eyeMoviePedia

Argus II-Epiret

The epiretinal implant ARGUS II is placed on the macula in one patient with advanced retinitis pigmentosa to restore some form of visual acuity

Cataract surgery with penetrating keratoplasty after anterior lamellar dissection

We introduce a new technique that after anterior stromal dissection, cataract surgery is performed with clear vision, and then, the posterior stroma is
removed and penetrating keratoplasty is completed for an eye that had penetrating keratoplasty and cataract surgery planned. Partial thickness corneal incision was done with a Hessburg-Barron trephine. From the corneal incision, anterior stroma dissection was performed with an angled crescent blade. When the dissection was over, the anterior stroma was excised with a keratoplasty scissor. The anterior capsule was clearly visible so the capsulorrhexis was not difficult and capsular staining was not necessary. After nucleus and cortex removal, posterior stroma was removed with keratoplasty scissors. After eight cardinal sutures of a donor cornea, an IOL(intraocular lens) was inserted into the anterior chamber. After that, there was no trouble in the procedures and the surgery ended without
any complications.

Transplantation of a free RPE-choroid graft in patients with exudative AMD

82 year old female, 5 Avastin injections for a vascularized RPE detachment, submacular hemorrhage treated with vitrectomy/TPA/gas in the acute stage, revealing an RPE-tear with VA of 20/800.

RPE transplantation in an effort to reconstitute the underlayer of the macula.

Exchange of multifocal IOL decentered in a fibrose capsular bag in the lens-IOL

A case of an IOL exchange. It is a multifocal slightly tilted IOL. The patient was operated six years ago. When she was in the mean time operated on the other eye with a bag-in-the-lens toric correction, she saw the difference and wanted to have an exchange of this decentered lens. The quality of vision was otherwise not good enough for her dominant eye.

Laser Refractive Lens Surgery using an Intraocular Femtosecond Laser

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 lens is implanted.

Laser refractive lens surgery provides a far more accurate size and position of the capsulorhexis than the manual technique and enables the surgeon to combine the lens surgery with intracorneal refractive incision to correct astigmatism.

Low viscosity silicone oil as infusion fluid in vitreous hemorrhage

In vitrectomy of massive vitreous hemorrhage the view is typically compromised by stirred blood. In order to speed up the procedure saline as infusion fluid is replaced by very low viscosity silicone oil. The silicone has the advantage not to mix with blood. At the same time all vitrectomy procedures can be performed as like under saline. The much improved view into the eye should shorten the procedure. In the end the silicone oil as infusion fluid is being exchanged here against standard 2000 cSt silicone oil as tamponade agend.

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

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, we demonstrate that this approach provides excellent wound closure and potentially minimizes the risk of wound leak in sutureless vitreoretinal surgery.

Lars-Olof Hattenbach

Augenklinik des Klinikums Ludwigshafen, Ludwigshafen am Rhein, Germany

vitrectomy for Valsalva's maculopathy

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.

Hamartoma of the optic disc and the retinal pigment epithelium

A combined hamartoma of the optic disc and the RPE may show as a submacular CNV or/ and an epimacular gliosis. In this example the visual acuity is 20/200 and stable but metamorphopsia is a constant complaint. The surgical approach aims to release epiretinal traction via ILM peeling and thereby improve the metamorphopsia.

No epiretinal tissue is found, since the ILM stains homogenously. A fibrous tuft is peeled from the optic disc. Since in angiography there is no leakage from the subretinal RPE and no CNV, no subretinal membrane extraction is attempted. In concluding the retinal periphery is inspected an a fresh horseshoe tear is detected at 3 hours, not associated with the sclerotomy and addressed by cryopexy.

IOL Luxation during silicone oil removal

In an eye with a subluxated IOL and during silicone oil removal, all of a sudden the IOL disappears, possibly because the caspular bag was aspirated with the oil. Soon thereafter the iris is transiently aspirated by the aspiration needle. The IOL is found on the retina of the posterior pole. It is elevated with a flute needle (silicone tipped), grasped with foreps by its haptics and extracted via a sclerotomy. Later on a chamger angle suspended IOL will be implanted in the anterior chamber.