- •Practical Handbook for Small-Gauge Vitrectomy
- •Foreword 1 (German Edition)
- •Foreword 2
- •Preface
- •Acknowledgements
- •Abbreviations
- •Contents
- •1.1 History
- •1.2.1 Sutureless Sclerotomy
- •1.2.2 Trocar
- •1.2.3 Bimanual Surgery
- •2: Equipment
- •2.1 Devices
- •2.1.1 Operating Microscope
- •2.1.2 Binocular Indirect Ophthalmo Microscope (BIOM System)
- •2.1.3 Vitrectomy Machine
- •2.1.4 Laser Device
- •2.1.5 Cryo Console
- •2.1.6 Light Source
- •2.2 Standard Instruments for Pars Plana Vitrectomy
- •2.2.1 Instruments for Macular Surgery
- •2.2.2 Instruments for Peeling for Diabetic Retinopathy and Traction Retinal Detachment with PVR
- •2.3 What Instruments Are Needed for Different Interventions?
- •2.4 Gases and Liquids
- •2.4.1 Perfluorocarbon
- •Pits & Pearls No. 1
- •Pits & Pearls No. 2
- •2.4.3 Expanding Gases
- •Pits & Pearls No. 3
- •2.4.4 Light Silicone Oils
- •Pits & Pearls No. 4
- •2.5 Dyes for Vitreous and Membranes
- •2.5.1 Staining of the Vitreous
- •Pits & Pearls No. 5
- •2.5.2 Staining of Epiretinal Membranes
- •2.5.3 Staining of the Inner Limiting Membrane (ILM)
- •3.1 General Considerations
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •3.2 Patient Selection
- •3.3 Recommended Learning Steps for Beginners
- •3.4 Complicated Surgeries for Advanced Surgeons
- •3.5 Anaesthesia
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls No. 6
- •3.6 Combined Surgery: Phaco/IOL and Pars Plana Vitrectomy
- •Pits & Pearls
- •3.7 3-Port or 4-Port Vitrectomy
- •Pits & Pearls
- •4.1 Topography in Vitrectomy
- •4.2 Pars Plana Vitrectomy Step by Step
- •Pits & Pearls No. 7
- •Pits & Pearls
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- •Pits & Pearls No. 8
- •Pits & Pearls
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- •Pits & Pearls No. 9
- •Pits & Pearls No. 10
- •Pits & Pearls No. 11
- •Pits & Pearls No. 12
- •Pits & Pearls No. 13
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- •Pits & Pearls No. 15
- •Pits & Pearls No. 16
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- •Pits & Pearls No. 19
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- •Pits & Pearls No. 20
- •Pits & Pearls No. 21
- •Pits & Pearls No. 22
- •Pits & Pearls No. 23
- •Pits & Pearls No. 24
- •Pits & Pearls No. 25
- •Pits & Pearls No. 26
- •Pits & Pearls
- •Pits & Pearls No. 27
- •Pits & Pearls No. 28
- •Pits & Pearls No. 29
- •Pits & Pearls No. 30
- •Pits & Pearls No. 31
- •Pits & Pearls No. 32
- •References
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls No. 33
- •Pits & Pearls No. 34
- •Pits & Pearls No. 35
- •Pits & Pearls
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- •Pits & Pearls No. 36
- •Pits & Pearls No. 37
- •Pits & Pearls
- •5.2 Vitreous Haemorrhage
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls No. 38
- •Pits & Pearls No. 39
- •5.3 Epiretinal Membranes and Macular Holes
- •Pits & Pearls
- •Pits & Pearls No. 40
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls No. 41
- •Pits & Pearls No. 42
- •Pits & Pearls
- •5.4 25-Gauge Macular Peeling
- •Reference
- •6.1 Insertion of Chandelier Light
- •Pits & Pearls No. 43
- •7: Diabetic Retinopathy
- •7.1 Easy Proliferative Diabetic Retinopathy
- •Pits & Pearls
- •Pits & Pearls
- •7.2 Complicated Proliferative Diabetic Retinopathy (PDVR)
- •Pits & Pearls No. 44
- •Pits & Pearls No. 45
- •Pits & Pearls No. 46
- •8.1 Dislocation of the IOL with Capsular Bag due to Zonulolysis
- •8.2 Dropped Nucleus
- •Pits & Pearls No. 47
- •9: Endophthalmitis
- •Pits & Pearls No. 48
- •Pits & Pearls
- •Pits & Pearls
- •Reference
- •10: Retinal Detachment
- •10.1 Detachment Surgery
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls No. 49
- •Pits & Pearls
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- •Pits & Pearls No. 50
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- •Pits & Pearls No. 51
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- •Pits & Pearls No. 52
- •Pits & Pearls No. 53
- •Pits & Pearls
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- •Pits & Pearl No. 54
- •Pits & Pearls
- •Pits & Pearls
- •Pits & Pearls No. 55
- •Pits & Pearls No. 56
- •10.2 Retinal Detachment Complicated by Proliferative Vitreoretinopathy (PVR)
- •Pits & Pearls No. 57
- •Pits & Pearls No. 58
- •Pits & Pearls
- •Pits & Pearls No. 59
- •Pits & Pearls
- •Pits & Pearls No. 60
- •References
- •11: Trauma
- •11.1 Penetrating Eye Injury by Metal Intraocular Foreign Bodies (IOFB)
- •11.2 Suprachoroidal Haemorrhage
- •Pits & Pearls
- •12: Surgical Pearls
- •Subject Index
- •Appendix
- •A.1 Materials
- •A.2 Company Addresses
- •A.3 Instrument Set for PPV (combined and not combined)
- •A.4 List of Important Pits & Pearls (P & P)
Preface
Vitreoretinal surgery is developing rapidly. The new 23-gauge and 25-gauge techniques are transforming vitreoretinal surgery into a much safer and less traumatic surgical procedure. We are convinced that the 23-gauge and 25-gauge vitrectomy will become the gold standard for vitrectomy worldwide. It will be as safe and reliable as phacoemulsification is today.
