Index

Choroidal neovascular membranes (CNVs) (cont.) spontaneous idiopathic type 2, 262, 263 surgery, 265

Chronic postoperative endophthalmitis, 355 Chronic RRD, 117

Chronic uveitis, 358–359

Classification and regression tree (CART), 328, 329 Cloquet’s canal

posterior hyaloid membrane, 2 tubular condensation, 1–2 vitreous haemorrhage, 3

CMO. See Cystoid macular oedema (CMO)

CNVs. See Choroidal neovascular membranes (CNVs) Coat’s disease

macula, 394 peripheral lesion, 394

progression, exudation, 394

spectrum, retinal vascular anomalies, 395 Contusion injuries

angle recession, 311 corneal staining, 313 elasticated cord, 314 fovea, 315 hyphaema, 310

iris root dialysis, 310 lens dislocation, 313

pigmentary changes and OCT, 314

PVR membranes and inferior retinectomy, 313 rapid-onset cataract, 311

retinal break, 316–318 squash ball, 312, 313 subretinal haemorrhage, 312 sunflower cataract, 311 surgery, 318–322 transretinal fibrosis, 313 traumatic macular, 316 ultrasound, 313

visual outcome, 322 vitreous haemorrhage, 313 zonular dehiscence, 311

CRAO. See Central retinal artery occlusion (CRAO) CRT. See Central retinal thickness (CRT)

CRVO. See Central retinal vein occlusion (CRVO)

Cystoid macular oedema (CMO), 206, 297, 300, 301, 359, 367 Cytomegalovirus (CMV) retinitis

diagnosis, 376 ganciclovir implant, 376 HAART, 375 treatment, 376

visual recovery, 380

D

DACE. See Drainage air cryotherapy and explant (DACE) Diabetic maculopathy

cystoid macular oedema, 290 ERM, 291

massive subretinal exudation, 291 OCT, 291

retinopathy, 290 subfoveal fluid, 289 vitrectomy, 290

Diabetic retinal detachment anti-VEGF pretreatment, 283 bimanual surgery, 284 bleeding vessels, 285–286

contraction, neovascular membranes, 276

iatrogenic breaks, 286–287 PRP, 283

RRD and TRD, 288 screening, 276 silicone oil, 288 stenosis, 277 surgery, 277

tangential traction, 276 traction, 277

TRD, 272–276

vitreous detachment, 276 Diabetic retinopathy

C3F8 gas, 289

detachment (see Diabetic retinal detachment) grading, 269

iris neovascularisation, 289 laser photocoagulation, 269

maculopathy (see Diabetic maculopathy) neovascularisation, 270

NVD, 270

panretinal photocoagulation, 270 phthisis bulbi, 289

rhegmatogenous retinal detachment, 289 subfoveal fluid, 289

TRD (see Tractional retinal detachment (TRD)) visual improvement, 289

vitreous (see Vitreous)

Diabetic Retinopathy Study (DRS), 272 Disseminated intravascular coagulation, 408 Drainage air cryotherapy and explant (DACE)

air insertion, 153–154 choroidal/subretinal haemorrhage, 154 fluid vitreous loss, 155

rates, 152

retinal incarceration, 154 SRF drainage, 152–153

Dropped nucleus, anterior segment surgery difficult situations, 347

features, 343–344 management, 345 surgical steps, 344–345 visual outcome, 347

vitrectomy surgery, 345–346

DRS. See Diabetic Retinopathy Study (DRS) Dyes, retinal surgery, 58

E

Early Treatment Diabetic Retinopathy Study (EDTRS), 272 EBV. See Epstein–Barr virus (EBV)

EDTRS. See Early Treatment Diabetic Retinopathy Study (EDTRS)

ELM. See External limiting membrane (ELM) Endolaser

absorption, laser wavelengths, 33 adhesion, retina, 32–33 continuous burns, 33

fibre optic, 32 intensity, 33

lasering haemorrhage, 33

panretinal photocoagulation (PRP), 33 peripheral retina, 33

YAG lasers, 32

yellow and diode lasers, 32 Endophthalmitis

antibiotics, 353

ciliary body malignant melanoma, 355

features, 351–352 hypopyon, 354

infective organisms, 352–353 vitrectomy, 353

vitreous tap and biopsy, 352 Endotamponade

heavy oils, 204

silicone oil/perfluoropropane gas, 203–204 Epiretinal membrane (ERM)

bent MVR blade, 249 causes, macula pucker, 242 cellophane, pseudohole, 243 extensive and traction, 246

