77 Works

iLASIK after Implantation of a Tecnis Multifocal IOL

Prof. Dr. Michael C. Knorz
This video shows an iLASIK procdure using the IntraLase iFS femtosecond laaer and the Visx STAAR S4 excimer laser to perform a wavefront-guided LASIK after implantation of a Tecnis diffractive mutifocal IOL.

Trabeculectomy Limbus Based

New York Eye And Ear Infirmary
Trabeculectomy Limbus Based, Mitomycin,

Iatrogenic transfoveal submacular injection of liquid perfluorocarbon

Bernd Kirchhof
The overly hard fluid jet of liquid perfluorocarbon directed towards the posterior pole of the eye near the retinal surface perforates the fovea. Most of the subretinal fluid escapes spontaneously via a pre-existing retinotomy. Remnants of submacular PFCL are being evacuated by the pressure of a preretinal PFCL bubble and subretinal aspiration. The procedure is completed by submacular transplantation of autologous pigment epithelium and choroid. The iatrogenic macular hole is addressed by ILM peeling.

Implanting the Argus® II Retinal Prosthesis System in a patient with dry AMD

Manchester Vision Regeneration Lab
The following is an edited movie of a previously live-streamed surgical video featuring renowned Consultant Ophthalmologist and Vitreoretinal surgeon Professor Paulo E. Stanga, MD, implanting the Argus® II Retinal Prosthesis System in a patient with dry Age Related Macular Degeneration (AMD). To date, June 2016, over 180 Argus® II devices have been implanted worldwide, and are used routinely in advanced Retinitis Pigmentosa patients. This video, recorded at Manchester Royal Eye Hospital, UK, in April 2016,...

Posterior Vitreous Separation in Rhegmatogenous Retinal Detachment Complicated by Iatrogenic Retinal

Bernd Kirchhof
The combination of retinal detachment and adherent hyaloid is a situation a risk of iatrogenic retinal holes. The retina is mobile and aspiration of cortex cannot be separated from aspiration of retina. The cutter is apparently not a suitable instrument here. Two iatrogenic retinal holes occurred until the procedure was completed in a primary vitrectomy approach. Posterior vitreous separation is left for an eventual secondary procedure possibly in conjunction then with PVR surgery.

PVR in the Superior Retinal Periphery after Tamponade by Heavy Silicone oil

Bernd Kirchhof
This eye originally had PVR retinal detachment in the inferior retinal periphery. It was at first treated by vitrectomy, retinectomy and standard silicone oil. After PVR recurrence under standard silicone oil typically in the inferior peripheral retina, heavy silicone oil was filled at the occasion of re-vitrectomy. The Film shows the end of the removal of heavy silicone oil and a partially detached retina, but this time in the superior retinal periphery. The vitreous base...

Silicone oil bubbles entrapped in the vitreous base during silicone oil removal

Bernd Kirchhof
Especially heavy silicone oil has the peculiarity to be retained and entangled into the vitreous base. Thus after aspiration of the core of heavy oil it is strongly recommended to inspect the vitreous base with indentation. Since the oil bubbles are entrapped in the vitreous it requires active suction and cutting with a vitrectomy probe.

Peeling of Epiretinal Membranes in PVR

Bernd Kirchhof
Starfolds in PVR show considerable retinal traction, but the causing epiretinal membrane is rarely clearly to discern from the underlying retinal tissue. One must then grab the navel of the fold and while pulling tangentially learn by the difference in elasticity what is membrane and what is retina. The primary goal is to release traction. An incidental retinal hole is a minor disadvantage over leaving behind epiretinal membranes. However all retinal holes need to be...

Endoresection of Choroidal Melanoma

Bernd Kirchhof
The reason for the endoresection is the location of the tumor in the vicinity of the macula. Brachytherapy as only means would likely damage the fovea. Endoresection is always combined with brachytherapy, but after removal of the tumor a much lower dose is needed to “sterilize” the sclera. The vitrectomy after 180 degree retinotomy is performed under air to prevent seeding of tumor cells. Also eventual hemorrhage does not compromise the view. The disadvantage of...

Retinal Injury from Light Pipe

Bernd Kirchhof
Unexperienced surgeons must permanently observe both instruments in the eye, if not, both instruments must be removed. In this case the resident is so diverted by a first successful ILM peeling that on removing the forceps uncontrolled movement of the light pipe – still in the eye - ends up in a retinal hole inferior to the macula. No noticeable functional loss remained. The procedure was completed as planned by fluid gas exchange for macular...

Laser Refractive Lens Surgery using an Intraocular Femtosecond Laser

Prof. Dr. Michael C. Knorz
This video shows an intraocular femtosecond laser (Alcon LenSx Lasers, Inc, Ft. Worth, TX, USA) used to perform laser refractive lens surgery. The laser uses build-in optical coherence tomography (OCT) to image the cornea, lens capsule and lens. Nucleus liquefaction, capsulorhexis and corneal incisions are then positioned on the screen, and the laser performs lens liquefaction followed by capsulorhexis and corneal incisions. Irrigation/aspiration only is used to remove the liquefied lens nucleus, and an intraocular...

Newborn vitreous hemorrhage

Bernd Kirchhof
vitreous hemorrhage in a newborn is a challange: Why hemorrhage: ROP? Malformation? Trauma during delivery? Iatrogenic damage to the lens and peripheral retina is at risk. Here the indication was: no pupullary red reflex, while the other eye was normal and the risk was amblyopia. The removal of the vitreous with trocar access went normal. However the infusion line slipped from the clip. The tip of the trocar leaned against the lens equator. Fortunately the...

