Videos by Topic

AMd/Macular surgery

Instrumentation & devices

Retinal detachments
 
 

Diabetic retinopathy
 
 

Intraocular lens

Trauma

Inflammatory disease

oncology

VITREORETINAL TRACTION


AMD/Macular Surgery

Partial Thickness Inner Retinal Fenestration for the Treatment of Optic Pit Maculopathy

Johnstone M. Kim, MD; Joseph D. Boss, MD; Joaquin Tosi, MD; Asheesh Tewari, MD; and Gary W. Abrams, MD 

Featured Video for December 2016

A surgical video of an inner retinal fenestration to treat optic pit maculopathy.  The procedures performed are: pars plana vitrectomy, induction of posterior vitreous detachment, inner retinal fenestration, and full air fill.

Epiretinal Membrane Peel Using Intraoperative OCT (iOCT)

Shlomit Schaal, MD, PhD;  Wei Wang, MD, PhD; Shivani Reddy, MD; Denis Jusufbegovic, MD
March 2015 Featured Video

We used the Zeiss ReScan 700 (Carl Zeiss Meditec, Dublin, CA) in a case of a thick epiretinal membrane (ERM). This video demonstrates visualization of the vitreoretinal interface with real-time view through the microscope. The integrated view provides real-time feedback to the surgeon.   

Double Staining for Peeling the ERM and ILM

Matias Iglicki, MD, and Marcelo Zas, MD, PhD

February 25, 2015
 

The best way to peel off not only the ERM, but also the ILM is by getting the best view possible. This is accomplished by staining the ERM with Trypan Blue and the ILM with Brillant Blue G. However, in  some cases it is not simple to stain the tissue, that is why we double stain from the beginning  to distinguish the ERM and the ILM, otherwise it can cause retinal tears. Moreover, if we cannot see the tissues properly we can cause retinal detachment.

 

27-Gauge Vitrectomy for a Thick Epiretinal Membrane: New Tools

Shlomit Schaal, MD, PhD; Niloofar Piri, MD; and Janelle Fassbender, MD, PhD
November 11, 2014
 

A 67-year-old woman presented with severe metamorphopsia secondary to a thick epiretinal membrane. Examination reveals a prior horseshoe tear in the periphery. She has an artificial valve and is on Coumadin (warfarin sodium, Bristol-Myers Squibb Company, New York, NY).

  
The surgeons demonstrate a 27-gauge vitrectomy without the need to stop anticoagulant therapy, as well as a new 27-gauge instrument, Finesse Flex Loop (Alcon Laboratories, Inc, Fort Worth, TX) to help peel the epiretinal membrane.

  

 

Subretinal TPA

Mauricio Maia, MD, PhD, and Rodrigo Milan Navarro, MD
July 15, 2014
 

This video shows a patient with subfoveal hemorrhage due to polypoidal vasculopathy. He had already lost 1 eye due to past hemorrhage, and his best-eye visual acuity decreased to hand movements 1 day before surgery.

   

The physicians decided to inject Tissue Plasminogen Activator (tPA) at a dose of 5 micrograms/0.1 cc using 0.2 cc of solution.

  

25-Gauge Vitrectomy for the Treatment of Massive Submacular Hemorrhage

Shlomit Schaal, MD, PhD; Niloofar Piri, MD; Brooke Nesmith, MD
October 22, 2013

 

The case of an exudative-AMD patient with a vitreous hemorrhage and massive hemorrhagic retinal detachment.

   

   

Macular Surgery: Techniques, Results and Complications

Marcelo Zas, MD, PhD, and Arturo A. Alezzandrini, MD, PhD
October 7, 2014
 

This is a retrospective chart review of 32 consecutive 23g and 25g cases. The indications for surgical intervention were macular hole (stage 4) (n = 22) and macular epiretinal membrane (MEM) (n = 10). Brilliant Blue G and Tripan Blue were used to stain the membranes.

The physicians found minimally invasive vitreoretinal surgery (MIVS) to be an effective and safe surgical technique in the management of macular hole and macular epiretinal membrane surgery. This minimally invasive technique appears to decrease the operating time and improve patient comfort.

   

 

23-Gauge PPV With ILM Peel for Fovea-Involving Sub-ILM Hemorrhage Due to Retinal Arterial Macroaneurysm

Enchun M. Liu, MD, and Matthew A. Thomas, MD
October 7, 2014
 

An 80-year-old woman presented with acute vision loss in her right eye due to a retinal arterial macroaneurysm. Because she had a large fovea-involving sub-internal limiting membrane (ILM) hemorrhage precluding a clear view of the subfoveal space, she elected for vitrectomy with ILM peel with the possibility of subretinal tissue plasminogen activator (tPA) injection if subfoveal hemorrhage was found.