FFA, parafoveal telangiectasia causing, 396 lamellar macular holes, 221

macula, 244

parafoveal telangiectasia causing, 397 pegs, attachment, 248

recurrent, 252 removal, 251 RRD, 245–246

separation, 241, 245 sickle-cell disease, 246

thickening and wrinkling, retina, 242 trypan blue, staining, 249

visual recovery, 221 Epstein–Barr virus (EBV), 380

ERM. See Epiretinal membrane (ERM) Examination technique

Amsler charts, 17 BIOM, 7–8

electronic patient record, 6–7 indenter, 8

lenses, characteristics, 7

OCT (see Optical coherence tomography (OCT)) preoperative assessment, 17

slit lamp, 7

ultrasonography (see Ultrasonography) visual acuity, 7

Watzke Allen test, 17

External limiting membrane (ELM), 235

F

FD-OCT. See Frequency-domain OCT (FD-OCT) FF-OCT. See Full-field OCT (FF-OCT)

Fick’s diffusion equation, 61, 63 Flat retinal breaks

cryotherapy, 121–122 laser, 122–123 retinopexy, 121, 122

Frequency-domain OCT (FD-OCT), 13 Full-field OCT (FF-OCT), 13

Fungal endophthalmitis

acute myeloid leukaemia, 379

Aspergillus, 378 Candida, 377 CNV, 379 diagnosis, 378–379 heroin, 377–378 PHM, 379

puff balls, 378 rating, PPV, 378 RRD, 376

systemic antifungal therapy, 379 treatment, 378

visual recovery, 377

G

Gases, internal tamponade absolute pressure, eye, 68 AC, 66

anaesthesia, 69

anterior ischaemic optic neuropathy, 66 break closure, 61–62

cataract, 64

drawing, visual phenomena, 64 insertion, gases, 62, 67 intraocular gas bubble, 62 IOP, 63, 64

loss, gas bubble, 64–66 pars plana vitrectomy, 67

pressure changes, normal-sized eye, 68 principles, 61

properties, 63 refraction, 64

suprachoroidal or subretinal spaces, 66 surgical steps, 61

vision, 64

20 Gauge vitrectomy angled wound, 46

conjunctival wounds, 45, 46 construction, superior sclerotomies, 45 flow rates, 52

non-sealing sclerotomies, 46 peroperative complications, 53 postoperative retinal break formation, 54 sclerotomies, priming, 45

self-sealing sclerotomies, 45–46 silicone oil, 52, 53

steps, adjustments, 44 23 Gauge vitrectomy

advantages and disadvantages, 54 flow rates, 52

insertion, 23 G unsutured canula, 49 instrumentation, 48–49

rubbing, 45-degree wound, 50 silicone oil, 52, 53

steps, adjustments, 47–48 surgical technique, 49–50 10/0 suture, 50

trochar internal protrusion, 52 two-step procedure, 48, 49

25 Gauge vitrectomy

advantages and disadvantages, 54 chandelier light pipe insertion, 51 flexibility, 51

flow rates, 52 indentation, 51–52 instrumentation, 48 internal search, 51

one-way trochar system, 48 peroperative complications, 53 silicone oil, 52, 53

steps, adjustments, 47–48 sutureless vitrectomy, 51 trochar internal protrusion, 52

Giant retinal tear (GRT) definition, 168

Stickler’s syndrome, 168–171 surgery

endotamponade, 174 heavy liquids, 172 insertion, silicone oil, 174 retinopexy, 173

Giant retinal tear (GRT) (cont.) silicone oil removal, 174

trans-scleral illumination technique, 174 vitrectomy, 174

GRT. See Giant retinal tear (GRT)

H

HAART. See Highly active antiretroviral therapy (HAART) HD OCT. See High-definition optical coherence tomography

(HD OCT)

High-definition optical coherence tomography (HD OCT) cystoid spaces, 218

grade 2 macular hole, 217, 218

Highly active antiretroviral therapy (HAART), 375 HPMC. See Hydroxymethylcellulose (HPMC) Hydroxymethylcellulose (HPMC), 25, 35 Hypotony

CMO, 367 macula, 365

peroperative complications, 39, 43 polyclonal white cells, 370 posterior layers, eye, 368 postoperative complications, 43 uveitic process, 368

vitrectomy, 369

I

ILM. See Internal limiting membrane (ILM) Indirect viewing system (IVS)

