Sunday 15 March 2009

Inducing a PVD

Usually it is easy to induce a posterior vitreous detachment, but some times the posterior hyaloid face can be very resistant to coming off...

Here is one such case, after trying all the usual manouvres which failed, I decided to 'stain' the vitreous with triamcinolone and then mechanically peel the posterior hyaloid face till I could develop the plane of separation. Once tha was achieved, engaging and pulling up the posterior hyaloid face with the ocutome was easy.


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11 comments:

  1. Anonymous16 March 2009 at 00:08

    great surgery!
    thanks for the videos. it really helps me esp dat il be entering the vitreo retina fellowship next year.

    ReplyDelete
  2. Anonymous16 March 2009 at 00:36

    Welcome to the vitreo-retinal world. Great work, however can also be frustrating at times! Best Luck with your fellowship, and hope it all goes well.

    Som

    ReplyDelete
  3. Anonymous16 March 2009 at 03:12

    What was this case?

    Pratima

    ReplyDelete
  4. Anonymous16 March 2009 at 11:07

    Pratima,

    A branch retinal vein occlusion - mac oedema not responding to triamcinolone. The surgery was an arterio-venous sheathotomy.

    Best Wishes

    Som

    ReplyDelete
  5. Anonymous17 March 2009 at 02:00

    thanks Dr Som, but y is it frustrating? . Is Vitreoretina subspec the most unlikely or the most fulfilling as an eye surgeon?.. i need ur advice ..i still have time to change my mind with regards to the choice of fellowship training. thank you so much.

    ReplyDelete
  6. Som Prasad17 March 2009 at 14:52

    Frustating, because the success rate (visual outcomes) are not as good as - say - cataract surgery. And some patients seem to keep going bad - no matter how well you operate. So it isnot a 'quick fix' as in some forms of anterior segment surgery.

    However, it is very challenging, and satisfying. After all the pleasure is in fixing difficult things.....

    Best Wishes

    Som

    ReplyDelete
  7. Anonymous22 March 2009 at 10:10

    Dear Dr Prasad
    I congratulate & thank you for starting this blog.I have been reading your comments on various other group mails & they are indeed thoughtful.I am an anterior segment person, but to be candid, i have learnt a lot about posterior sement by following the discussions on retnet & other groups.This blog adds one more dimension to learning about this speciality. It is indeed utilizing the power of this medium to its fullest.
    Thanks once more & do keep uploading your great videos
    Dr.Mandar.Paranjpe
    Pune,India

    ReplyDelete
  8. Som Prasad22 March 2009 at 10:47

    Thanks Dr Paranjape, Keep visiting and contributing to the discussion. Best Wishes
    Som

    ReplyDelete
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