   
Once the ILM peel was performed, the fovea was found to be clear and subretinal tPA was not needed. The patient did well with SF6 gas and face-down positioning.

     
 

ERM Removal Using a 27g Vitrectomy System  

John W. Kitchens, MD
September 9, 2014
 

This is an assessment of a 27g system in a case of a patient with a previous posterior vitreous detachment and a taut epiretinal membrane.
  

 

Lutein: A New Dye for Chromovitrectomy

Mauricio Maia, MD, PhD, and Rodrigo Milan Navarro, MD
June 10, 2014

 

This is a chromovitrectomy technique using a new green dye that improved the intraoperative identification of internal limiting membrane (ILM) in blue color, similar to Brilliant Blue G, and the posterior hyaloid/vitreous base identification in a golden appearance by deposition of lutein golden crystals.

 

 

Epiretinal Membrane and Internal Limiting Membrane Peel Utilizing Wide-Field Viewing System With HD Lens

John W. Kitchens, MD

February 11, 2014

 

This video demonstrates an epiretinal membrane (ERM) and internal limiting membrane (ILM) peel utilizing an HD lens. Despite the wide field of view provided by the lens, it provides great depth of field.

     
 

Management of Myopic Foveoschisis With Vitrectomy With ILM Peeling

Hector H. Hernandez-Torres, MD, and Francisco J. Rodriguez, MD
October 22, 2013

 

An interesting approach incorporating Brilliant Blue G staining yields technical feasibility and good visual and anatomical outcomes.

   
 

Management of a Macular Hole Secondary to a Retinal Macroaneurysm

John W. Kitchens, MD

March 11, 2014

 

A case of a large macular hole secondary to a retinal arterial macroaneurysm that bled into the subretinal space and resulted in a full-thickness macular hole.

  


Diabetic Retinopathy

Bimanual Vitrectomy for Diabetic Tractional Retinal Detachment

Rohit Adyanthaya, MD
Featured Video January 2017

This video demonstrates method of bimanual vitrectomy for tractional retinal detachment repair. For detailed method, visit: http://retinatoday.com/pdfs/0515RT_Pearls.pdf.

PhacoVitrectomy for Cataract and Diabetic Tractional Retinal Detachment

Rohit Adyanthaya, MD 

Featured Video Feburary 2017

Video showing method of combining phacoemulsification with intraocular lens implantation and pars plana vitrectomy for visually significant cataract and diabetic tractional retinal detachment.

 

Vitreopapillary Traction: Managing the Posterior Hyaloid

Hemanth Murthy, MBBS, MD, and Naveenam Srinivasa Muralidhar, MD
September 9, 2014
 

Vitreopapillary traction is a rare complication of proliferative diabetic retinopathy. In this case, the posterior hyaloid is thickened and adherent to the retina posing difficulties in separation. Further, the optic nerve fibers are already affected by the traction.

The physicians demonstrate methods in relieving the traction without causing further trauma.

 

Diabetic Retinopathy: Current Techniques Using the Latest Technologies

Virgilio Morales-Canton, MD
November 26, 2013

 

Innovative recommendations for diabetic retinopathy cases, including modifications on fluidics and cutting speeds and chandelier illumination using only a laser probe in order to perform adequate coagulation.

Metallic Intraocular Foreign Body Removal
September 2015

A surgical video of removal of a 2.3 cm metallic foreign body in a 33-year-old male. The procedures performed are; pars plana vitrectomy, pars plana lensectomy, removal of intraocular foreign body, endolaser, and silicone oil in the right eye.



Inflammatory Disease

2-for-1: Removal of 2 Dislocated Fluocinolone Acetonide Implants With Placement of a New Implant

Glenn C. Yiu, MD, PhD
September 25, 2013

 

A complex procedure in which the surgeon uses the same sclerotomy to remove 2 fluocinolone implants in exchange for a new implant.

   

Small-Gauge Retinal Biopsy

Baseer Ahmad, MD, and Bradley T. Smith, MD

June 2014 Featured Video

 

An example of 23-gauge vitreous and retinal biopsy taken from an eye with suspected primary vitreoretinal lymphoma. The use of air infusion for vitreous biopsy is illustrated, as well as the use of small-gauge diathermy, vertical scissors, and forceps for removal of the retinal tissue.

  


Instrumentation & Devices 

23-Gauge Pars Plana Choroidal Tumor Biopsy

David R. Lally, MD, and Jay S. Duker, MD

March 2015 Featured Video

A 32-year-old Caucasian female presented with an atypical, amelanotic choroidal lesion overhanging the right optic nerve. The lesion showed definitive growth, and she elected to proceed with 23-gauge pars plana choroidal biopsy for definitive diagnosis.