BIOM, 26

vs. contact lenses, 26 Eibos, 26 examination, 34 independent, 25–28 pupillary dilation, 35 rotation, 25 structure, 26

Indocyanine green (ICG) nasal visual field loss, 234 RPE toxicity, 227

Inner and outer segment (IS/OS) junction, 15 Internal limiting membrane (ILM)

blue staining, 229 early hole closure, 230 ICG, 227

nerve fibre layer, 224 paracentral scotoma, 225 postoperative macular holes, 229 trypan blue, 228

visualisation, macula, 229 Internal tamponade

gases (see Gases, internal tamponade)

silicone oil (see Silicone oil, internal tamponade) Intraocular foreign bodies (IOFB)

alloy metals, 330 blunt injury, 331 chalcosis, 332

diagnostic imaging, 331–332

diffuse illumination and transillumination, 330 endophthalmitis and vitritis, 332

fibroblast proliferation, 331 hitting nail gun pellets, 333 magnet, 336

orbital air-gun pellet, 333 phacoemulsification cataract surgery, 329

posterior segment damage, 330 PPV, 335–336

procedure, 334 siderosis, 332, 337 surgery, 334

visual outcome, 336–337 whitened reaction, 330

Intraocular lens (IOLs). See also Aphakic eye accommodation, 56

Berger’s space, 79 biometry systems, 233 cataract extraction, 233

combined PPV and phako, 55 condensation, 35 dislocations

prosthetic, 347 surgery, 347–348

gas bubble, 68

grade 4 macular hole, 232 oil droplet, 77 phacoemulsification, 55 pseudophakic eyes, 73

Intraocular pressure (IOP)

anterior ischaemic optic neuropathy, 66 elevation, 64

phakic/pseudophakic eyes, 74 phthisis bulbi, 339

trabecular meshwork, 74

IOFB. See Intraocular foreign bodies (IOFB) IOLs. See Intraocular lens (IOLs)

IOP. See Intraocular pressure (IOP) Iris neovascularisation, 289

IVS. See Indirect viewing system (IVS)

L

Laser therapy, 303–305 Lymphoma

B-cell, 383 intraocular, 384 ocular, 380

M

Macula off/on retinal detachment, 120–121 Macular hole

ELM, 235

foveal disruption, 214 grading system, 213 high-definition OCT, 215 lamellar and partial

ERM, 220

OCT, 221 resolution, 221

visual improvement, 221 macular disorders, 209 microplasmin, 236 neuroretina, 210 operculum, tissue, 211 PHM, 222

PPV, 222 reoperation, 235–236 retina dehiscence, 218

secondary macular holes, 220 spontaneous closure, 213, 217 surgery, 222–234

symptomatic retinal pathology, 209

symptoms, 211 temporal, fovea, 225 visual field loss, 234 vitreal traction, 215 vitreous separation, 210

Watzke–Allen test, 211–212

Macular pucker and vitreomacular traction cataract surgery, 246

cellophane maculopathy, 240 chronic shallow elevation, retina, 245 damage, macula, 251

diffuse membrane, 239 distortion, 251

epiretinal membrane, 242, 243

ERM (see Epiretinal membrane (ERM)) idiopathic epiretinal membrane formation,

macula, 239 lesion, macular striae, 245 membrane recurrence, 251

myopic postoperative refraction, 250 phacocataract surgery, 247

rates, 250

removal, membrane, 248 retinal tear and detachment, 250 sergery, 248–249

vitreous shrinkage, posterior hyaloid membrane, 245 Marfan’s syndrome, 404

Micro vitreoretinal (MVR) blade aphake/pseudophake, 25 ERM, 249

20-gauge surgery, 248 Mild PVR

contraction, 196 posterior retina, 196, 197 rating, surgery, 196 silicone oil, 196

trypan blue dye, 196 Moderate PVR

proliferative process, 196 retinectomy, 196

Morning glory syndrome oil and heavy liquid, 402 retinal elevation, 402

subarachnoid and subretinal space, 401 MVR. See Micro vitreoretinal blade (MVR) MVR blade. See Microvitreoretinal (MVR) blade

