14 Works

Transconjunctival 25 gauge vitrectomy

Gabor B. Scharioth
Transconjunctival 25 gauge pars plana vitrectomy has evolved considerably since its introduction. New stiff instruments and technical progress expanded the scope and indications and reduced the limitations. This video shows the author’s experience in 25 gauge vitrectomy used for several indications. Primarily this technique was used for simple vitrectomy, epiretinal membrane peeling and macular hole surgery. Recent improvements in the instrumentation and illumination enable the surgeon to perform sutureless transconjunctival 25 gauge vitrectomy for the...

Suprachoroidal drug delivery: A novel approach in treatment of wet age-related macular degeneration (AMD)

Gabor B. Scharioth
Currently several approaches exist for drug delivery to the back of the eye of which intravitreal injection is the most popular. This video described a new technique for drug administration to the back of the eye, namely to the suprachoroid space using a microcatheter. The catheter is introduced under the choroid using a transscleral approach at temporal superior quadrant. The exact position of the microcatheter is visualized by a blinking light source at its tip....

“Oh! I find the way – I can create retinal detachment” - Gnathostomata spinigerum

Subhendu Kumar Boral, Santanu Mandal, Arnab Das & Tushar Kanti Sinha
A 30 years old female presented in Disha Eye Hospitals, Barrackpore, West Bengal, India with panuveitis with progressive tractional retinal detachment (TRD) involving macula in right eye. Her left eye was absolutely normal. An actively motile worm was detected at pars plana area at the time of vitreous base excision and removed in intact motile form. The large granulomatous tissue over the disc with thick epimacular membranes were removed. The retina was reattached and silicone...

Surgery of proliferative vitreoretinopathy (PVR): A step by step approach

Manish Nagpal & Vikram Mehta
Proliferative vitreoretinopathy (PVR) often leads to failure in retinal detachment surgery. Surgeons need to be well versed with managing different aspects of retinal detachment complicated by PVR to achieve successful outcomes. Various techniques such as membrane peeling, dissection, air fluid exchange , endo-drainage, endo laser, usage of perfluorocarbon liquid (PFCL), retinectomies etc. are shown in detail. Carefully assessing the PVR and managing it can improve the surgical outcomes in these cases.

Uveal effusion syndrome: diagnosis and management

S. Chien Wong & Paul M. Sullivan
Uveal effusion syndrome (UES) is a difficult condition to accurately diagnose and treat. In this video, we illustrate the features, differential diagnoses and management of UES using a combination of surgical clips and 3D animation. Surgical treatment with sclerectomy is demonstrated, including tips for effective control of sclerectomy depth. Good anatomical and visual outcomes can be achieved following sclerectomy for UES. Uveal effusion syndrome is a challenging condition to diagnose and treat. Good outcomes can...

The bell pepper experiment: introducing a novel self-sealing “screwcut” incision for sutureless transconjunctival vitrectomy

L.-O. Hattenbach
Flattened sclerotomies are an essential step in ensuring postoperative wound stability in transconjunctival sutureless vitrectomy. However, in complex cases involving complete vitrectomy with shaving of the vitreous base, laser application and peeling of surface membranes, conventional angled incisions often leak at the end of the procedure. Here, we present a novel curved and twisted (screw-like=“screwcut“) self-sealing incision technique using a 23-gauge one-step microcannula array with sharp solid trocar blades. Based on a simple kitchen experiment,...

Sutureless intraocular lens fixation of a dislocated intraocular lens - capsular bag - capsular tension ring complex

Kannan Naresh Babu & Ramasamy Kim
Intraocular lens (IOL) implantation and fixation techniques are controversial in eyes with insufficient or no capsular support. In such eyes, cataract surgery can be performed using a capsular tension ring and an IOL implanted in the bag. Dislocation of this IOL-capsular bag-capsular tension ring (IOL-CB-CTR) complex is rare, but can happen in cases with zonular dialysis or a history of trauma. We report a technique of removal of the CTR with sutureless fixation of the...

