retinal deatchment teaching course 2008, prof ingrid kreissig
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Minimal surgery for retinal detachment Dr. Ingrid KreissigTRANSCRIPT
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Teaching course 2008 at retina Foundation Ahmedabad by Prof. Ingrid Kreissig
Presentation by
Dr. Anand Sudhalkar
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Patient: 1 male:JD Age: 66 years oldComplaints: progressive visual loss over last 2 weeks.
No photopsiaHistory: No H/O trauma
Preop. Findings:R: FC temp VA L: 6/18 -4.0Dsph Nuclear cataracts BE
Fellow eye
Detachment with no break
Detachment with 1 break
Detachment with 2 or several breaks
Lattice
Tears
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Postop. Findings:
Case 1. JD Operation Dr.: Anand Sudhalkar
Cryocoagulation around breaks
11.00 o'clk 5x 3mm radial buckle
4.30o' clk 5 x 3mm radial Buckle
1 month postop. VA
RE FC 10' Cat+++
LE -4.0 6/18 Cat++
Treatment / Operations:
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Compare with preop clinical pictures
Case 1. JD
Radial Sponge
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Case 1. JD Post OP
12. month postop. VA R -1.0 -2.0 110* = 6/18 (IOL). L -4.0 = 6/12 (Phakic)
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Case: 2. Dr. Anand Sudhalkar Patient: male : J.D. Age: 67 yearsComplaints: Sudden loss LE 4 daysHistory: LE psuedophakia 5 months, RE RD 1 year agoPreop. Findings: R 6/18 with -3.0Dsph (IOL) VA L HM
Detachment with no break
Detachment with 2 or several breaks
Fellow Eye
Detachment with one break
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2. Preop pictures LE
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case: 2 LE Dr.: Anand SudhalkarTreatment / Operations:
cryocoagulation—8.30 to 10.30 hrs.5x7 mm circumferential silicone buckle— 3 MERSILENE 5/0 mattress suturesAt 1.15hrs. clk 5x4mm radial silicone buckle held by 1 5/0 mersiline mattress suture
R -2.0 -1.0 90*= 6/18 1 month postop. VA L -3.0=6/24
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Case 2. 2 months post op
2 months post op
RE -2.0 -1.0 90*=6/18
LE -2.0 -1.0 180*= 6/18
Segmental Buckle
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Case 2 LE 4 months post op
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Case 3 Dr.: Anand SudhalkarPatient: female Mrs. Jyotsna R. Dave Age: 27Complaints: Sudden Loss of vision LE 2 daysHistory: High Myope BEPreop. Findings: R -17.0 D 6/24VAL Light perception
Detachment with no break
Detachment with 1 break
Detachment with 2 or several breaks
Fellow eye
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Case 3: Pre op Retina Pictures
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Segmental 5x7 mm sponge 7 to 10.30 clk hrs
Radial 5x4mm sponges at 2.30 and 5.30 clk hrs.
No SRF Drainage, High IOP Schiotz tonometry Paracentesis, mannitol, diamox
Retina settled after 20 days
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LE
Attached Retina RE
Post op Pictures
Case 3 RE
Inf Radial Buckle
Superior Radial Buckle
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Case 3: Redetachment 2months post op
SRF at Macula
The SRF collected 6 to 10 o’clk, pointing to the Location of slipped hole.
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Case 3: Buckle revisionThe segmental buckle shifted posteriorly, additional cryo done, No SRF drainage
SRF
Inf Radial buckle
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Retina attached after resurgery
Pre op
Post OP