 

27-Gauge Vitrectomy for Retinal Detachment Repair 

Raj K. Maturi, MD
December 9, 2014
 

Surgeons need to use 27g instruments differently, because they are more flexible and slower to debulk the vitreous. During retinal detachment (RD) repair, however, the smaller tip allows a much closer shave of the periphery.

   
This video shows a demonstration of a RD repair using Alcon 27g vitrectomy system (Alcon Manufacturing, Ltd, Fort Worth, TX) and an external illuminated indenter, allowing for quick peripheral shaving.

   

 

Femtosecond Cataract Extraction and Minimally Invasive Vitreoretinal Surgery: A New Combined Procedure

Marcelo Zas, MD, PhD, and Arturo A. Alezzandrini, MD, PhD
November 11, 2014
 

Surgical management of patients with vitreoretinal diseases and cataracts has always presented a significant problem for vitreoretinal surgeons.

In this video, the surgeons present advantages, indications, and their experience with a new technique using femtosecond technology combined with minimally invasive vitreoretinal surgery.

   

 

27-Gauge Vitrectomy for a Thick Epiretinal Membrane: New Tools

Shlomit Schaal, MD, PhD; Niloofar Piri, MD; and Janelle Fassbender, MD, PhD
November 11, 2014
 

A 67-year-old woman presented with severe metamorphopsia secondary to a thick epiretinal membrane. Examination reveals a prior horseshoe tear in the periphery. She has an artificial valve and is on Coumadin (warfarin sodium, Bristol-Myers Squibb Company, New York, NY).

  
The surgeons demonstrate a 27-gauge vitrectomy without the need to stop anticoagulant therapy, as well as a new 27-gauge instrument, Finesse Flex Loop (Alcon Laboratories, Inc, Fort Worth, TX) to help peel the epiretinal membrane.

  

 

Macular Surgery: Techniques, Results and Complications

Marcelo Zas, MD, PhD, and Arturo A. Alezzandrini, MD, PhD
October 7, 2014
 

This is a retrospective chart review of 32 consecutive 23g and 25g cases. The indications for surgical intervention were macular hole (stage 4) (n = 22) and macular epiretinal membrane (MEM) (n = 10). Brilliant Blue G and Tripan Blue were used to stain the membranes.

The physicians found minimally invasive vitreoretinal surgery (MIVS) to be an effective and safe surgical technique in the management of macular hole and macular epiretinal membrane surgery. This minimally invasive technique appears to decrease the operating time and improve patient comfort.
  
  

 

23-Gauge PPV With ILM Peel for Fovea-Involving Sub-ILM Hemorrhage Due to Retinal Arterial Macroaneurysm

Enchun M. Liu, MD, and Matthew A. Thomas, MD
October 7, 2014
 

An 80-year-old woman presented with acute vision loss in her right eye due to a retinal arterial macroaneurysm. Because she had a large fovea-involving sub-internal limiting membrane (ILM) hemorrhage precluding a clear view of the subfoveal space, she elected for vitrectomy with ILM peel with the possibility of subretinal tissue plasminogen activator (tPA) injection if subfoveal hemorrhage was found.

  
Once the ILM peel was performed, the fovea was found to be clear and subretinal tPA was not needed. The patient did well with SF6 gas and face-down positioning.
  

  

 

Tough Hyaloid Forceps Technique

John W. Kitchens, MD
July 15, 2014
 

A demonstration of a difficult posterior hyaloid separation utilizing a forceps technique.

Small-Gauge Retinal Biopsy

Baseer Ahmad, MD, and Bradley T. Smith, MD

June 2014 Featured Video

 

An example of 23-gauge vitreous and retinal biopsy taken from an eye with suspected primary vitreoretinal lymphoma. The use of air infusion for vitreous biopsy is illustrated, as well as the use of small-gauge diathermy, vertical scissors, and forceps for removal of the retinal tissue.

  

Lutein: A New Dye for Chromovitrectomy

Mauricio Maia, MD, PhD, and Rodrigo Milan Navarro, MD
June 10, 2014

 

This is a chromovitrectomy technique using a new green dye that improved the intraoperative identification of internal limiting membrane (ILM) in blue color, similar to Brilliant Blue G, and the posterior hyaloid/vitreous base identification in a golden appearance by deposition of lutein golden crystals.

 

 

ERM Removal Using a 27g Vitrectomy System  

John W. Kitchens, MD
September 9, 2014
 

This is an assessment of a 27g system in a case of a patient with a previous posterior vitreous detachment and a taut epiretinal membrane.
  