N

Needlestick injury features, 355–357 surgery, 357

Neovascularisation elsewhere (NVE), 272 Neovascularisation of the disc (NVD), 270 Non-drain procedure, RRD

limbal conjunctival perimetry, 142 operative stages

break indentation, cryotherapy probe, 143 freezing, 143

hooking, superior rectus, 142 indentation mark, external sclera, 144 internal indent, cryotherapy scar, 147 leakage, subretinal fluid, 145 penetration, choroid, 145

penetration, suprachoroidal space, 145 peripheral retina, 143

placement, plombage, 146

retinal perforation, 145 scleral suture, 145

sling, extraocular muscles, 142 sutures placement, 144 tension, sutures, 146

U tear, 143 visualisation, break, 144

peroperative complications, 148 postoperative care, 148 postperative complications

astigmatism, 149 explant infection, 148

indentation, external plombage creation, 152 sequence, OCTs, 150, 151

SRF, 149 rating, 142

Non-infectious uveitis CMO, 365

Eales’ disease, 364 hypotony, 367–370 intermediate uveitis, 364 PPV, 370

retinal detachment, 363 sarcoidosis, 364

slit lamp beam, cells detect, 363

subretinal exudation and epiretinal membranes, 364 sympathetic uveitis, 365

vitreous biopsy, 370

debris and cells, 365 opacification, 366 TRD/RRD, 365

Vogt–Koyanagi–Harada syndrome, 364, 365 NVD. See Neovascularisation of the disc (NVD) NVE. See Neovascularisation elsewhere (NVE)

O

OCT. See Optical coherence tomography (OCT) Ocular trauma score (OTS), 328

Optical coherence tomography (OCT) central retinal thickness (CRT), 15

CNV membranes and fluid detection, 255 colour coding, 13

description, 11 examination, 15

external limiting membrane (ELM), 16 FD-OCT, 13

FF-OCT, 13

higher-resolution scanning, 11–12 images and measurements, 15 IS/OS junction, 15–16

lasers incoherence, 12 machinery, 12

macular scan patterns, 15 microperimetry, 16 ophthalmic imaging, 11 pigmentary changes, 17 postoperative, 251 reference laser, 12 resolution, scan, 13, 15 scan and devices, 14

SD-OCTs (see Spectral domain OCTs (SD-OCTs)) segmentation, 12

TD-OCT (see Time-domain OCTs (TD-OCTs)) thickening and wrinkling, ERM, 242

vitreous separation, 220, 222

Optic disc anomalies gas injection, 399

macular retinoschisis, 398 morning glory syndrome, 401 patient, flat fovea, 399

pits and coloboma, 399 retinal detachment, 402

Optic disc coloboma CHARGE syndrome, 400 pit maculopathy, 400

pneumatic retinopexy and vitrectomy, 398 renal hypoplasia and mutation, PAX2, 401 retinal adhesion, 401

vitreous cavity and subretinal space postoperatively, 401 Optic disc pits, 399–401

OTS. See Ocular trauma score (OTS)

P

Panretinal photocoagulation (PRP), 272, 283, 285, 288 Paraneoplastic retinopathy, 387

Pars plana vitrectomy (PPV)

advantages and disadvantages, retinopexy, 128–129 anterior segment, 335

autofluorescence, RPE cells, 137 avoidance, retinal folds, 131 BIOM system, 25, 26

Candida endophthalmitis, 378 cataract, 231

and combined cataract extraction, 56 cutter settings, 23

detachment, vitreous, 28–29 displacement, retina, 137 draping and sterility, 23 droplet, heavy liquid, 138 dry tap, 370

elevation, macula, 137 filling, gas, 140, 141 gas insertion, retina, 131

haemorrhage and visual axis, 366 heavy liquids, 130

hypotony, 135 indentation, 127

independent viewing system, 25–28 inferior buckle indentation, 135 inferior buckle, vitrectomised eye, 134 infusion cannula and checking, 24 infusion fluid, 370

insertion, heavy liquid, 134 insertion, lens, 27

intraocular pellet, slow-release steroid, 371 IVS, 25–26

laser, 140–141

left vitreous biopsy, 379 macular fold, 139 magnification, 27 neutral distance, IVS, 27

objective lens and microscope, distance, 28 ocular lymphoma, 385

operations, 23

optimum use, Oculus BIOM, 26 orientation, lens, 127

PHM, 366

pigment, otic nerve, 140

placement, solid silicone explant, 134 posterior and inferior breaks, 132 posterior segment, 335–336

postoperative folding, retina, 139 posturing, 141

PVR, 132–133 rating, RRD, 127

refractive index and myopic shift, 28 removal, heavy liquids, 130–131 repair, RRD, 126, 138

