- Видео 53
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D.G.Vavvas Harvard Retina Ophthalmology MEE
США
Добавлен 19 окт 2019
All recorded procedures have been performed at the Department of Retina, Massachusetts Eye and Ear Infirmary, Harvard Medical School in Boston, Massachusetts.
The aim of this non-profit RUclips channel is to contribute to Vitreoretinal Surgical education by sharing practical tips, tricks, and techniques. The material has been organized in short, accelerated clips so that the viewer might distill all educational points rapidly and efficiently. We focus on 1-3 educational points per clip to maximize integration.
We hope this material will prove to be of paramount assistance to Vitreoretinal Surgery trainees worldwide. Please keep in mind to follow the advice of your attendings, and always approach knowledge of any source with a critical intellect before adopting it, throughout your training.
Enjoy!
Channel supervisor: Demetrios G. Vavvas M.D., Ph.D.
Channel manager: Dimitrios P. Ntentakis M.D.
The aim of this non-profit RUclips channel is to contribute to Vitreoretinal Surgical education by sharing practical tips, tricks, and techniques. The material has been organized in short, accelerated clips so that the viewer might distill all educational points rapidly and efficiently. We focus on 1-3 educational points per clip to maximize integration.
We hope this material will prove to be of paramount assistance to Vitreoretinal Surgery trainees worldwide. Please keep in mind to follow the advice of your attendings, and always approach knowledge of any source with a critical intellect before adopting it, throughout your training.
Enjoy!
Channel supervisor: Demetrios G. Vavvas M.D., Ph.D.
Channel manager: Dimitrios P. Ntentakis M.D.
PRIOR UVEITIS (SYPHILIS HIV =) PROLIFERATIVE RETINOPATHY STAR FOLDS COMPLEX RETINA DETACHMENT
This is a complex retinal detachment with posterior PVR Grade C and star folds in prior uveitis scaring from syphilis
Posterior retinectomy and PRP styles laser followed with C3F8
Result was great from 20/125 to 20/20
Posterior retinectomy and PRP styles laser followed with C3F8
Result was great from 20/125 to 20/20
Просмотров: 764
Видео
pars plana cysts seen during scleral depression in vitrectomy
Просмотров 2238 месяцев назад
pars plana cysts seen during scleral depression in vitrectomy
Capsular removal Crocodile alligator "death roll"
Просмотров 1738 месяцев назад
We all know the Crocodile death roll ! This is a short video of it on a capsule remnant
Soft tip extrusion cannula for disclocated single piece plate IOL. Placement of an acIOL. P
Просмотров 1379 месяцев назад
This is a step by step approach for retrieval of a dropped silicone plate single piece intraocular lens (IOL) and placement of an acIOL. How to construct a sclera tunnel to avoid iris prolapse, how to rotate the acIOL in appropriate position is described.
Management of a dislocated single piece Acrysof lens (IOL) with sulcus 3 piece.
Просмотров 1669 месяцев назад
This is one of the simplest dislocated IOL scenarios with intact anterior capsule. Repositioning into AC, cut in half, remove and place a sulcus 3 piece with optic-capsule capture.
Repairing traumatic cataract, vascularized corneal wound, iridocorneal adhesions.
Просмотров 1219 месяцев назад
Here we use meticulous attention to anterior segment pathology. We use pre-op Avastin(Bevacizumab), the DORC vitrectomy system for the lensectomy and meticulous attention to remove scar tissue to cornea endothelium and wound as well as iridocorneal adhesions. We left the patient aphakic. With contact lens he reaches 20/60. Options of intraocular lens and corneal transplant are on the table, but...
Management of Glasses and intraocular foreign bodies in the eye (Nitinol end grasping, CLAW forcep)
Просмотров 3469 месяцев назад
Here we discuss glasses and other intraocular foreign bodies and instruments for their removal such as nitinol kidney stone baskets and their variations (zero tip, end grasping), as well the CLAW IOFB and other instruments to remove various IOFBs
Complex Cataract post Endopthalmitis. Single incision. VisionBlue® Trypan Blue Malyugin® Ring.
Просмотров 10810 месяцев назад
Complex Cataract post Endopthalmitis. Single incision. VisionBlue® Trypan Blue Malyugin® Ring.
