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Q&A?

Here’s your opportunity to ask questions, answer others’ questions and learn from our experts. You can ask a question using the form below, or comment on what has already been posted. Not all questions will be posted or answered, but all will be read!

Ask a question

Here’s your opportunity to ask questions, answer others’ questions and learn from our experts. You can ask a question using the form below, or comment on what has already been posted. Not all questions will be posted or answered, but all will be read!

You must login or register to submit a question to OphthalmicEdge.org.

Most Recent Q&As

Images:
A:

I will give some examples:

  • First, say your patient is a 57-year-old -6.00 myope who is spectacle dependent, you can sign him to cataract surgery as a certainly if you do a vitrectomy. If you do scleral buckling, there is a 90% likelihood that he will be surgically repaired and need only a minor modification of his glasses.
  • Second, any surgical procedure has a risk of failure. In my experience, dealing with both my cases and many referred cases, it is very clear that a failed scleral buckle for retinal reattachment requires a simple vitrectomy whereas a failed vitrectomy is often very complicated requiring silicone oil and scleral buckling.
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Images:
A:

Patients who have shallow subretinal fluid do not necessarily need drainage of fluid if the buckle elements are appropriately placed. There is a higher risk for retinal perforation or incarceration in this setting. Additionally, patients with an inferotemporal dialysis often do not need drainage. An anterior chamber tap can be very helpful in reducing the intraocular pressure during surgery.

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Images:
A:

There are three main advantages:

  • First, removing most of the subretinal fluid brings the retina closer to the wall of the eye and will allow you to tell if your indentation is adequately placed and increase the chances of the rest of the fluid resorbing.
  • Second, in the case of macula-off detachments, cryotherapy can be applied at this point in time with a reduced risk of pigment cells being dispersed under the macula.
  • Third, in the case of a fairly bullous detachment, this gives space in the eye for the injection of a gas bubble which can act as an internal tamponade.
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Images:
A:

Yes, we have heard from several users who use Internet Explorer 9 (IE9) to visit the site who are unable to play the videos. Users with Apple's Quicktime installed and using IE9 to browse ophthalmicedge.org receive codec errors that cannot be repaired- even by taking the steps outlined in the error message instructions.

We are actively working to resolve this issue. Please note that this error effects only Internet Explorer 9 so other browsers such as Mozilla's Firefox or Google Chrome can be used to watch these resources as we work to make them available to you in IE9.

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Images:
A:

There are really three steps: knowing the anatomy, knowing the possible abnormalities you may be looking at, and knowing the registration of the image (the top, bottom, left and right of the image). Using this information you need to visualize all the cross-sections that are possible and assemble them in your mind.

As an exercise, take a Bosc pear. Most of us would recognize the anatomy of this pear. With your knife, make thin slices of the pear vertically from the top to the bottom. Look at the slices from all angles. Reassemble the pear in your mind from the thin slices. Now slice your pear horizontally in thin slices and do the same exercise. In this example, the knife is the cut of the beam, the pear has a recognizable anatomy, and the registration of the visualization is the position of the slice (left, right, top, bottom).

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Images:
A:

Cases will sometimes present where the view is limited, common in complex cases. Any number of things can cause the view to be obscured during surgery. Using the endoscope allows you to regain your view and continue surgery often without more invasive actions.

Assuming one sees the value of mastering this instrument, the best place to learn is in a wet lab environment, rather than the pressure of the operating room.

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Images:
A:

Yes. With the release of the new Ophthalmic Edge website, I have added a textual transcription section to each of my ultrasound lectures. A transcript will be provided for all lectures if they are available.

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