Phaco Instrumentation for Pars Plana Lensectomy

Yannek I. Leiderman, MD, PhD

April 2014 Featured Video

 

As demonstrated in this video, contemporary phacoemulsification instrumentation allows for more efficient and rapid removal of a luxated cataractous crystalline lens or lens fragments.

 

Several simple modifications allow for the implementation of this widely available anterior segment surgical instrumentation to pars plana lensectomy.
 

Epiretinal Membrane and Internal Limiting Membrane Peel Utilizing Wide-Field Viewing System With HD Lens

John W. Kitchens, MD

February 11, 2014

 

This video demonstrates an epiretinal membrane (ERM) and internal limiting membrane (ILM) peel utilizing an HD lens. Despite the wide field of view provided by the lens, it provides great depth of field.

 

 

Wide-Field Viewing System With HD Lens for Epiretinal Membrane Peel in a Patient With a Small Pupil

John W. Kitchens, MD

February 11, 2014

 

Peeling an epiretinal membrane (ERM) in a patient with a small pupil is typically difficult, but viewing through an HD lens provides an optimal depth of field while also maintaining a wide field of view.

 

This video shows the utilization of an HD lens in the case of a male patient on Flomax (tamsulosin, Boehringer Ingelheim Pharmaceuticals, Inc, Downers Grove, IL) with a horseshoe-shaped tear as a result of an ERM.

 

New Intraocular Foreign Body Forceps

Nur Acar, MD, FEBO
September 25, 2013
 

View newly designed intraocular foreign body (IOFB) prototype forceps and watch simulations of their use in IOFB removals.
 
 

Illuminated External Needle Drainage

John W. Kitchens, MD
September 25, 2013

 

A new technique for subretinal fluid drainage using both a guarded needle and a 29-gauge chandelier.

 


Intraocular Lens

27-Gauge Sutureless Transconjunctival Cannula-Based Scleral Fixation of Dislocated 3-Piece IOL

Ashkan M. Abbey, MD; Jeremy D. Wolfe, MD, MS; George A Williams, MD

July 2015 Featured Video

A 63-year-old male with h/o SB/PPV presents with a dislocated 3-piece IOL after initial sulcus placement. The IOL is rescued with scleral fixation.

IOL Exchange With Sutureless Transconjunctival Cannula-Based Scleral Fixation

Ashkan M. Abbey, MD; Jeremy D. Wolfe, MD, MS; George A Williams, MD

July 2015

A 72-year-old male presents with a dislocated 1-piece IOL. The IOL is removed and a 3-piece IOL is used for scleral fixation.

Removal of a Linear Intraocular Foreign Body

Nicholas D. Chinskey, MD, and Kevin J. Blinder, MD

January 2015 Featured Video

A 52-year-old woman hit herself in the left eye with pliers and 20-gauge silver wire.  An intraocular foreign body (IOFB) was noted.  It was seen on a B-scan, but not on CT (photo and B-scan shown).  

The video shows the removal of the IOFB through a trocar using forceps.  The IOFB was later found to be plastic. How the IOFB got into the eye (during a prior scleral buckle vs recently with trauma) remains a mystery as the patient was not handling plastic at the time of her injury.

 

Explantation of a Dislocated IOL and Secondary Scleral Fixation of Akreos Lens

Alok Shawn Bansal, MD, and Rahul N. Khurana, MD

December 2014 Featured Video
 

A 55-year-old man presented with a dislocated 3-piece intraocular lens (IOL) encased in a Sommering's ring. The surgeons demonstrate removal of the Sommering's ring from the vitreous cavity followed by cutting the IOL in the anterior chamber and explanting it through a small clear corneal wound. The surgeons then implant an Akreos AO Lens IOL (Bausch + Lomb, Bridgewater, NJ) with scleral fixation using a CV-8 GORE-TEX (WL Gore & Associates, Inc, Elkton, MD) suture.
  

 

Intraocular Lens Refixation Using GORE-TEX Suture

Adam T. Gerstenblith, MD
July 2014 Featured Video
 

This is a case of a refixation of a partially dislocated CZ70BD lens that had been sutured to the sclera with Prolene (polypropylene sutures, Ethicon Endo-Surgery, Inc, Somerville, NJ) 10 years ago. One of the Prolene sutures had broken, while the other was still intact.
   
The physician refixates the loose haptic with a GORE-TEX (W.L. Gore & Associates, Inc, Newark, DE) suture and cuts the intact Prolene suture and replaces it with another GORE-TEX suture.
   

Phaco Instrumentation for Pars Plana Lensectomy

Yannek I. Leiderman, MD, PhD

April 2014 Featured Video

 

As demonstrated in this video, contemporary phacoemulsification instrumentation allows for more efficient and rapid removal of a luxated cataractous crystalline lens or lens fragments.