Partial FAx for determining drainage site /AC air fluid reconstitution and effect on field/360 laser
Просмотров 156Год назад
This is another option available for determining drainage site in a shallow RD
Basic ERM peel without ILM peel / fast recovery post op week 1
Просмотров 351Год назад
This is a basic ERM peel with no ILM peel. Low light intensity (20% on Constellation) and atraumatic. Excellent and fast recovery for the patient
Vitreous strand clogged tube Soemmering ring cataract
Просмотров 290Год назад
The patient is a 36 year old woman with a history of juvenile idiopathic arthritis and advanced secondary glaucoma in both eyes. She was aphakic after cataract removal in both eyes during childhood and had an Ahmed valve placed in her right eye 13 years ago, as depicted in the photograph above. She was also followed for an iris lesion for the past ten years. As seen on ultrasound biomicroscopy,...
Can you tell the closest you can get to the cornea without touching the BIOM or Resight lens?
Просмотров 7492 года назад
How to maximize field of view without touching the cornea. How do you know when you are close enough but that you dont touch? The closer you get the more field of view you have. but if you touch you will loose clarity . So is there an easy way to tell? The answer is yes. When the edge of IOL barely fills your field of view you are at maximum point and safe away from the cornea. If the patient i...
Epiretinal Membrane (ERM) Macular Pucker , epiretinal proliferation. Need for ILM peel ? Basics (HD)
Просмотров 5 тыс.2 года назад
What causes ERM? How it affects patients? What are surgical outcomes? DO you need to peel ILM? What is the time course of recovery? What about Epiretinal proliferation ?
OCT basics Lancaster 2022 / How to get the most of OCT understanding ? (HD 1080p)
Просмотров 2692 года назад
How to get the most of OCT understanding ? What are pros and cons of different systems What confuses people most? What are some of the artifacts ? Optical Coherence Tomography
Diabetic ERM ILUVIEN IOFB removal | ERM removal | HD 1080p
Просмотров 1532 года назад
This procedure was performed in June 30, 2022 at Massachusetts Eye and Ear, Harvard Medical School. Note the intact ILM, the effect of the 25-g vitrector on the ILUVIEN shield, and the rapid improvement in visual acuity and OCT in less than 24 hours, and after 1 week.
2 in 1 | PVD & ERM peel together | HD 1080p
Просмотров 3342 года назад
2 in 1 | PVD & ERM peel together | HD 1080p
poor view vascularized cornea PPV PPL pax6 aniridia dislocated lens
Просмотров 3382 года назад
poor view vascularized cornea PPV PPL pax6 aniridia dislocated lens
Single bubble in fluid air exchange and issues w/ intact posterior capsule droplet under air HD
Просмотров 2672 года назад
Single bubble in fluid air exchange and issues w/ intact posterior capsule droplet under air HD
Effects of new diabetic drugs on diabetic retinopathy. 7 min Talk at Macula 2022
Просмотров 1732 года назад
Effects of new diabetic drugs on diabetic retinopathy. 7 min Talk at Macula 2022
two pieces of glass inside the eye IOFB glass HD 1080p
Просмотров 8433 года назад
two pieces of glass inside the eye IOFB glass HD 1080p
monocular diabetic with PDR PVR TRD RRD KPRO pars plans tube delayed due to COVID-19
Просмотров 1153 года назад
monocular diabetic with PDR PVR TRD RRD KPRO pars plans tube delayed due to COVID-19
pseudophakic RRD OS drainage from ST anterior periphery using Ultravit Cutter HD 1080p
Просмотров 1013 года назад
pseudophakic RRD OS drainage from ST anterior periphery using Ultravit Cutter HD 1080p
IOL fogging and viscoelastic HD 1080p
Просмотров 1263 года назад
IOL fogging and viscoelastic HD 1080p
role of ant vitrectomy in bullous RRD HD 1080p
Просмотров 1213 года назад
role of ant vitrectomy in bullous RRD HD 1080p
pseudophakic RRD drainage from tears switching ports HD 1080p
Просмотров 583 года назад
pseudophakic RRD drainage from tears switching ports HD 1080p
topical 2 port PPV on a 17 year old HD 1080p
Просмотров 903 года назад
topical 2 port PPV on a 17 year old HD 1080p
young patient w mac hole epiretinal proliferation HD 1080p
Просмотров 863 года назад
young patient w mac hole epiretinal proliferation HD 1080p
PVD tip: break vacuum suction:potential space HD 1080p
Просмотров 1093 года назад
PVD tip: break vacuum suction:potential space HD 1080p
Excellent video
Please help a non medical professional understand... 80% see improvement with peel, but you still recommend avoiding the surgery because of associated risks?