retinal folding, 137–139 reversion, incarceration, 136 sclerotomies, 24

SRF, 129–130

superior sclerotomies, 25 surgery, eyes, 140

tear, laser retinopexy, 135 toxoplasmosis chorioretinitis, 381 treatment, macular hole, 236 ultrasound, hypotonous eye, 136 U-shaped tear, 127

vitreous and retina, incarceration, 136

PDRR. See Planned delayed relieving retinotomy (PDRR) Penetrating injury

cilia, 326 endophthalmitis, 326 projectiles, 325

retinal detachment, 326–327 sharp instruments, 325 surgery, 327–328

visual outcome, 328

Perfluorocarbon liquids (PFCLs), 69, 78, 83, 84, 86 Perforating injury, 338

Peroperative complications avoidance, 39

choroidal haemorrhage, 37–38 conjunctival chemosis, 53 diabetic surgery, detachment, 36 endophthalmitis, 53–54 extrusion, trochar, 53

hypotony, 39, 43

iatrogenic retinal breaks, 36 lens touch, 38–39

sources, bleeding, 38

Persistent hyperplastic primary vitreous, 393 PFCLs. See Perfluorocarbon liquids (PFCLs) Phacoemulsification procedure, 55

PHM. See Posterior hyaloid membrane (PHM) Phthisis bulbi, 289, 325, 328, 339

Planned delayed relieving retinotomy (PDRR), 205 Posterior hyaloid membrane (PHM)

detachment process, 222 nerve fibre layer, 224 optic disc, 222, 223 PVD induction, 223

traction, opposite retina, 224 vitreous detachment, 223

Posterior vitreous detachment (PVD) defined, 89

detection, 93 erythrocytes, 94 flashes

characteristics, 92–93 ‘lightning streaks’, 92 photopsia, 92 presentations, 93

floaters, 91

forward displacement, 93 haemorrhage, 94, 95 ophthalmoscopy, 94–95

peripheral retinal degenerations age-related macular, 97 Cobblestone degeneration, 98 inferotemporal peripheral retina, 97 lattice, 97

retinal break formation, 96–97 plasmin injection, 90

retinal tears, 95–96 Shafer’s sign, 93–94

syneresis, lacuna formation, 89 tears

clot, fabrin, 112 retinal break, 111, 112 retinal tear, 112 U-shaped tear, 112

and vitreoretinal conditions, 90 Weiss ring, 90

Postoperative complications cataract formation, 40 choroidal haemorrhage, 41 corneal endothelial changes, 41 endophthalmitis, 40

fibrin, 44 hypotony, 43

iatrogenic break formation, 20 gauge, 54

IOP, 41

retinal breaks and RRD, 41–42 scleritis, 43

sympathetic uveitis, 43–44

PPV. See Pars plana vitrectomy (PPV) Proliferative vitreoretinopathy (PVR) chronic retinal detachment, 195

grading

CP2, 191, 192 CP4, 192 CP12, 192, 193

grade A PVR, 191, 192 partial-thickness wrinkling, 191 retinal folds, 190

retinal tear, 190, 191 RPE cells, 190 RRD, 190

subretinal band, fibrosis, 195 subretinal fibrosis, 195

ocular trauma, 189 pathogenesis, 190

recurrent retinal detachment, 66 RRD, 189

silicone oil, 69

subretinal band, fibrosis, 194 surgery, 196–206

PRP. See Panretinal photocoagulation (PRP) PVD. See Posterior vitreous detachment (PVD) PVR. See Proliferative vitreoretinopathy (PVR)

R

Radial optic neurotomy (RON), 297 Radial retinotomy, 200

Removal of silicone oil (ROSO), 202 Retina

blood vessels, 5 Bruch’s membrane, 5 choroid, 5

cones, 3 embryology, 3

ganglion cells, 5 intermediary neurones, 4 Muller cells, 3 photoreceptor layer, 4 RPE, 3

stratified structure, 4 types, 3

Retinal breaks

choroidal ruptures, 317 commotio retinae, 316 dialysis, 316

giant retinal tears, 316 high-velocity projectile, 317 macular oedema, 317

pars ciliaris tears, 316

pigment epithelial changes, 318 traumatic macular hole, 318

Retinal dialysis

dialysis and PVR, 167 giant retinal dialysis, 167

inferotemporal and superonasal, 165 ophthalmoscopy and indentation, 165 par ciliaris tear, 167–168

surgery cryotherapy, 166 diplopia, 167 optic nerve, 166 plombage, 166

Retinal haemangioma and telangiectasia Coat’s disease, 394–395

dragged disc, 398 ERM, 397

Leber’s miliary aneurysms, 397

macular exudation and optic nerve head angioma, 396 peripheral angioma, indentation, 396