Transretinal biopsy technique for cytogenetic phenotyping of posterior uveal melanoma

Javier Elizalde
Cytogenetic phenotyping is a world-wide accepted procedure in ocular oncology to know the risk of metastatic disease of uveal melanoma. We describe our effective and safe vitreoretinal surgical technique to obtain a sample of melanomas located posterior to the equator. A three-port 25-gauge microcannulae system through the pars plana is used to insert a vitrector or a 27-gauge needle to obtain the tissue, depending on the size of the tumor. Although minimal bleeding may be...

25 gauge vitrectomy techniques for proliferative diabetic retinopathy

Florian Balta
The proliferative diabetic retinopathy (PDR) cases are operated on with 25 G instruments, under the OFFISS System as viewing system, and the Constellation vitrectomy machine at 5000 cuts / minute ,using either an unimanual or a bimanual technique. In the unimanual technique, the vitreous cutter is used. In the bimanual technique, the combination between the intraocular forceps and the vitreous cutter is used. Less frequent the illuminated spatula and the forceps are used together. The...

Incision making in small gauge surgery

Manish Nagpal
Small gauge surgery or sutureless surgery is gaining widespread popularity. Incision making is the key to the success of achieving a good postoperative wound. Various techniques have evolved related to the incision making and this video discusses the steps of making a good incision. Significance of retracting the conjunctiva using a stabiliser and then placing a biplanar incision are demonstrated. Steps to acheive a good incision closure at the time of removal of cannulas and...

23 gauge vitrectomy and subretinal rTPA injection for submacular hemorrhage

Joachim Puchta & Alireza Mirshahi
This video shows 23 gauge sutureless pars plana vitrectomy, subretinal injection of recombinant tissue plasminogen activator (rTPA) and SF6 endotamponade for treatment of a submacular hemorrhage secondary to age-related macular degeneration. The subretinal injection is performed using a 41 gauge cannula. The preferred injection area is the temporal margin of the hemorrhage. Postoperatively, face-down position is necessary for dislocation of the blood. Subsequent treatment of the choroidal neovascular membrane is necessary for disease control, e....

Corneal surprise during vitreoretinal surgery

Francisco J. Ascaso, Paula Casas & Enrique Mínguez
A 65-year old man underwent pars plana vitrectomy for dislocated lens fragments into the vitreous cavity during a previous cataract surgery. The right eye anterior chamber exam showed three nylon 10/0 corneal sutures and fundus examination revealed dislocated lens fragments into the vitreous cavity. There was no history of refractive surgery. The patient was scheduled for a standard 20-gauge three-port pars plana vitrectomy. During the surgery a big epithelial bleb appeared in the corneal surface...

Dancing nematodes in the eye

Avinash Pathengay, William Aylward, Biju Raju, Jalli Gangadhar, Kolli Goverdhan Babu & Shobha Mocherla
Ocular nematode infections such as cysticercosis, diffuse unilateral subacute neuroretinitis (DUSN) and filariasis are commonly seen in the developing nations of the world. In this video, we will highlight the features and management of five cases comprising of cysticercosis (intravitreal, subretinal and inside the anterior chamber), diffuse unilateral subacute neuroretinitis and ocular filariasis. The epidemological features, clinical characteristics and medical and surgical options are highlighted. When alive, an intra-vitreal cysticercus can move and shy away...

Transretinal resection of submacular hemorrhage

Alireza Mirshahi
Several methods have been introduced for the treatment of submacular hemorrhages secondary to age-related macular degeneration. Small bleedings may be dislocated by intravitreal injection of SF6 gas, possibly combined with recombinant tissue plasminogen activator (rTPA). Larger hemorrhages can be treated by pars plana vitrectomy, subretinal injection of rTPA and gas tamponade. Large and particularly thick bleedings may require additional procedures such as subretinal lavage or the surgical removal of blood clots. Moreover, macular translocation surgery...

Registration Year

  • 2011
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  • 2012
    5

Resource Types

  • Film
    14