Great case!Thank you for sharing!
Thank you for sharing the great technique for removing the plate IOL! I usually perform sutureless intrascleral IOL fixation. Is there any advantage for using ACIOL?
great result congratulations thank you for sharing!
any reason not to perform a yamane rather than ACIOL? or just surgeon preference?
Great technique for removing that plate IOL! Thanks for sharing!
Great cases thank you for sharing!
Awesome!
I also do ERM peeling without ILM peeling, too. But can't see so fast recovery😩. Very good recovery for this case!!👍
decreased OR time is important. Also I do pretreat patients in the OR with 250mg of IV solumedrol to reduce impact of surgical trauma
Very interesting!! Always learning
you are very kind!
Sir, do you use PFCL in retinal detchment? Do you perform the majority of them with or without? Can you upload a surgical video on that please? Please explain us, thank you. Dr. Filippo Confalonieri
apologies for the very late reply. I do but not in the majority. Yes I wil make a video and upload one on that as well . Thank you for your comment
𝕡𝕣𝕠𝕞𝕠𝕤𝕞 💘
Dear Dr. Vavvas, Great case! I have a question for you. In diabetic ERM and DME, I usually peel both ERM and ILM combined with injection of Ozurdex, and have a good visual acuity improvement after 2 weeks. Is it necessary to peel ILM in diabetic ERM and DME? Thank you!
Hi Yanyun. good to hear from you . It is an unanswered question in diabetics if you need or not. Diabetics a lot of time have anomalous vitreous wiht much schisms and potential "several membrane layers" . Will suggest you that you try to do a series of cases without ILM peel but make sure that ERM is indeed peeled and compare. also you may want to try temporal region ILM peeling only and spare fovea and papillomacualr bundle ! Thank you for bringing up an interesting question !
Great case! Cheers Dr. Vavvas from a Greek med student!
thank you !
Great case!!
Thank you Sandra
Thank you Dr emuakhe on RUclips.this is my third time of hearing about the effectiveness of your great herbs for a total cure for diabetes from my close friends.i will place order for my old mom.keep saving life....
Dr. Vavvas performed this same procedure on me in 2016 during a vitrectomy and retina reattachment. There is a tear in the capsular bag of that eye, apparently caused by another doctor during my cataract surgery several months earlier. I have the video of my vitrectomy/retina reattachment on my phone (8x speed) that Dr. Vavvas gave me at my first follow-up exam, complete with captions, including a description of the surprise fogging and the Viscoat application. A year later Dr. Vavvas went back in and removed the IOL, because it had been improperly placed by the cataract surgeon. It was touching my iris, and every time I bent over it caused bleeding, which took five days to clear up and was making my glaucoma worse. Thank you Dr. Vavvas for saving my sight more than once.
you are very kind ! Surgery is a privilege ! We all strive to do the best for our patients! I am thankful to my teachers, and trainees and of course to my parents. My father had congenital cataracts and that was the main catalyst for me going into this field
Which camera are you using? Amazing video quality!
this is the Zeiss Lumera with the Resight system and with the build in Video recording at 1080p
Hello Doctor, Great vídeo. great video. How many days did you wait for drainage? Do you always use a single sclerotomy or drain several quadrants in any case? Regards.
most often I will use one site. I usually wait 1-2 weeks for the clot to have lysed. I obtain B-Scans to monitor the clot status. When it is more than 50% lysed I will perform the drainage. The goal is to drain enough , not need to go overboard. If >50% is drained you can stop.
I never try topical anesthesia for vitrectomy. How about the patient's feeling? Should I finish the surgery less than 20 minutes?
the patient felt very well. It is important to have the anesthesiologist work with you and the patient giving short acting sedation and/or analgesia. I like to ask the anesthesiologist to give Remifentanyl (very short acting opioid) just 45 seconds prior to the inesrtion of my port. Also if I have to do laser or some other potentially more painful procedures I do ask for another dose of remifentanyl.
Please explain it..is it treatment for RP ?
no, this patient had a complication from his prior cataract surgery. So we were addressing that issue only