RETINA PEARLS: Bimanual Vitreoretinal Surgery for Tractional Retinal Detachment Due to Proliferative Diabetic Retinopathy
In this issue of Retina Today, Elliott Sohn, MD, provides surgical pearls for performing bimanual
vitreoretinal surgery for tractional retinal detachment due to proliferative diabetic
retinopathy using 20- or 23-gauge instrumentation.
We extend an invitation to readers to submit pearls for publication in Retina Today. Please
send submissions for consideration to Ingrid U. Scott, MD, MPH (firstname.lastname@example.org); or Dean Eliott, MD
(email@example.com). We look forward to hearing from you.
—Ingrid U. Scott, MD, MPH; and Dean Eliott, MD
Managing eyes with tractional retinal detachment
(TRD) due to severe proliferative diabetic
retinopathy (PDR) can be challenging
for vitreoretinal surgeons (Figure 1). TRD
from PDR, resulting from contraction of epiretinal fibrovascular
proliferative membranes, requires surgery when it
involves or threatens the macula or has a combined rhegmatogenous
retinal detachment (RRD) component.
In bimanual vitreoretinal surgery, two instruments are
used simultaneously to manipulate the same tissue inside
the eye. This concept typically excludes the use of a single-
function light pipe as one of the instruments,
although this too can be used for manipulation. Due to
the complexi… [read more...]
SURGICAL UPDATES: The Next Generation Machines for Modern Vitrectomy
At the 2011 Association for Research and
Vision in Ophthalmology (ARVO) meeting,
the Vit-Buckle Society met to discuss three
current-generation vitrectomy machines.
2010 was a banner year for vitreoretinal surgical equipment.
To help start a discussion about the surgical platforms,
Christopher Riemann, MD; Derek Kunimoto,
MD; and Jorge Fortun, MD, presented a quick summary
of the Dutch Ophthalmic USA (Exeter, NH), Bausch +
Lomb (Aliso Viejo, CA), and Alcon Laboratories, Inc.
(Fort Worth, TX), systems, respectively (three lectures
linked to EYETUBE.NET).
In the first half of the year, the Constellation Vision
System (Alcon Laboratories, Inc.) gained significant
traction in hospitals, universities, and some ambulatory
surgical centers (ASCs). In the second half of the year,
all kinds of excitement broke loose with two new
machines introduced (the Associate [Dutch Ophthalmic
USA]; and the Stellaris PC [Bausch + Lomb]) and the
voluntary recall of the Constellation by Alcon. Indeed,
the second half of 2010 was the equivalent of a soap
opera. Our hospital had purchased two Constellations
in the last weeks of June, just prior to the recall. In fact,
our in-service training was scheduled to take place on
the Mond… [read more...]