Videos by Topic

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Topics

AMD	Instrumentation & devices	Retinal detachments
Diabetic retinopathy	Intraocular lens	Trauma
Inflammatory disease	Myopic foveoschisis

AMD

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.

Diabetic retinopathy

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.

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.

Instrumentation & devices

	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 June 2014 Featured Video Baseer Ahmad, MD, and Bradley T. Smith, MD June 10, 2014 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 April 2014 Featured Video Yannek I. Leiderman, MD, PhD April 8, 2014 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

	Intraocular Lens Refixation Using GORE-TEX Suture *July 2014 Featured Video* Adam T. Gerstenblith, MD July 15, 2014 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.
	Scleral Fixated Intraocular Lens Using GORE-TEX Suture and Akreos Lens April 2014 Featured Video Omesh P. Gupta, MD, MBA; Marc J. Spirn, MD; and Jason Hsu, MD April 8, 2014 This is a technique of scleral fixating a Bausch + Lomb Akreos Lens using GORE-TEX 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 February 2014 Featured Video Jonathan L. Prenner, MD; Harold M. Wheatley, MD; and John D Wilgucki, BS February 11, 2014 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 October 2013 Featured Video Deval D. Joshi, MD; Jonathan A. Feistmann, MD; and Shaminder Singh Bhullar, MD October 22, 2013 This unique procedure allows for easier externalization of haptics and eliminates any anterior-segment manipulation.
	Sutureless Scleral Fixation of an IOL August 2013 Featured Video Jonathan L. Prenner, MD August 14, 2013 An inventive sutureless technique for secondary intraocular lens (IOL) rescue.

Myopic foveoschisis

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.

Retinal detachments

	Iatrogenic Retinal Detachment Inflicted During 25-Gauge Air-to-Fluid Exchange October 2014 Video of the Month Christopher G. Fuller, MD October 7, 2014 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 September 2014 Video of the Month Marcelo Zas, MD, PhD, and Arturo A. Alezzandrini, MD, PhD September 9, 2014 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 *May 2014 Featured Video* Maria H. Berrocal, MD May 13, 2014 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 May 2014 Featured Video Kevin J. Blinder, MD, and Baseer Ahmad, MD May 13, 2014 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 March 2014 Featured Video Gaurav K. Shah, MD, and Baseer Ahmad, MD 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 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 This video shows a basic tractional retinal detachment/pre-macular hemorrhage—with a surprise at the end.
	Scleral Buckling Illuminated January 2014 Featured Video Ahmad B. Tarabishy, MD, and Frederick H. Davidorf, MD January 7, 2014 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 September 2013 Featured Video Gaurav K. Shah, MD, and Baseer Ahmad, MD September 25, 2013 A demonstration of schisis, inner holes, and ILM peeling over a detached retina.
	Retinectomy Under Oil November 2013 Featured Video John W. Kitchens, MD November 26, 2013 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).

Trauma

	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 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 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.

The Innovative Retina Surgical Video Series is made possible by a contribution from Alcon Laboratories, Inc.

Education

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The Innovative Retina Surgical Video Series
is made possible by a contribution from
Alcon Laboratories, Inc.