of fiber optic illumination. Without fiber optic illumination, the surgeon is able to perform bimanuel surgery. A 40D non-contact lens provides a...

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Vitrectomy for Dummies

Virgilio Morales-Canton, MD (Mexico City, Mexico) SYNOPSIS Vitrectomy techniques have evolved greatly during the last decade thanks to improvements in technology. Wide-angle visualization, and better instrumentation offers better surgical outcomes. This video describes important considerations during surgery that facilitates the maneuvers giving better results, and that’s why can be considered “a reference for the rest of us.”

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Surgical Approach to the Macula: A Mathematical Model

Sal Rassam, (Worthing, UK) PURPOSE: A mathematical model is proposed for the posterior pole of the eye that will aid in the design of vitreoretinal microsurgical instruments. METHODS: An initial 2-Dimensional mathematical model is formulated based on certain basic assumptions. It is then carried forward to a 3-Dimensional view of the posterior pole from which angles of approaches to the macula are extrapolated. These are then put to the...

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“BEST OF SHOW” Managing Dry Macular Folds after Vitreoretinal Surgery

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

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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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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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Reversal of Ischemic Central Retinal Vein Occlusion: A Novel Technique of Multiple Retinal Vein Decompression and Chorioretinal Venous Anastomosis

Calvin A. Grant, MD (Oak Lawn, IL) PURPOSE: To address the possibility of safe and reproducible multiple sequential branch retinal vein decompression and chorioretinal venous anastomosis for the reversal ischemia central vein occlusion as evidenced by patient satisfaction, vision, pupillary function, and fluorescein and/or ICG angiography. To monitor for neovascularization and vitreous hemorrhage known in laser only CRVA...

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Shielded Bullet Pick

http://www.evrs.eu/medias/2006/videos/Shielded-Bullet-Pick.flv Edwin H. Ryan, MD (Minneapolis, MN)* SYNOPSIS The shielded bullet pick has been available for nearly 10 years. I think it is underutilized, and feel it both saves time and improves outcomes in complex cases. This video will show some of its uses for bimanual membrane dissection. The cases include PVR, PDR, RD with macular hole, myopic macular hole, and management of dislocated...

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Limited Invasive Procedures to Treat CNV’s in ARMD

Frank Koch, MD, 1, Lars-Olof Hattenbach, MD, 1, Albert Augustin, MD, 2 – 1 University Eye Clinic Frankfurt/M., Germany, 2. Staedt. Kliniken Karlsruhe, Germany Purpose: To summarize the treatment potentials of steroid injections w/o laser coagulation for treatment of the macula in ARMD. Methods: Triamcinolone (0.4 to 20 mg) is injected intravitreally and/or subretinally. Subthreshold laser is applied transretinally or subretinally through...

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Is Face Down Positioning Necessary in Macular Hole Surgery?

http://www.evrs.eu/medias/2005/congress/Is-Face-Down-Positioning-Necessary-in-Macular-Hole-Surgery.swf Jan-Olof Carlsson Purpose: To evaluate the possibility of abandon face down positioning in order to widen the indications for idiopathic macular hole surgery and to facilitate the postoperative period without compromising the success rate. Methods: One experienced surgeon, using a standard 3-port vitrectomy, ILM peeling and fluid-gas...

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25g Sutureless Surgery for Macular Pucker

http://www.evrs.eu/medias/2005/congress/25g-Sutureless-Surgery-for-Macular-Pucker.swf A. Nikolakopoulos, I. Panidou, E. Fantel, E. Psimenidou, A. Vakalis Purpose: To present a new system for 25g sutureless vitrectomy using high vacum for a quicker and safer result. Methods: In our clinic in Thessaloniki we are trying to modify our technique for macular surgery by using 25g instruments-pressurized infusion and high vacum to facilitate quick...

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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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One Port VPPV for the Treatment of Epimacular Disorders: Slit Lamp and New Anterior Chamber Maintainer (ACM) in Phakic Patient. Personal Technique

Cesare Forlini, MD, Paolo Rossini, MD, Giuseppe Giunchiglia, MD, Barbara Campanini, MD, Department of Ophthalmology – Ravenna Hospital Viale V. Randi, 548100 Ravenna, Italy Purpose: This presentation shows a personal technique of one port VPPV for the treatment of epiretinal disorder. Moreover, it will be shown that through anterior chamber infusion it is possibile to create a new dynamics in intraocular flows. Methods: This one port VPPV...

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Internal Limiting Membrane Removal Indications and Techniques

Ferenc Kuhn, Robert Morris, Viktoria Mester, Gyongyi Kiss, Purpose: To present the rationale, indications, and techniques of internal limiting membrane (ILM) removal. Methods: Analysis of personal experience and videotape demonstration. Results: Surface traction relief is the primary reason for ILM peeling. A long list of indications for ILM removal exist today, including its original condition (hemorrhagic macular cyst in eyes with Terson...

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Illuminated Vitrector, Facilitates Bimanual Vitrectomy and Benefits in Macular Hole Surgery without Demand for Face Down

Jan-Olof Carlsson Purpose: The advantage of bimanual vitrectomy is wellknown by vitreoretinal surgeons. The reason for using a prototype of an illuminated vitrector is an ambition to further facilitate development of this technique. The primary purpose of the study was to evaluate the capacity and consistency of this instrument as the only vitrectorprobe used, both in straightforward and complex surgery. The other purpose was to evaluate...

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The Challenge of Retinal Transplantation

http://www.evrs.eu/medias/2005/congress/The-Challenge-of-Retinal-Transplantation.swf Peep V. Algvere, M.D., Ph.D., Relya Zivojnovic Award Since several retinal diseases and dystrophies exhibit apoptotic cell death of photoreceptors and/or RPE cells, transplantation of young and healthy cells has been most desirable to replace the diseased tissue. A remarkable achievement was the first successful grafting of RPE cells to the RCS-rat showing...

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