- 17 Sep, 2024
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Vitreoretinal Surgery Course 2025
Vitreoretinal Surgery Course
The “Vitreoretinal Surgery Course” is an educational program designed to provide participants
with a comprehensive understanding of vitreoretinal surgery.
The course is targeted towards healthcare professionals who are interested in gaining
knowledge and skills in this field.
The main objective of the Vitreoretinal Surgery Course is to equip participants
with the necessary knowledge and skills to perform vitreoretinal surgery effectively.
However, it also aims to instill the importance of evidence-based practice and staying up-to-date
with the latest developments in the field.
The course is designed to be both theoretical and practical so that participants
can apply their knowledge in a clinical setting.
The course coordinators and teaching faculty come from a variety of backgrounds
and collectively have extensive experience in teaching and research in vitreoretinal surgery.
By the end of the Vitreoretinal Surgery Course, participants should have an improved level
of confidence in understanding this complex area of ophthalmic surgery.
The participants will no doubt enjoy the opportunity to engage in various practical
activities and discussions to consolidate their learning.
Purpose of the Vitreoretinal Surgery Course
Over the past few years, there have been major advancements in the techniques
and equipment used in vitreoretinal surgery.
So, it is important to understand the rationale behind the various aspects
of the surgical techniques and maneuvers.
This would allow a surgeon not only to be able to perform the procedure effectively
but also to be flexible and confident to modify the technique according to the specific requirements of the patient.
Also, one needs to understand how to manage and achieve the best possible outcomes for the complications.
First and foremost, the Vitreoretinal Surgery Course would walk the participants through the key anatomy,
histology, and physiology of both the vitreous and retina, as well as the pharmacotherapeutics in the medical retina.
This is essential not only in understanding the pathological basis of vitreoretinal diseases
but also in the visual outcome of the treatment.
Secondly, all the basic science knowledge and current clinical and surgical management
options for different vitreoretinal diseases would be taught.
Last but not least, the course would focus on the surgical techniques that are commonly
performed in modern vitreoretinal practices.
Vitreoretinal Surgery Course Objectives
The main objectives of the Vitreoretinal Surgery Course are:
- provide ophthalmic surgeons with a comprehensive knowledge of the indications,
surgical techniques, and outcomes in vitreoretinal surgery:
The program is designed for practicing ophthalmologists and ophthalmology
residents (in their final year of training) who have little or no prior experience with vitreoretinal surgery.
- By the end of the course, it is expected that participants will be able to understand
and explain the rationale for surgical decision-making in vitreoretinal surgery,
know the basic operative steps, potential difficulties,
and how to overcome them, become familiar with the routine pre-and postoperative care
of these patients, and gain a deeper understanding of the kind of symptoms
and signs one might expect from a procedural complication and how best to investigate and manage these.
- Wet-Lab training: These are not only useful for understanding why certain procedures
are performed in the way they are but also in developing the manual dexterity
and hand-eye coordination needed to perform surgery safely.
Finally, it is hoped that the transition of knowledge from the wet labs to improvement in surgical ability
Fundamentals of Vitreoretinal Surgery Course
1- Basic Principles of Vitreoretinal Surgery
‘occlusive vasculopathy’ can lead to a sudden and painless loss of vision in that eye,
known as a ‘retinal artery occlusion’.
The main blood supply to the retinal tissue is from the central retinal artery,
which has its origins in the internal carotid system of blood vessels, and so the blockage
– which is typically caused by a blood clot – is often a consequence of a transient ischemic attack or,
more concurringly, can indicate a risk of stroke.
The course will explain that prompt action in the form of medical treatment to reduce
the risk factors and surgical intervention to remove the clot may be initiated
to protect vision and prevent other complications
2- Instrumentation and Equipment
The appropriate number and type of instruments for each surgery will vary,
but some instruments are used routinely for most cases.
3- Surgical Techniques
Through the Vitreoretinal Surgery Course, surgeons can learn about many of the surgical
techniques used around the world:
- Mudhouse Maffei dye technique: Since the advent of this new dye called Methylene Blue,
a new surgical technique has been introduced in the management of giant retinal tears.
This technique involves tissue approximation or rejoining of the giant retinal tear after
the removal of the vitreous gel.
By soaking the already dissected and mobilized edges of the retina surrounding
the giant retinal tear with Methylene Blue dye and exposing it to intense illumination,
mobility of the retina is enhanced, and it helps in the easy and stable final rejoining
of the retina around the giant retinal tear, relieving endophthalmitis,
a sight-threatening postoperative complication. - Relaxing retinotomy: It is a technique used in advanced stages of retinal detachment.
