The Duke Manual of Vitreoretinal Surgery

Contents
SECTION I: JUST THE BASICS ........................................................................................................1
1 The Preoperative Discussion ........................................................................................................... 3
Christian J. Sanfilippo, MD and Thomas A. Hanscom, MD
2 Vitrectomy Systems .......................................................................................................................... 6
Mohsin H. Ali, MD
3 Vitrectomy Machine Settings ........................................................................................................ 12
Fadi Shaya, BSc and Kent Small, MD
4 Lenses and Viewing Systems ......................................................................................................... 22
R. Joel Welch, MD and Lawrence S. Morse, MD, PhD
5 Setting Up for Vitreoretinal Surgery ............................................................................................ 26
Jack O. Sipperley, MD
SECTION II: PARS PLANA VITRECTOMY .................................................................................... 29
6 Gauge Selection and Cannula Placement .................................................................................. 31
Ryan N. Vogel, MD, Sally S. Ong, MD, and James T. Handa, MD
7 Getting and Maintaining Your View ............................................................................................. 35
Frank Brodie, MD, MBA and Eugene de Juan Jr, MD
8 Vitrectomy Surgery Steps .............................................................................................................. 39
Naryan Sabherwal, MD and Mathew W. MacCumber, MD, PhD
9 PVD Induction .................................................................................................................................. 43
Shriji Patel, MD and Paul Sternberg Jr, MD
10 Illumination During Vitreous Surgery ......................................................................................... 46
Jaycob Avaylon, BS and Ron P . Gallemore, MD, PhD
11 Endolaser Types and Settings ....................................................................................................... 50
Adam AufderHeide, MD, PhD and Jeffrey Rinkoff, MD
SECTION III: VITREORETINAL SURGICAL ADJUNCTS .............................................................. 55
12 Intraoperative Visualization Agents ............................................................................................ 57
Alice C. Jiang, MD, MS and Justis P . Ehlers, MD
13 Perfluorocarbon Liquid .................................................................................................................. 60
Eric Steuer, MD, PhD
14 Gas Tamponade ............................................................................................................................... 63
Belinda Shirkey, MD
15 Silicone Oil Tamponade.................................................................................................................. 68SECTION IV: EXCHANGES ........................................................................................................... 73
Fluid Air Exchange........................................................................................................................... 75
Joseph A. Khawly, MD, FACS
Air Gas Exchange ............................................................................................................................. 79
Adam Berger, MD
Air Silicone Oil Exchange ............................................................................................................... 81
John D. Zilis, MD
Perfluorocarbon Liquid Silicone Oil Exchange .......................................................................... 85
Shelley Day Ghafoori, MD
SECTION V: RHEGMATOGENOUS RETINAL DETACHMENT ..................................................... 89
Rhegmatogenous RD vs Exudative RD vs Retinoschisis .......................................................... 91
Lawrence P . Chong, MD
Retinal Break Localization ............................................................................................................. 93
Karen Gehrs, MD
Pneumatic Retinopexy ................................................................................................................... 96
Michelle Y . Peng, MD and J. Michael Jumper, MD
Scleral Buckling Basics ................................................................................................................... 99
Claxton Baer, MD, PhD
Scleral Buckling Steps ..................................................................................................................103
Anne Hanneken, MD
Radial Elements .............................................................................................................................110
Asad F. Durrani, MD and Thomas R. Friberg, MD, MS
External Subretinal Fluid Drainage ............................................................................................113
Durga S. Borkar, MD
The Chandelier Buckle ..................................................................................................................116
Eric W. Schneider, MD
Vitrectomy for RRD ........................................................................................................................119
Daniel Ting, MD, PhD
Posterior SRF During Vitrectomy for RRD .................................................................................123
Christopher L. Haupert, MD
Scleral Buckle and Vitrectomy for RRD ......................................................................................126
James C. Lai, MD, MMM
Postop Positioning ........................................................................................................................129
Akshay S. Thomas, MD, MS and Avni P . Finn, MD, MBA
SECTION VI: MACULAR SURGERY ........................................................................................... 133
Epiretinal Membrane ....................................................................................................................135
Pouya N. Dayani, MD
Macular Hole ..................................................................................................................................139
Charles Wilson, MD
Advanced Vitrectomy Techniques for Macular Holes .............................................................143
Cindy X. Cai, MD and Cynthia A. Toth, MD