 

Several simple modifications allow for the implementation of this widely available anterior segment surgical instrumentation to pars plana lensectomy.
 

 

Scleral Fixated Intraocular Lens Using GORE-TEX Suture and Akreos Lens

Omesh P. Gupta, MD, MBA; Marc J. Spirn, MD; and Jason Hsu, MD

April 2014 Featured Video
  

This is a technique of scleral fixating a Bausch + Lomb Akreos Lens using GORE-TEX (W.L. Gore & Associates, Inc, Newark, DE) suture. The attractive features of this approach are the use of standard small incision vitrectomy instrumentation and a standard phacoemulsification wound.

The intraocular lens (IOL) is fixated to the sclera using GORE-TEX suture, and the knots are buried into the sclerotomies. There is no corneal or scleral suturing.
  

Novel Technique for IOL Rescue

Jonathan L. Prenner, MD; Harold M. Wheatley, MD; and John D. Wilgucki, BS

February 2014 Featured Video

 

An eye in which a secondary intraocular lens (IOL) completely dislocates into the posterior segment while remaining completely in the bag presents a unique surgical challenge. One can remove the lens/bag complex and place a secondary IOL or explant the lens from the bag and then reposition the lens.

 

The surgeons present a novel, minimally invasive procedure that allows for suture fixation of the lens/bag complex without the need for manipulating the conjunctiva.

 

Bimanual IOL Rescue

Deval D. Joshi, MD; Jonathan A. Feistmann, MD; and Shaminder Singh Bhullar, MD
October 2013 Featured Video
 

This unique procedure allows for easier externalization of haptics and eliminates any anterior-segment manipulation.
 

Sutureless Scleral Fixation of an IOL

Jonathan L. Prenner, MD
August 2013 Featured Video
 

An inventive sutureless technique for secondary intraocular lens (IOL) rescue.


Ocular Oncology

Fine Needle Aspiration Biopsy for Optic Disc Melanocytoma With Presumed Malignant Transformation 

Victor M. Villegas, MD, and Timothy G. Murray, MD, MBA
January 21, 2015
 

Combined phaco-vitrectomy with fine needle aspiration biopsy to optic nerve melanocytoma with presumed malignant transformation. 

 

Transscleral Biopsy of a Choroidal Mass

Vincent Y. Ho, MD, BS, and Bradley T. Smith, MD

November 2014 Video of the Month
 

A 76-year-old woman with a history of breast cancer, basal cell carcinoma, and cutaneous melanoma presented with an 18 mm x14 mm inferonasal lesion 11 mm in height. Given her extensive cancer history, a tissue biopsy was ordered to aid in diagnosis and help determine her treatment plan.

   

The surgeons created a limited peritomy and looped 2 muscles. A partial-thickness scleral flap provided access to the underlying choroid, and 3 needle passes yielded specimens for pathology and gene-expression profiling.

   

 

Small-Gauge Retinal Biopsy

Baseer Ahmad, MD, and Bradley T. Smith, MD

June 2014 Featured Video

 

An example of 23-gauge vitreous and retinal biopsy taken from an eye with suspected primary vitreoretinal lymphoma. The use of air infusion for vitreous biopsy is illustrated, as well as the use of small-gauge diathermy, vertical scissors, and forceps for removal of the retinal tissue.

   


Retinal Detachments

 

Suction-Assisted External Drainage

Ahmad Bakir Tarabishy, MD

Featured Video October 2015

A 41-year-old phakic gentleman with high myopia develops a superonasal detachment that is treated with scleral buckling. A 24-guage pediatric intravenous catheter is introduced into the subretinal space. The subretinal fluid is drained using footpedal-controlled suction provided by the vitrectomy machine. Complete drainage of SRF is achieved using this technique. A general description of the scleral buckle technique can be seen in the video titled "Scleral Buckling Illuminated".

27-Gauge Vitrectomy for the Treatment of Anterior Capsule Fibrosis-Phymosis and Silicone Oil Removal

Shlomit Schaal, MD, PhD; Denis Jusufbegovic, MD; Amir Hadayer, MD; Thomas Neyer, BSN

August 2015


Exciting surgical technical advancements during the last decade have allowed retinal surgery to evolve up to a level where minimally invasive 27-gauge vitrectomy may be used for combined procedures involving both anterior and posterior segments.

 

The video demonstrates the treatment of anterior capsular fibrosis and phymosis using iris hooks, 27-gauge intraocular scissors and 27 vitrectomy probe. Posterior segment surgery included small gauge silicone oil removal, posterior vitrectomy and air fluid exchange.

