- 17 Sep, 2024
- 0 Comments
- 4 Mins Read
Retina and Vitreous Surgery
Retina and Vitreous Surgery
Novice trainees are often prevented or discouraged from valuable hands-on surgical
opportunities and patient experiences.
Thus This Retina and Vitreous Surgery Course is designed to facilitate the learning of retina
and vitreous surgical skills with the knowledge that improved surgical ability after training
is highly transferable to improved patient care with minimal surgical harm.
These include didactic courses in basic science for ophthalmologists interested in retina and vitreous,
wet labs involving animals and/or cadaver eyes, and clinical observation.
Of these approaches, the learning model that most closely approximates medical education
and has the greatest subjective impression of acquiring necessary skills is surgical training
with the intent to actively operate on human pathology.
Retina and Vitreous Surgery Course Objectives
- To present a comprehensive series of didactic lectures that will instruct the physician in the indications,
contraindications, use of adjuvant studies, and various surgical approaches to retina and vitreous diseases. - To assist clinical and basic research to further the understanding of the pathogenesis
and the development of new treatments for diseases of the retina and vitreous. - To improve the knowledge base and the clinical skills of ophthalmologists who are in training
or are currently providing care to patients with diseases of the retina and vitreous.
This will be addressed with several new course offerings. - improve the quality of care that patients with these diseases receive.
Retina and Vitreous Surgery Course Curriculum
Preoperative Evaluation and Preparation
It is essential as the surgery proceeds according to the plan.
For retina and vitreous surgery, the determining factor in the success of the surgery is the rate
of complete visualization and the minimization of damage to ocular tissues.
This is heavily dependent on the experience of the surgeon and the quality of the surgical instruments.
However, the use of adjuvant pharmacologic agents, and specific patient positioning and ocular
manipulations can also increase the surgeon’s visualization and decrease the likelihood
of iatrogenic damage to ocular tissues.
Finally, assessment of the level of postoperative care that the patient will require will allow the surgeon
to better decide on the specific operative technique and allow the patient to better prepare for surgery and recovery.
Surgical Techniques
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying
layer of support tissue.
Initial detachment may be localized, but without rapid treatment,
the entire retina may detach, and vision can be lost in the eye
Surgery should be carried out as soon as possible after a retinal detachment is diagnosed.
It is easier to carry out and the visual results are better if the macula is still attached at the time of surgery.
If surgery is delayed (sometimes for weeks) and the macula becomes detached,
the visual prognosis is much worse.
Surgery aims to close the retinal break, reattach the retina, and restore as much normal vision as possible.
This can be achieved in many cases, but sometimes the visual outcome is not good because the central
part of the retina (macula) may have become detached, or other retina abnormalities may be present.
During the retina and vitreous surgery course, many surgical techniques can be learned, including:
Application of scleral depression: conventional surgery is usually performed with a three-port pars
plana vitrectomy using conjunctival suture closure.
Entry of the vitrector into the eye should be monitored by the surgeon as high-speed
penetration can lead to complications.
During surgery, the surgeon must be aware of the specific anatomical problem and aim to remove
as little vitreous as possible, especially in young patients with vitreous degeneration.
A thorough knowledge of the anatomy of the ciliary body region and peripheral retina
is essential to avoid iatrogenic breaks.
Postoperative Care after Retina and Vitreous Surgery
The final key to a successful outcome from vitreoretinal surgery is proper postoperative management.
Often, simple cases are managed quite well, but patients with complicated features
or unanticipated problems may not be managed optimally.
During the retina and vitreous surgery course this section outlines contemporary concepts
in postoperative management of common vitreoretinal surgical problems.
It specifically addresses surgical outcomes, complications, and physician-patient communications.
Common surgical problems are analyzed, and evidence-based recommendations
are offered for optimal management strategies.
Communication between the surgeon and the patient is essential to achieve the best outcome
following vitreoretinal surgery.
Recommendations are made for communicating expected surgical
Why do Surgeons Need Retina and Vitreous Surgery Courses?
Vitreoretinal diseases constitute one of the major causes of visual impairment and blindness.
In the last two decades, significant progress in managing both retinal and vitreous
diseases has been made possible through technical innovations,
particularly in the realm of microsurgery.
Today, as a result of the subspecialty’s well-defined body of knowledge and techniques coupled
with an increasing prevalence of vitreoretinal diseases in an aging population,
it is becoming apparent that more vitreous and retina specialists and their respective
training programs are necessary to care for affected patients.
A solid understanding of retinal disease and appropriate diagnostic and therapeutic interventions
is the only way to prevent recurrent adverse events in vitreoretinal surgery.
When the trainee reaches the section on surgical training, it will become clear that knowledge
of retinal disease is a prerequisite for learning most of the surgical techniques.
This preoperative training has been addressed in previous curriculums.
This present curriculum was designed for learners ranging from those with very little experience
in ophthalmology, to experienced ophthalmologists seeking to learn vitreoretinal surgery.
The purpose of the retina and vitreous surgery course is to provide an overview of training
in modern vitreous and retinal surgery.
Considerable diversity exists in the quality of retina and vitreous training programs,
and we intend to improve the overall standard of training by offering a clear description
of what comprises a comprehensive fellowship experience.
In addition, general ophthalmologists or international ophthalmologists practicing retinal surgery
will find this course helpful in providing a structured learning experience to improve their knowledge
and skills in vitreous and retinal surgery techniques.