Retinal Deatchment Teaching course 2008, Prof Ingrid Kreissig

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www.sudhalkareyehospital.heal th.officelive.com 1 Teaching course 2008 at retina Foundation Ahmedabad by Prof. Ingrid Kreissig Presentation by Dr. Anand Sudhalkar

description

Minimal surgery for retinal detachment Dr. Ingrid Kreissig

Transcript of Retinal Deatchment Teaching course 2008, Prof Ingrid Kreissig

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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