A Complication During Vitrectomy for Aspergillus Endophthalmitis

Ankur M. Shah, MD, Seenu M. Hariprasad, MD, and Shawn A. Lewis, MD

April 1, 2015

This video demonstrates a potential complication of vitreoretinal surgery for treatment of a case of endogenous Aspergillus endophthalmitis. Attempts to debride a strongly adherent vitreoretinal abscess led to development of a retinal break. 

Novel Use of ReSure Ophthalmic Sealant After 23-Gauge Pars Plana Vitrectomy

Enchun M. Liu, MD, and Gaurav K. Shah, MD

February 2015 Featured Video

 

The ReSure Ophthalmic Sealant was recently FDA approved for sealing clear corneal incisions after cataract surgery. It is a nontoxic synthetic polyethylene glycol hyrdogel that sloughs off the ocular surface after 1-3 days. Although it has not been FDA approved for vitrectomy cases, there are potential applications for sealing sclerotomy incisions specifically for patients with thin sclera or those who need repeat vitrectomies.

27-Gauge Bullous Retinal Detachment Repair

Dilraj S. Grewal, MD, and Lejla Vajzovic, MD
January 21, 2015
 

There are several advantages to 27-gauge vitrectomy including a faster cut rate of 7500 cuts per minute and superior wound construction.

The video illustrates the repair of a bullous rhegmatogenous retinal detachment using the 27-gauge vitrectomy system and highlights its advantages and limitations.

 

27-Gauge Vitrectomy for Diabetic Tractional Retinal Detachment and Vitreous Hemorrhage 

Dilraj S. Grewal, MD, and Lejla Vajzovic, MD
January 21, 2015
 

This video demonstrates the utility of 27-gauge vitrectomy in a diabetic patient with a vitreous hemorrhage and a tractional retinal detachment. Also demonstrated are the benefits of a high-speed cutting system and smaller port size, allowing for membrane segmentation with the vitreous cutter alone.

 

27-Gauge Vitrectomy for Retinal Detachment Repair 

Raj K. Maturi, MD
December 9, 2014
 

Surgeons need to use 27g instruments differently, because they are more flexible and slower to debulk the vitreous. During retinal detachment (RD) repair, however, the smaller tip allows a much closer shave of the periphery.

   
This video shows a demonstration of a RD repair using Alcon 27g vitrectomy system (Alcon Manufacturing, Ltd, Fort Worth, TX) and an external illuminated indenter, allowing for quick peripheral shaving.
  

 

Retinal Detachment Repair Through a Boston K-Pro 

Manthan Shah, MD, and Rithwick Rajagopal, MD, PhD
December 9, 2014
 

Surgical management of patients with vitreoretinal diseases and cataracts has always presented a significant problem for vitreoretinal surgeons.

   

In this video, the surgeons present advantages, indications, and their experience with a new technique using femtosecond technology combined with minimally invasive vitreoretinal surgery.
  

   
 

Iatrogenic Retinal Detachment Inflicted During 25-Gauge Air-to-Fluid Exchange

Christopher G. Fuller, MD

October 2014 Video of the Month
 

This is the case of a 67-year-old woman who underwent vitrectomy for chronic vitreomacular traction and macular puckering. She suffered a retinal detachment at the time of surgical repair, likely secondary to intraocular irrigation reinitiated after Brilliant Blue G staining under air. It was the surgeon's first experience with Brilliant Blue G and provided an unexpected (and somewhat unhappy) teaching moment about the perils of air-to-fluid exchange.

  
At 1-month post op, retina is attached and the patient had significant visual improvement (20/40).
 

 

Retinotomies and Retinectomies: When and How? Current Techniques

Marcelo Zas, MD, PhD, and Arturo A. Alezzandrini, MD, PhD

September 2014 Video of the Month
 

Retinotomies and retinectomies can improve the therapeutic effects of complicated retinal detachments (RDs) in proliferative vitreoretinopathy (PVR) cases. Complications of these maneuvers are high and should be managed properly.

The physicians assess the techniques, indications, and complications of relaxing retinotomies and retinectomies for a complicated RD with severe PVR.
  

An approach to a Patient With Failed Cornea and Retinal Pathology -- Temporary Keratoprostheses and Pseudo-Iris

Yannek I. Leiderman, MD, PhD
June 10, 2014

  

This case illustrates the approach to a patient with a failed cornea and history of recurrent retinal detachment. Combined pars plana vitrectomy and penetrating keratoplasty were performed. A pseudo-iris was fashioned from a cyclitic membrane, conferring improved cosmesis and retention of silicone oil.