This book is intended to be a hands-on instructive compendium for vitreoretinal surgery, which is more technical and sophisticated than phacosurgery. First we describe the instruments and materials needed for vitreoretinal surgery, after which we describe the most important surgeries. Just like a recipe in a cookbook – first the ingredients and then every surgical step in detail. In the final chapter of the book you will find a lot of useful information regarding the surgical material.
The surgical techniques described in the book, however, are not the only possible treatment for the described pathology. They are only recommendations, not guidelines or rules.
We wish every reader, may he or she be a beginner or an advanced surgeon, to enjoy reading this book and watching the surgical videos. Included are two DVDs with a huge amount of commented surgical videos. They begin with easy techniques and end with advanced pathologies. Our endeavour is to inspire more people to master this amazing surgical technique.
Uppsala, Sweden |
Ulrich Spandau |
Liverpool, UK |
Heinrich Heimann |
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Acknowledgements
The skills of vitreoretinal surgery cannot be gained by reading a book. However, there are many little tricks of the trade that one will not find in standard text books and which will be passed on from the supervisor to the learning surgeon during the training. It was our aim to collect as many of these pearls as possible to be passed on to a broader community of learning surgeons through this book. I was fortunate enough to be trained by and to work with some of the outstanding vitreoretinal surgeons of our time who taught and shared their knowledge with me. I am extremely grateful for giving me the opportunity to learn vitreoretinal surgery, for their patience, their invaluable advice and their generosity in sharing their skills: Michael Foerster (Berlin), Norbert Bornfeld (Essen), Ulrich Kellner (Siegburg), Horst Helbig (Regensburg), David Wong (Hong Kong), Bertil Damato (Liverpool) and Nikos Bechrakis (Innsbruck).
Together with my colleagues at the St. Paul’s Eye Unit at the Royal Liverpool University Hospital, I am also extremely lucky to be in a position that involves teaching fellows from all over the planet in vitreoretinal surgery. These highly skilled individuals are and were a sheer delight to work with. I would like to thank them for the great care they have provided for the patients in our department. They are constantly challenging and scrutinizing our techniques, which has helped us to further develop the techniques of vitreoretinal surgery: Ron Das (Malaysia), Ben Fleming (Australia), Christina Irigoyen (Spain), Stathis Liazos (Greece), Lazaros Konstandtinidis (Greece), Joaquin Marticorena (Chile), Haslina Mohd Ali (Malaysia), George Morphis (Greece), Mario Romano (Italy), Teresa Sandinha (Portugal) and Xavier Valldeperas (Spain).
Liverpool, UK |
Heinrich Heimann |
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xiv |
Acknowledgements |
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I wish to express my gratitude to Dr. Gangolf Sauder (Stuttgart) who taught me my first steps in vitreoretinal surgery, Prof. Claus Eckardt (Frankfurt-Hoechst) and Dr. Tillmann Eckert (Frankfurt-Hoechst) who generously shared their many practical skills.
I also wish to thank Dr. Reinhard Kaden for the constant support and encouragement during the preparation of the initial German version of this book, which is published by Kaden Verlag Heidelberg. Finally, I would also like to thank my colleagues, Dr. Tilmann Eckert (Frankfurt-Hoechst), Dr. Lothar Schneider (Sweden), Prof. Dr. Hans Liesenhoff (Mallorca), Dr. Yaser Biazid (Abu Dhabi) and Mr Brian Turner (Sweden) for their critical review of the manuscript.
Uppsala, Sweden |
Ulrich Spandau |
