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Incidence and Risk Factors of Dissociated Optic Nerve Fiber Layer After ERM Surgery

Sung Jin Lee_SCIENTIFIC POSTER 2015 Purpose: To investigate the incidence and risk factors of dissociated optic nerve fiber layer(DONFL) after epiretinal membrane surgery (ERM). Methods: A total of 296 pars plana vitrectomy (PPV) operations were included in the study and the study period was between July, 2009 and January, 2013. 30 consecutive eyes of 30 patients developed DONFL after primary PPV for ERM. Univariate and multivariate...

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Anatomical and Functional Results of Idiopathic ERM Surgeries

Lidmila Prochazkova_SCIENTIFIC POSTER 2015 Purpose: Evaluation anatomical and functional results in patients after pars plana vitrectomy due to idopathic epiretinal membrane (ERM). Patients Sample: The sample is formed by 79 eyes of 77 patients who underwent a surgery at Masaryk Hospital Eye Clinic in Usti nad Labem between 2007 and 2014. Two patients underwent a surgery of both eyes. There were 48 women (62.3%) and 29 men (37.7%), and...

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Iatrogenic Retinal Break During PPV for ERM

Objective: To report on a case of iatrogenic retinal break (IRB) during a 25-gauge pars plana vitrectomy (PPV) surgery for the treatment of epiretinal membrane. Design: Case Report Methods: Edited video submission displaying the diagnosis and treatment of an unexpected complication during pars plana vitrectomy. Results: A 63 year old male was sent to our clinic following complaints of long-standing, progressive diminished visual acuity on...

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ILM Peeling with and Without Adjunctive Triamcinolone – Did the ME Study Make a Difference ?

Background: Before the EVRTS-Meeting in Dresden 2012 we always used adjunctive Triamcinolone at the end of epiretinal membrane surgery with ILM-peeling, thinking, that this would reduce postoperative macular edema. However, in reaction to the results of the ME-Study, published in Dresden in 2012 which suggest that cortisone hinders the edema-lowering effect of ILM-peeling, we discontinued the use of adjunctive Triamcinolone in all cases...

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Inverted ILM Flap for the Treatment of Myopic MH

Purpose: To describe the functional and anatomical results of pars plana vitrectomy (PPV) with inverted internal limiting membrane (ILM) flap for the treatment of macular holes with or without retinal detachment (RD) in highly myopic eyes. Methods: Twenty-nine eyes affected by macular hole, associated (n=6) or not (n=23) with retinal detachment in high myopia (average axial length 26.80 mm) underwent PPV with inverted ILM...

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Temporal Inverted Flap Technique for MH Closure. A Comparative Study

Advantage: The aim of this study is to present the comparative non-randomised study of Temporal Inverted Flap Technique vs. Classic ILM Flap Technique for Macular Hole Closure. Methods: This is a single center, comparative study. 43 eyes of 39 patients mean age 67, were operated with classic ILM Flap technique (Group A) and 44 eyes of 40 patients, mean age 66, were operated on using only a temporal flap of ILM (Group B). In group B, ILM...

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ILM Graft for Persistent MH After Primary Surgical Failure

Advantages: To describe a new surgical technique for macular hole closure using a patch of internal limiting membrane for persisting macular holes who have underwent pars plana vitrectomy with internal limiting membrane peeling. Methods: Six eyes of 6 patients presented to our hospital with persistent macular holes after having underwent pars plana vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade. All patients...

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Inverted ILM Flap in MH with Poor Prognosis

Advantages: Inverted ILM flap technique can achieve good anatomical and functional success in large, long standing macular holes or in non idiopathic macular holes (as macular holes related to myopia, post vitrectomy for retinal detachment or post ocular trauma). Methods: Since July 2009 inverted ILM flap technique has been performed in macular hole with poor anatomical prognosis. ILM is incompletly peeled around the border of the hole...

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

Epiretinal membranes are avascular, fibro-cellular membranes that proliferate on the surface of the retina. These membranes have contractile properties and patients may present with metamorphopsia and visual changes because of their effect on the underlying retina. Epiretinal membrane surgery usually implies pulling the ERM itself and commonly the internal limiting membrane, exerting forces on the retina that may easily damage and...

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ILM Peeling During Vitrectomy for Tractional DME. My Way

I do ERM-ILM peeling by using: Chandelier illumination, aspheric macular contact lens, 23 G needle OR closed tip ILM Forceps for creating the ILM flap, clamping the infusion cannula during the BBG stain injection. Chandelier allows for satisfactory illumination with a free second hand that stabilizes the working hand and thus provides stability, precision, control and dexterity. However, positioning and redirecting by the assistant may...

