Surgical management of giant retinal break wins EURETINA Video Award

Rescue strategies and the intricate detail of vitreoretinal surgical techniques were showcased in the 2015 EURETINA Video Awards, with the very high standard of entries this year praised by the society’s president Francesco Bandello.

First prize went to Ahmed Elshewy of Egypt for his video entitled “Surgical management of a case of a 360-degree giant retinal break”.

Second prize went to Tushar K Sinha of India for his video entitled “Key of success – Keep both hands free: Efficacy of bimanual surgery in cases of 23G microincisional vitrectomy (MIVS) surgery”.

Third prize was awarded to Maria Isabel Relimpio Lopez of Spain for her two entries: “Delayed Boston keratoprosthesis exchange due to a first vitreoretinal surgery with an intraoperative choroidal detachment in a Stevens-Johnson patient” and “Surgical approaches for vitreomacular tractions”.

Dr Elshewy’s prize-winning entry gave an elegant example of the surgical techniques that can be successfully employed to deal with total retinal detachment and grade B proliferative vitreoretinopathy due to a 360-degree giant retinal break caused by ocular trauma.

In the video, Dr Elshewy, of Cairo University Hospital, described the various surgical steps needed to reattach the retina and minimise visual loss resulting from the trauma.

First phacoemulsification was performed, followed by insertion of a three-port 23-gauge trocar system and a 25-gauge chandelier lighting system to assist peeling of the adherent posterior hyaloid using end-gripping forceps and a retinal scraper. After removal of the vitreous surrounding the retinal funnel break and vitreous shaving aided with surgeon-assisted scleral depression, a small perfluorocarbon (PFC) bubble was used to support the posterior pole.

After refreshing the rolled edges of the retinal break, the eye was completely filled with PFC and argon laser retinopexy was performed. Dr Elshewy showed how he used direct PFC-silicone oil exchange to avoid retinal slippage.

In terms of the outcome, the patient had uncorrected visual acuity of 0.4 one month after removal of the silicone oil five months after the initial surgery.

Dr Elshewy’s video illustrated that a chandelier-assisted bimanual technique offers an effective means of dealing with adherent posterior hyaloid in a detached retina, particularly in cases of complex open funnel retinal detachment.