VHL, 395

Retinal pigment epithelium (RPE) adhesion, 6

function, 3, 262 ionic flow, 6

principle, retinal translocation, 259 pumps, 6

rotation, retina, 261 Retinal prosthesis, 408 Retinal tears, PVD

atrophic round holes, 96 paravascular, 96 progression, detachment, 96 U tears, 95–96

Retinal vasculitis, 306 Retinal vein occlusions (RVO)

arteriovenous decompression, 296–297 blockage, 295

chorioretinal anastomosis, 296 intravitreal steroid and anti-VEGF agents,

297–301 RON, 297 TPA, 301

Retinectomies

catastrophic folding, 206 inferior retina, 206 scarring, 199

Retinochoroidal coloboma congenital, 402

fovea, 401

retinal detachment, 402 Retinopathy of prematurity (ROP), 404

Retinoschisis

chronic rhegmatogenous retinal detachment, 179 coloboma, 183

fluid accumulation, 182 infantile retinoschisis, 177–178 macular retinoschisis, 177 retinal detachment, 179–180 retinal neuroepithelium, 176 schisis RRD, 182

schitic retina, 177 senile retinoschisis, 179

Rhegmatogenous retinal detachments (RRDs) age-related, 163

anterior segment signs, 117 aphakic, 163

ARN, 374

atopic dermatitis, 184 atrophic hole, 164 break patterns, 120 causes, failure, 156 changes, RPE, 116

choroidal effusions, 157–158 chronic inferior, 117 congenital cataract, 184 demarcation, 114

dialysis, retina, 165–168 formation, retinal break, 155 GRT, 168–174

inferior retina, 113 inferotemporal dialysis, 316 juvenile retinal detachment, 184 lattice degeneration, 113 macula off/on, 120–121 macular holes, 157

phacoemulsification cataract extraction, 163 pneumatic retinopexy, 155

pseudophakic, 164 PVD formation, 366 rates, 155–156

Redo vitreous-attached surgery, 157 Redo vitreous-detached, 157 refractive surgery, 184

removal, explant, 158–159 retinal cyst, 114, 115

retinal detachment, high myopes, 174–176 retinoschisis, 11

RPE hypertrophy and atrophy, 114 scleral buckling procedures, 163 signs, vitreous, 117–118

silicone oil injection and subsequent removal, 380 slit-lamp camera, 114

speck, oxalate, 116

SRF (see Subretinal fluid (SRF)) subretinal bands, 115

surgery

break closure, 124–125

DACE (see Drainage air cryotherapy and explant (DACE)) flat retinal breaks, 121–123

modification, fluid currents, 125–126

non-drain procedure (see Non-drain procedure, RRD) pneumatic retinopexy, 155

PPV (see Pars plana vitrectomy (PPV)) principles, 124

redetachment, 156–157 relief, traction, 125 retinopexy, 126

SRF, 123 superior bull, 124

tears, PVD, 111–113 TRD, 365

tuberculosis retinitis, 382 tuberculous panuveitis, 383 vitreal traction, 113 vitreoretinal adhesions, 168 vitreous separation, 222 white flecks, 116

white spots, outer retina, 116

RON. See Radial optic neurotomy (RON) ROP. See Retinopathy of prematurity (ROP) RPE. See Retinal pigment epithelium (RPE)

RRD. See Rhegmatogenous retinal detachments (RRDs) Rupture, trauma

anterior incarceration site, 323 automobile air bag, 323

choroidal and vitreous haemorrhage, 322 crystalline lens and prolapse, 322 extraocular muscles, 323

