Minimal Extraocular Surgery for Retinal Detachment and Prophylaxis of the Fellow Eye
The controversial issue of prophylaxis for a retinal detachment and its application on an evidence based approach is discussed, followed by a rational and minimal approach for repair of a retinal detachment with longterm anatomical and functional results. The attendee will partake in the diagnostics and treatment of various presented retinal detachments.
Summary of Content/Synopsis of the course
Review of the evidence and the effectiveness of prophylactic treatment in the fellow eye of a retinal detachment and its accompagning complications: when to apply prophylaxis and when better not and , instead, to apply a so-called passive prophylaxis. It consists of: explaining to the partient the prodromes of a retinal detachment and to test the visual field when these symptoms are observed.
A rational and minimal approach for repair of a retinal detachment is presented by applying the 4 Rules of How to find the primary break and the 4 Rules of How to detect the missed break in an eye up for reoperation. The subsequent surgery of closing the break(s) is demonstrated by a video. The operation consists of: minimal segmental buckling and coagulation being limited to the area of the break(s) and it is performed without drainage of subretinal fluid. Radial buckles provide an optimal tamponade of a tear. The anantomical and functional results of 107 retinal detachments with a complete follow-up of 15 years are presented. Discussion of how to avoid PVR and of a series of 72 retinal detachments with PVR-C1/C2 which were treated with minimal segmental buckling and coagulation limited to the break(s) and without drainage of subretinal fluid and which have a complete 13.5 year follow-up. Presentation of their longterm anatomical and functional results. This is followed by a comparison of the present different techniques for repair of a retinal reattachment in relation to their morbidity, socioeconomic implication and results. At the end of the course various retinal detachments are presented and discussed with the participants.
At conclusion of the course, the attendee will be able to apply a logical and minimal approach for repair of a retinal detachment with a minimum of trauma and optimal longterm results and to know when an active prophylaxis in the fellow eye should be considered and when a prophylaxis better not should be applied, but, instead, a so-called passive prophylaxis be adviced and explained to the patient.
subspecialists for retinal surgery, general opthalmologists
intermediate educational level
[ Keyword ]
rhegmatogenous retinal detachment / prophylaxis of retinal detachment in the fellow eye / minimal extraocular retinal detachment surgery / retinal detachment with PVR-C1/C2 / longtern postoperative visual function
[ Conflict of Interest ]