 

Stereoscopic 3D Video Demonstrating the Repair of a Complex Retinal Detachment

Shlomit Schaal, MD, PhD; Augustina Palacio, MD; Douglas Sigford, MD; and Ahmet Ozkok, MD
June 10, 2014

  

This video illustrates the complex repair of a chronic rhegmatogenous retinal detachment with proliferative vitreoretinopathy. It was recorded using 2 different cameras, allowing 3-dimensional viewing.

Video page includes 3D viewing instructions.

 

 

Diabetic Traction and Rhegmatogenous Retinal Detachment 27-Gauge Vitrectomy

Maria H. Berrocal, MD

May 2014 Featured Video

 
A very ischemic diabetic traction and rhegmatogenous retinal detachment (TRRD) is managed with 27-gauge vitrectomy. The 27-gauge forceps are utilized to remove subretinal membranes.

   

 

Subretinal Band Excision

Kevin J. Blinder, MD, and Baseer Ahmad, MD

May 2014 Featured Video

 

A case of a 40-year-old woman with a rhegmatogenous retinal detachment (RRD) proliferative vitreoretinopathy (PVR) and subretinal band along the inner aspect of the macula. This video explores and illustrates the decision-making process and intraoperative technique of the subretinal band excision.

 

 

Traction and Rhegmatogenous Retinal Detachment: 25g Probe-Peel Technique

Maria H. Berrocal, MD
April 8, 2014

 
Diabetic traction and rhegmatogenous retinal detachment is managed entirely with vitrectomy probe dissection with the lift-peel technique.

 

 

Diabetic Traction Retinal Detachment Repair Utilizing 7500 CPM 25-Gauge Vitrectomy

Maria H. Berrocal, MD
April 8, 2014

 

A demonstration of 25-gauge vitrectomy utilizing a 7500 cuts per minute (CPM) probe to remove fibrovascular tissue from the surface of the retina.

 

Using this method, the surgeon can safely perform peeling of the membranes with minimal traction on the underlying retina.

 
 

25-Gauge Pars Plana Vitrectomy of Total Retinal Detachment and Massive Fibrovascular Proliferation

Maria H. Berrocal, MD
April 8, 2014

 

This video shows a case of fulminant progression of fibrovascular tissue in a young diabetic patient, managed with 25-gauge membrane peeling techniques and pre-operative anti-VEGF injection.
  

23-Gauge Retinectomy Under Silicone Oil

Gaurav K. Shah, MD, and Baseer Ahmad, MD

March 2014 Featured Video
 

This is an illustration of a method of performing retinectomy under silicone oil using small-gauge instrumentation and direct infusion of silicone oil through the infusion line.

 

 

Management of a Macular Hole Secondary to a Retinal Macroaneurysm

John W. Kitchens, MD

March 11, 2014

 

A case of a large macular hole secondary to a retinal arterial macroaneurysm that bled into the subretinal space and resulted in a full-thickness macular hole.

 

 

Tractional Retinal Detachment: 101

Kevin J. Blinder, MD, and Enchun M. Liu, MD

March 11, 2014

 

This video shows a basic tractional retinal detachment/pre-macular hemorrhage—with a surprise at the end.

Scleral Buckling Illuminated

Ahmad B. Tarabishy, MD, and Frederick H. Davidorf, MD
January 2014 Featured Video

 

Scleral buckling is an important technique for retinal detachment repair, and various approaches have been described. This video demonstrates the use of an operating microscope for superior visualization and better surgeon ergonomics.

   

Using the BIOM (Insight Instruments, Inc, Stuart, FL) with an endoilluminator chandelier allows for intraoperative fundus visualization and assists with cryotherapy of retinal breaks and drainage of subretinal fluid.
    

Internal Limiting Membrane Peeling for Primary Rhegmatogenous Retinal Detachment

Gaurav K. Shah, MD, and Rajesh C. Rao, MD
August 14, 2013

 

An innovative internal limiting membrane (ILM) peeling technique and highlights of a recent study that links ILM removal during primary retinal detachment repair to decreased secondary macular pucker formation.
 

Repair of Retinoschisis-Associated Retinal Detachment

Gaurav K. Shah, MD, and Baseer Ahmad, MD

September 2013 Featured Video

 

A demonstration of schisis, inner holes, and ILM peeling over a detached retina.
   

Retinectomy Under Oil

John W. Kitchens, MD
November 2013 Featured Video

 

View the difficult case of a 20-gauge retinectomy in an oil-filled eye of a patient with a proliferative vitreoretinopathy (PVR)-related redetachment.
 

Straight to Oil

John W. Kitchens, MD
January 7, 2014

 

In this case, a male patient presented with a retina re-detachment after silicone oil removal. Following removal of the dense cataract, the physicians decided to go directly to oil, rather than the more traditional approach of performing a retinectomy, utilizing perfluoro-n-octane (PFO) and then placing oil.