PPV, 324 surgery, 324–325 ultrasound, 323

visual outcome, 325 vitreous gel, 324

S

Schwartz’s syndrome, 117

SD-OCTs. See Spectral domain OCTs (SD-OCTs) Severe PVR

flat macula, 199 rating, surgery, 198

relieving retinectomy, 199–200 silicone oil insertion, 198 vitrectomy, 198

Shaken baby syndrome, 102 Sickle-cell disease

asymptomatic patient, 302 atrophic macular hole, 303 description, 301

hypoxia stimulating neovascularisation, 302 inheritance and race, 302

laser therapy, 303–305 macula, 302

retinal tear, 303 screening, 306 surgery, 305

systemic investigation, 302 systemic manifestations, 302 types, 302

visual outcome, 305–306 Siderosis, 332, 337

Silicone oil, internal tamponade

AC (see Anterior chamber (AC), silicon oil) capsule opacification, 73

cataract, 73 cornea, 75 emulsion, 78, 79 heavy liquids

droplets, 85 PFCLs, 84

removal, emulsified oil, 86 retina, incarceration, 86 subfoveal, 86

subretinal, 85

two-way cannula, insertion, 85 heavy silicone oils, 82–83 inferior edge, 77

IOLs, 78 IOP, 74–75

Light’ heavy liquids, 86 macular toxicity, 75

oil droplet, 77 properties, 69–70 refractive changes, 72–73 removal

AC, aphakic patient, 80 band keratopathy, 81 cannula, 79, 80 cataract extraction, 82 complications, 80

corneal scar, decompensation, 81 emulsion, oil, 79, 80, 86 keyhole capsulectomy, 81, 82 lens, eye, 81

rating, 82

retinal redetachment, 82 ROSO plus operation, 82 Tenon’s layer, 80

retina manipulation, oil insertion, 69 subconjunctival oil, 76

subretinal oil, 76, 77

Spectral domain OCTs (SD-OCTs) description, 13

devices, 14

scan resolution, 13 Stickler’s syndrome

arthropathy, 168, 169

flattened nasal bridge, 168, 169 high-arched palate, 168, 169 lattice degeneration, 168, 170 retinal tear, 168, 171

vitreous veils, 168, 170 Subretinal bands

bimanual, 204 unimanual, 204 Subretinal fluid (SRF)

anterior break, 119 drainage, 133, 152–153 failure, laser retinopexy, 123 fovea, 120

inferotemporal, 119 referral procedure, 119

separation, neuroepithelium, 118 Sympathetic ophthalmia, 339

T

TD-OCTs. See Time-domain OCTs (TD-OCTs) Terson’s syndrome, 102, 103, 105, 407 Time-domain OCTs (TD-OCTs)

first-generation, 12 macula, 13 principles, 13

Tissue plasminogen activator (TPA), 301 TPA. See Tissue plasminogen activator (TPA) Tractional retinal detachment (TRD)

anti-VEGF injections, 273 bimanual surgery, 282 B-scan ultrasound, 273

‘burnt out’ retinopathy, 279 causes, vitreous haemorrhage, 272 characterization, 281

cortical gel and posterior hyaloid, 278 demographic information, 272 diabetic vitreous haemorrhage, 274

dissection, membranes and insertion, 281 DRS and EDTRS, 272

ERM and avoidance, retinal tear, 280 indicators, 273

macula, 279 neovascularisation, 274, 275 NVE, 272

optic nerve, 278 pancreatic transplant, 275 PHM, 278, 280, 282 posterior hyaloid, 280 principles, 274

PRP, 277

PVD, 272

retinal break, 276 retinoschisis, 280

retrohyaloid haemorrhage, 272 rhegmatogenous, 278 scissors, 279

subhyaloid blood, 273 taut peripheral gel, 278 vascular arcades, 273 vitreoschisis, 282

Trauma

CART, 328, 329 classification, 309–310

contusion injuries (see Contusion injuries) description, 309

intraocular foreign bodies (see Intraocular foreign bodies) IOP, 339

OTS, 328

penetrating injury, 325–328 perforating injury, 338 phthisis bulbi, 339

PVR, 339

rupture (see Rupture, trauma) solid choroidal haemorrhage, 339 sympathetic ophthalmia, 339 ultrasonography, 11

TRD. See Tractional retinal detachment (TRD)

U

Ultrasonography abnormalities, 9–10 B-scan ultrasound, 8, 9 cataract, 11

choroidal effusions, 11

colour Doppler ultrasound, 9–11 description, 8

Doppler, 9–11 echoes/clumps, 9 elevation, choroidal, 11 examination, 8–9 frequencies, 8 haemorrhage, choroidal, 11 PVD, 10

retinal detachment, 10 retinal tear, 10 retinoschisis, 11

Ultrasonography (cont.) sinuous mobility, 10 sound travels, 8

subretinal haemorrhage, 11 and time-domain OCT, 12 trauma, 11

vitreous haemorrhage, 3 Uveal effusion syndrome

choroidal elevation, 405 Coat’s disease, 406 deep sclerectomy, 407

exudative retinal detachment, 406 familial exudative vitreoretinopathy, 398 leopard spots, 406

