Gentlemen (& ladies),
I did an extreme myope -18 D, phakic with a posterior central detachment and a macular hole. Careful peripheral indented search showed no other holes. I thought I had induced a PVD, but on injecting dilute Triamcinolone realised that there was a very thin sheet of adherent vitreous still there, this was very resistant to come off, and had to be scraped off with a Tano Diamond dusted scraper. Yasou Tano has shown these cases in the past at various meetings, so I had an idea of what needed doing. Having cleared the vitreous and adherent hyaloid to the equator (at least), I decided to do a mid periphereal retinotomy to flatten the retina and then used brilliant peel (blue)under air hoping to stain ILM and remove it. PFCL fill after retina is flat under air, but when I put contact lens on to try and focus on ILM, I just could not get it to focus! Tried to peel ILM through BIOM view - I think with partial success. Laser to retinotomy and an area of 'suspicious' retina peripherally, then direct PFCL to silicon oil exchange. Let us see how she does.
I will try to make the time to edit the video and post it on my blog over the next few days - so watch this space
Som
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Hi Som,
ReplyDeleteDifficult case no wonder. I'll be interested in watching the video once you've edited it. You seem to have very nice videos, Can you tell me what system are you using in theatre for capturing the video. I wanted to know what Oil did you use for this case, Standard or heavy?. I ve had good experience with OxaneHD in closing the myopic detachment macular holes without the need for posturing.
Kind regards
Rubina
Rubina,
ReplyDeleteI used normal oil, there is no real issue about inferior tamponade here, one only needs posterior pole tamponade, and my thought was that normal oil would provide that. I postured her face down for a few hours, after which she has been upright - I have left her phakic for now, but will take the lens when I remove her oil (all being well). Let's see. Should get the video up in the next day or two, so do visit back.
BTW - what is your current email address - you can send that to me separately, I had sent a message to your old hotmail address which bounced. Can you send me your current email address separately please.
I'll do a separate post on the video setup, as it may be of interest to others.
Som,
ReplyDeleteThanks for the detailed explanation re:video capturing. I am trying to get a new one for us as the current one from Video south is not ideal for post segment work. My e-mail address is : binarahman@fsmail.net.
Regards
Rubina