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Combined Peeling of Epiretinal and Internal Limiting Membranes with the Single Injection of Membrane Blue-dual Dye in Eyes with Idiopathic ERM

Objective: Epiretinal membranes are sometimes multilayered which needs peeling more than once during vitrectomy. Although some surgeons prefer not to peel ILM in the surgical management of ERMs; ILM peeling is shown to decrease the recurrence of ERMs while not affecting the visual outcome. Different dyes may be used to stain ERM and ILM, although toxicity concerns still exist especially regarding the use of ICG. Also multiple times of...

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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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Photoreceptor Change and Visual Outcome After Idiopathic Epiretinal Membrane Removal with or Without Additional Internal Limiting Membrane Peeling

Advantages: To compare postoperative photoreceptor status and visual outcome after epiretinal membrane (ERM) removal with or without additional internal limiting membrane (ILM) peeling Methods: Medical records of forty eyes from 37 patients undergoing ERM removal with residual ILM peeling (additional ILM peeling group) and 69 eyes from 65 patients undergoing ERM removal without additional ILM peeling (no additional peeling group) were...

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Is Process of Epiretinal Membrane Biopsy Analysis Easy?

Purpose : To show the process of epiretinal membrane biopsy analysis. Methods: Five cases of different retinal disease that have epiretinal membrane formation, during pars plana vitreoctomy membrane peeled and placed in a tube with 10% formalin then sent to histopathology laboratory for preparation and analysis. Results: It’s not easy to work with epiretinal membrane because it’s very tiny fragments measuring about 0.2-0.3 cm...

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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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Combined Peeling of ERM and ILM in One-step After Dying with Brilliant and Trypan Blue Mixture

Epiretinal membranes (ERM) are sometimes multilayered and need peeling more than once during vitrectomy. Different dyes with multiple times of injections may be used to stain ERM, and internal limiting membrane (ILM). In this video combined peeling of ERM, and ILM in a single-step after dying with a brilliant and trypan blue mixture (BBG-TBm) in ERMs is demonstrated. The main objective is to decrease mechanical trauma of sequential peeling...

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Outcome of Vitrectomy for Lamellar Macular Hole

http://www.evrs.eu/medias/2008/congress/Outcome-of-Vitrectomy-for-Lamellar-Macular-Hole.flv Hassan Mortada Advantages: The diagnosis, pathogenesis and the best therapeutic approach for lamellar macular hole is still unclear. This work describes the surgical technique used for management of these cases and the postoperative anatomical and functional results. Methods: Sixteen eyes with symptomatic lamellar macular hole underwent 20-gauge...

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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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Stardust – Triamcinolone Acetonide in Macular Surgery

http://www.evrs.eu/medias/2006/videos/Stardust-Triamcinolone-Acetonide-in-Macular-Surgery.flv Joseph Moisseiev, MD (Tel Aviv, Israel) SYNOPSIS The film demonstrates how injection of Triamcinolone acetonide during vitrectomy improves the visibility of residual cortical vitreous in three cases: a case of vitreomacular traction syndrome, diabetic macular edema in an eye with PDR, and very thin ERM following PVD with multiple retinal breaks....

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Colorants in Vitreo-retinal Surgery “United Colours of Vitrectomy”

http://www.evrs.eu/medias/2006/videos/Colorants-in-Vitreo-retinal-Surgery-United-Colours-of-Vitrectomy.flv Giuseppe Giunchiglia, MD (Palermo, Italy), Cesare Forlini, MD (Ravenna, Italy), Benedetto Scarpulla, MD (Palermo, Italy), Francesco la Barbera, MD (Palermo, Italy) SYNOPSIS This video shows the use of colorants during the various stages of vitreo-retinal surgery. An endovitreal injection of Triamcinolone Acetonide and/or of Tripan Blue...

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Modified Technique for Improving Trypan Blue Staining of Epiretinal Membranes

Modified Technique for Improving Trypan Blue Staining of Epiretinal Membranes

Stanislao Rizzo, MD (Lucca, Italy), Michele Palla, MD (Pisa, Italy), Federica Genovesi-Ebert, MD, PhD (Pisa, Italy) SYNOPSIS In the air-filled vitreous cavity we have instilled first TB and subsequently liquid perfluorocarbon, that due to its high specific gravity pushes down the coloring agent, thus making it spread better on the retinal surface, allowing a more effective and complete ERM staining and removal.   VIDEO not...

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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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Modified Technique for Improving Trypan Blue (TB) Staining of Epiretinal Membranes (ERM)

Stanislao Rizzo, MD (Lucca, Italy), Michele Palla, MD (Pisa, Italy), Federica Genovesi-Ebert, MD, PhD (Pisa, Italy) SYNOPSIS In the air-filled vitreous cavity we have instilled first TB and subsequently liquid perfluorocarbon, that due to its high specific gravity pushes down the coloring agent, thus making it spread better on the retinal surface, allowing a more effective and complete ERM staining and removal.

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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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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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