Illuminated Cutter plus Chandelier Light

Bernd Kirchhof
Vitreous to be demonstrated requires a focused light or a light source close to the cutter tip. A diffuse light pipe must be approached to the cutter tip. A chandelier light is diffuse and in most locations to distant from the cutter tip and unsuitable to visualize vitreous. The chandelier light provides the diffuse light for the overview (safety) and an additional light should be positioned close to the cutter opening. An illuminated cutter delivers...

Removal of retinal fold after primary vitrectomy

Bernd Kirchhof
The retinal fold crossed the macula and was a residuum of retinal detachment surgery with vitrectomy and gas tamponade. The video shows the flattening of the fold across the macula via vitrectomy approach, submacular fluid injection and retinal massage from a manipulator.

RPE and Choroid Translocation in Anti-VEGF-Non-Responder

Bernd Kirchhof
Until present it is difficult to indentify an Anti-VEGF Non-Responder early enough for submacular surgery to be still worthwhile. In this case (typically) surgery was considered not before VA had dropped to 0,1. There was an absolute scotoma temporal to the central fixation (microperimetry). Otherwise the surgical technique is identical to the approach for exsudative AMD before the introduction of VEGF-Blockers: Vitrectomy Posterior vitreous separation (if not yet present) 360 degree laser cerclage Laser demarcation...

Endoscopy Assisted Argus II Epiretinal Prosthesis Implantation

SSMP
Endoscopy Assisted Argus II Epiretinal Prosthesis Implantation Surgical Video Recording done by Prof. Emin Ozmert, in Ankara University Vehbi Koç Eye Hospital, Ankara - TURKEY. By using endoscopic imaging during Argus II Retinal Implant surgery, it's easier to see that the ciliar body isn't damaged due to scleratomy as well as the retinal tack is in place and the spring is squeezed properly.

Pucker Membrane does not stain with ICG

Bernd Kirchhof
Even though this is a macular hole this film focuses on the staining characteristics of the accompanying pucker membrane extrafoveally. The epiretinal membrane stands out in negative contrast, as unstained. Once the pucker is peeled then a second application of ICG unreveals the remaining ILM.

Sub-ILM Hemorrhage from a retina macroaneurysm

Bernd Kirchhof
The relevant cause of visual loss is here a preretinal but sub-ILM bleeding from a retina macroaneurysm. Part of the hemorrhage is (typically) intraretina, part subretina, but fortunately these more difficult representations are outside the macula. By peeling of the premacular ILM and aspiration of the fresher premacular blood visual improvement could be achieved.

Low viscosity silicone oil as infusion fluid in massive subretinal hemorrhage

Bernd Kirchhof
Vitrectomy with BSS infusion in massive intraokular hemorrhage is very tiring, because of the impedment of sight from the swirling-up blood. Here a silicone oil of very low viscosity - like 20 cSt - replaces the BSS infusion, does not mix with blood and allows a rapid removal of the blood from within the eye.

iLASIK using IntraLase iFS and Visx STAR S4

Prof. Dr. Michael C. Knorz
The video shows an iLASIK procedure performed with the IntraLase iFS femtosecond laser and the Visx STAR S4 excimer laser.

vitrectomy for Valsalva's maculopathy

M.D. Shaarawy
Valsalva's Maculopathy is an uncommon cause of visual loss in young patients following severe physical exertion,strains,vomiting and sexual intercourse.A video clip describing a vitrectomy procedure to treat that condition.

Optic Disc Pit treated by Vitrectomy and Platelet Concentrate

Bernd Kirchhof
After unsuccessful pretreatment with laser along the temporal circumference of the optic disc (old scars) a vitrectomy is performed, posterior vitreous separation and platelet concentrate. The idea of platelets is to clog the pig. The idea of vitrectomy is to release traction of eventual vitreous strands into the pit. Both rationales are hypothetical.

Horseshoe tear at the End of Vitrectomy

Bernd Kirchhof
It is mandatory to inspect the peripheral retina at the end of vitrectomy of incidental retinal tears usually associated with the sclerotomies. These may be preformed or newly formed by incarceration of vitreous base into the sclerotomie during change of instruments.

aniridia aphakia implant and corneal transplant surgery

Dr. Barbara Parolini Carbognin
the patient had undergone perforating trauma with loss of corneal tissue, aniridia aphakia and retinal detachment. the first surgery was performed to repair retinal detachment and to perform the first corneal transplant, with a gain in vision to 0,1 Snellen acuity pinhole. the corneal graft failed after silicone oil removal. one further surgery (Video) was planned to replace the corneal graft and to reconstruct the anterior segment with an aniridia aphakia implant.

Missed Posterior Vitreous Separation in a Child with PVR Reaction

Bernd Kirchhof
The surgeon meant to have separated the posterior hyaloid. But especially in children the vitreous separation is likely to be incomplete or non-existent at all despite vitrectomy. Leaving the hyloid in place raises the risk of a PVR reaction. As shown here the fibrous condensations were confined to the hyaloids and no relevant traction was evident on the retina. The indication for vitrectomy was a retinectomy as pressure lowering procedure in refractive glaucoma. I hope...

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