macular changes, 406 ‘ring melanoma’, 405

Uveitis

acute relapse, acute lymphocytic leukaemia, 386 ARN, 372–375

chorioretinal biopsy, 385 CMV retinitis, 375–376

cytology, vitreous in infectious and non-infectious, 383 detachment and retinal tear, 374

diagnosis, 385

fungal endophthalmitis, 377–380 intravitreal steroid, posterior, 381 low-dose radiotherapy, 383 lymphoma, 383–384

ocular toxoplasmosis, 382 paraneoplastic retinopathy, 387 PCR, 374

posterior segment, 363–371 PPV, ocular lymphoma, 385 retinal and choroidal biopsy, 386 RRD, 382

thickening, 384 toxoplasmosis, 374, 380 treatment, 385

tuberculous panuveitis, 383

tuberculous uveitis and secondary vitreous haemorrhage, 381 visual recovery, 386

V

Vascular endothelial growth factor (VEGF). See Anti-VEGF Very severe PVR

laser retinopexy, 202 rating, surgery, 202 subretinal band, 202, 203

tamponading effect, silicone oil, 203 VHL. See von Hipple–Lindau (VHL) Vitrectomy

cutters efficiency, 30 flow rate, 30

guillotine action, 30 high-speed cutters, 30 instrumentation, 28 MVR, 25

settings, 23, 30 vitreous opacities

nuisance, floaters tolerable, 391 PPV, 392

PVD, 392 Vitreoretinal surgery

anaesthesia, 23

23 and 25 gauge vitrectomy, 47–53 biometry, 56–57

blood, anterior chamber, 35 cataract formation, 35

chandelier systems and bimanual surgery, 57–58 closure, 35–36

collagen metabolism, 6 combined surgery, 56 concentration fluorescein, 36 contact lens, 33–34

corneal epithelium, 35 direction, nerve fibres, 6 dyes, 58

endolaser, 32–33 fluid flow, 35

20 gauge vitrectomy (see 20 Gauge vitrectomy) internal search, 31–32

intraocular pressure, 36 intravitreal injections, 58–59 IOL, condensation, 35

IVS, 34

light pipe, handling, 30–31 microscope, 34

nerve fibre layer orientation, 6 ora serrata, 5–6

osmotic pressure, 6

peroperative complications (see Peroperative complications) phacoemulsification procedure, 55

posterior hyaloid membrane, 6–7

postoperative complications (see Postoperative complications) PPV (see Pars plana vitrectomy (PPV))

preoperative check, 22 pupillary dilation, 35

retinal pigment epithelium, 6 sclerotomy plugs, 31

setup, PPV, 22

slow release preparations, 59 standard footpedal arrangement, 22 transconjunctival cannulas, 52 vitrectomy cutters, 30

Vitreous anatomy, 1–2 anomalies

amyloidosis, 393 asteroid hyalosis, 393

persistent hyperplastic primary vitreous, 393 attachments, 2

base, 2 biopsy, 370

Cloquet’s canal, 2, 3 embryology, 1 haemorrhage

aetiology, 102 Behcet’s disease, 102 defined, 101

determination, aetiology, 103 diabetic retinopathy, 271 diffusion, vitreous gel, 101 erythroclastic glaucoma, 103 haemolysis, 102 management, 106 neovascularisation, 271 nondiabetic, 106

preretinal, 104 retrohyaloid/ubhyaloid/preretinal, 104 subhyaloid, 103, 104

subretinal, 105 surgery, 107

and TRD( see Tractional retinal detachment (TRD)) ultrasound, 105

vitrectomy, 108–109 lattice degeneration, 2 opacification

PHM, 379

retinal vasculitis, 366

secondary epiretinal membrane, 366 visual recovery, 366

physiology, 5

posterior hyaloid membrane, 2 posterior vitreous detachment, 2 Weigert’s ligament, 2

Vogt–Koyanagi–Harada syndrome, 364, 365 von Hipple–Lindau (VHL)

isolated retinal angiomas, 396 large angioma, 395

PVR formation, 397 retinal complications, 396 small angioma, 395

vitreoretinal traction, lesion, 396

W

Watzke–Allen test

discrimination, macular holes, 17 grade 1B hole, 212

grade 1 hole, 211 loss of vision, 211

patterns, abnormality, 213 Weigert’s ligament, 2

Y

YAG lasers. See Yttrium aluminum garnet (YAG) lasers Yttrium aluminum garnet (YAG) lasers, 32