Autologous Retinal Transplant ...................................................................................................147
Tamer H. Mahmoud, MD, PhD
SECTION VII: LENSECTOMY AND SECONDARY IOL PLACEMENT ........................................ 151
Pars Plana Lensectomy .................................................................................................................153
Kevin Broderick, MD and Alex Melamud, MD, MA
Dislocated IOL ................................................................................................................................158
R. Keith Shuler Jr, MD38 ACIOL and Iris-Fixated IOL ...........................................................................................................161
Sai H. Chavala, MD
39 Sutured Scleral Fixated IOL .........................................................................................................165
Frank Brodie, MD, MBA, Durga S. Borkar, MD, and Dilraj S. Grewal, MD
40 Sutureless Scleral Fixation Techniques .....................................................................................169
Nicholas Saba, BS and Scott D. Walter, MD, MSc
SECTION VIII: DIABETIC VITRECTOMY .................................................................................... 175
41 Considerations and Instrumentation for Diabetic Vitrectomy .............................................177
H. Michael Lambert, MD, FACS
42 Nonclearing Vitreous Hemorrhage ............................................................................................180
Wenlan Zhang, MD
43 Diabetic TRD ...................................................................................................................................183
Akosua Nti, MD and Adrienne Scott, MD
SECTION IX: PEDIATRIC VITREORETINAL SURGERY ............................................................. 189
44 Indications and Unique Surgical Considerations for Pediatric Vitreoretinal Surgery ......191
Karl Olsen, MD and Antonio Capone Jr, MD, FACS
45 Retinopathy of Prematurity ........................................................................................................195
Michael T. Trese, MD
46 Pediatric RRD ..................................................................................................................................198
Xinxin Zhang, MD and Lejla Vajzovic, MD
SECTION X: VITREORETINAL SURGERY FOR TUMORS AND UVEITIS .................................. 203
47 Diagnostic Vitrectomy ..................................................................................................................205
Sruthi Arepalli, MD and Phoebe Lin, MD, PhD
48 Retisert Placement ........................................................................................................................208
Ankur Mehra, MD and Andrew Pearson, MD
49 RD Repair in Uveitis .......................................................................................................................211
Ananth Sastry, MD and Glenn J. Jaffe, MD
50 Vitrectomy-Assisted Choroidal Biopsy ......................................................................................216
Prithvi Mruthyunjaya, MD, MHS
51 Transscleral Choroidal Biopsy .....................................................................................................218
Michael Seider, MD
52 Chorioretinal Biopsy .....................................................................................................................222
Akshay S. Thomas, MD, MS
SECTION XI: CHALLENGING VITREORETINAL SURGICAL SCENARIOS ................................ 225
53 Giant Retinal Tear ..........................................................................................................................227
Roger L. Novack, MD, PhD, FACS
54 Proliferative Vitreoretinopathy Surgery ...................................................................................230
Mohammad Dahrouj, MD, PhD and Dean Eliott, MD
55 Choroidals .......................................................................................................................................233
Xi Chen, MD, PhD
56 Submacular Hemorrhage ............................................................................................................236
Kenneth Taubenslag, MD and Joseph Martel, MD
57 Subretinal Perfluorocarbon Liquid ............................................................................................ 239
Glenn C. Yiu, MD, PhD
58 Subretinal Silicone Oil ..................................................................................................................242
Jeremy Lavine, MD, PhD and Sumit Sharma, MD
59 Uveal Effusion Syndrome ............................................................................................................. 245 Endophthalmitis ............................................................................................................................247
Andrew N. Antoszyk, MD
Intraocular Foreign Body .............................................................................................................251
Johnathan Warminski, MD and Jawad Qureshi, MD, MBA
Retinal Detachment in Open Globe Injury ...............................................................................256
Durga S. Borkar, MD and Carl H. Park, MD
Macular Hole Retinal Detachment .............................................................................................260
Max Treacy, BA, BAI, MSc, FRCSI, FRCOphth, FEBO and Mark Cahill, MCh, MMedSci, FRCSI, FRCOphth, FEBO
Retinoschisis Retinal Detachment .............................................................................................264
Harsha A. Sen, MD
Postop Retinal Fold .......................................................................................................................267
Akshay S. Thomas, MD, MS and Avni P . Finn, MD, MBA
Vitrectomy With the Endoscope .................................................................................................269
Brendan Seto, BA and Jorge Arroyo, MD, MPH
Optic Pit Maculopathy ..................................................................................................................272
Wenlan Zhang, MD and Eric Postel, MD
Argus II Retinal Prosthesis ...........................................................................................................275
Paul Hahn, MD, PhD
Physiology of Vitreous Surgery ..................................................................................................278
Jóhann Ragnar Guðmundsson, MD and Einar Stefánsson, MD, PhD
Index 285