 

Because of the tension of the oil on the retina, having it in place early allowed for direct visualization of the relaxing retinectomy and helped with hemostasis.
 

Abnormal Vitreous Base

Gaurav K. Shah, MD, and Baseer Ahmad, MD
January 7, 2014

 

This video shows an eye with an abnormal vitreoretinal interface with numerous iatrogenic intraoperative retinal breaks along the vitreous base. Laser cerclage is performed, and the surgeons demonstrate the utility of 360° laser and scleral buckling after vitrectomy.
 
 

Attacking PVR

John W. Kitchens, MD
November 26, 2013

 

A variety of approaches are used to successfully reattach a retina, including anterior vitrectomy, membrane peeling, and peeling under perfluoro-n-octane (PFO).
    

Illuminated External Needle Drainage

John W. Kitchens, MD
September 25, 2013

 

A new technique for subretinal fluid drainage using both a guarded needle and a 29-gauge chandelier.

 


Trauma

Scleral Embedded Intraocular Foreign Bodies: Trauma Minimization

Devon Ghodasra, MD, and Grant M. Comer, MD, MS

April 1, 2015

This video demonstrates techniques to minimize additional retinal and scleral trauma in the removal of scleral embedded intraocular foreign bodies. Performing several steps prior to and during the actual removal of the foreign body from the sclera may help to avert catastrophic intraoperative complications.

 

Removal of Intraocular Foreign Body: New Technique 

Randee Miller, MD, and Veeral S. Sheth, MD
December 9, 2014
 

A 29-year-old man who works at a factory cutting wires presented with mildly decreased vision and a remote history of eye trauma 1 year previously. Clinical exam revealed a large metallic intraocular foreign body.

  

This video highlights a new application for the Finesse Flex Loop (Alcon Laboratories, Inc, Fort Worth, TX), which the surgeons utilize here to snare the distal end of the foreign body and aid in its extraction.

    

 

Evisceration or Reconstruction in a Case of Globe Rupture With No Light Perception

S. Natarajan, MD; Juhi Garg, MBBS, MS; Divya Gupta Thakur, MBBS, MS; and Purva Valvekar, MBBS, MS
September 9, 2014
 

A 40-year-old male presented with an injury from a bamboo stick. There was no light perception in the right eye, the patient had total hyphema with a flat anterior chamber, and CT showed a distorted globe. A B-scan showed posterior dislocation of the lens with dense vitreous hemorrhage. A large superior scleral tear extending up to the optic disc posteriorly with incarcerated vitreous was also noted.

The patient was planned for primary scleral tear repair with intraocular injection of antibiotics. Later 23-gauge pars plana vitrectomy and pars plana lensectomy with perfluorocarbon liquid, endolaser, fluid/gas exchange and Densiron injection were performed. The eye was saved, and the patient improved to hand motions close to face.

   

 

Pars Plana Retrieval of Glass Intraocular Foreign Body

Rithwick Rajagopal, MD, PhD; Daniel P. Joseph, MD, PhD; and Rajendra S. Apte, MD, PhD

March 11, 2014

 

A man involved in a motor vehicle collision presented with a large retained intravitreal foreign body in the left eye, presumed to be glass based on the history of windshield shatter. Removal presents a challenge because of the large, irregular shape of the object and its nonmagnetic nature.

   

 

Four-Headed Retinal Surgical Monster: RP + ERM + FTMH + RD

Christopher G. Fuller, MD

March 11, 2014

 

This is the case of a 65-year-old white woman with a long history of retinitis pigmentosa (RP) and best corrected visual acuity (BCVA) 20/60 in both eyes. After suffering a fall, she reported sudden vision loss in her left eye and presented with RP, full-thickness macular hole (FTMH), somewhat chronic-appearing epiretinal membrane, and macular-involving retinal detachment
 

Microincisional Vitrectomy Instrumentation in Anterior and Posterior Segment Eye Trauma

Yannek I. Leiderman, MD, PhD
November 26, 2013

 

This alternative to traditional anterior segment techniques utilizes vitrectomy cutting, aspiration, blunt dissection, and scissors capabilities of a vitrectomy probe, with minimal instrument exchanges.

   

New Intraocular Foreign Body Forceps

Nur Acar, MD, FEBO
September 25, 2013
 

View newly designed intraocular foreign body (IOFB) prototype forceps and watch simulations of their use in IOFB removals.
  

Vitreoretinal traction

                    

Tough Hyaloid Forceps Technique

John W. Kitchens, MD
July 15, 2014
 

A demonstration of a difficult posterior hyaloid separation utilizing a forceps technique.