To facilitate retinal detachment surgery, anterior retinotomy or relaxing incisions
can be put in the area where there is a tight or strong retina.
This helps in the progression of retinal detachment towards the area where the buckle has been applied. - Machado’s technique: It is a unique technique used only by a few ophthalmologists around the world.
In this technique, the laser is used to create a chorioretinal scar around the retinal break
along with drainage of subretinal fluid. It has been seen that Machado’s technique
has less risk of developing cataract changes in the fellow eye as compared
to the conventional method of sub-retinal fluid drainage.
- Edgeworth’s technique: One of the most widely used surgical techniques by retina surgeons
in the world is Edgeworth’s technique.
It consists of stripping the internal limiting membrane with the help of special
dyes under brilliant blue light, and a dye called Trypan Blue is used.
Internal limiting membrane peeling helps in cases of non-resolving cystoid macular edema.
This is performed by the vitreo-retina surgeon after the removal of the vitreous
gel and is used as a last step just before gas or silicone oil injection.
Advanced Vitreoretinal Surgery Course
Advanced Vitreoretinal Surgery Course: In advanced training courses, training includes:
- Retinal Detachment Repair
- Macular Hole Surgery
- Epiretinal Membrane Peeling
- Vitrectomy for Diabetic Retinopathy
- Complications and Management in Vitreoretinal Surgery:
– Intraoperative Complications
– Postoperative Complications
– Strategies for Complication Prevention and Management
– Complications and Management in Vitreoretinal Surgery
- Advances in Surgical Equipment
Complications and Management in Vitreoretinal Surgery
The skills that the doctor needs to be trained in are not only related to surgery but extend to the following stage
Many complications may occur during vitreoretinal surgery.
These complications can be divided into intraoperative and postoperative.
Intraoperative complications include instrument breakage, suturing of the retina,
lens damage, vitreous hemorrhage, and so on.
Postoperative complications include the development of postoperative infection,
cystoid macular edema, development of cataracts, development of glaucoma,
retinal detachment, and so on.
Management of the complications includes accurate assessment of the complication
and discrimination between mild and severe complications.
Severe complications may necessitate immediate intervention
As a prevention, various measures can be taken, and these measures can be divided
into prevention of the increase in complications and prevention of the occurrence of new complications.
For example, the application of appropriate sterilization measures can prevent the occurrence of postoperative infection
In addition, skillful manipulation of the instruments can prevent the occurrence of vitreous hemorrhage.
In every step of the surgery, immediate and correct intervention will help prevent the increase in complications.
For example, after suspicion of infection, regular and invigorating antibiotics can prevent
the increase in the effect of the infection.
Also, prevention of secondary complications is related to correct and immediate prevention measures.
So, the patient should be closely monitored postoperatively.
All in all, improvement of surgical techniques, development of new instruments,
and enhancement of the practical experience of the surgeons will help us reduce complication rates.
However, information from more and more operations will provide more data to find out the underlying
problems and possible solutions.
Strategies for Complication Prevention and Management
One of the most important steps in preventing complications in vitreoretinal surgery is patient selection.
Patients with uncontrolled systemic comorbidities, severe hypotony,
and dense vitreous hemorrhage are at a higher risk for complications and should be managed accordingly.
Advances in Surgical Equipment
The course concentrates not only on standard vitrectomy surgery but also on advances
in surgical equipment and advanced vitrectomy techniques.
It is important to keep up to date with the progress of technology and research in this area,
as improved patient outcomes and more efficient treatment services can be offered.
Some of The kinds of advanced techniques that may be discussed are Microincision
Vitrectomy Surgery (MIVS) and the use of very sophisticated technology such as high-definition camera systems.
It elucidates Microincision Vitrectomy Surgery (MIVS) cells and shows how advanced techniques
can help to speed up the process of diagnosis and treatment for the patient.
Specialists in MIVS have innovative tools for retina procedures.
A wide variety of instruments can be used in MIVS surgery.
They include a vitrectomy machine, Microincisional instruments, and several other tools such as forceps.
The training also looks at the diagnostic equipment used in this type of surgery, such as optical coherence tomography.
The uses and benefits of this sort of advanced diagnostic equipment are discussed,
as well as how it can benefit the practice for both the patient and the clinician.
The course also includes discussions on the maintenance and sterilization of surgical equipment.
MoAcademy Vitreoretinal Surgery Course
MoAcademy designs a proficiency-based training methodology that would increase trainees’ confidence,
reduce training costs, and improve patient safety.
The program offers both theoretical and hands-on skills training and takes place in an actual operating
room with actual surgical tools and utilizing a plastic model eye to build up trainees’ surgical skills.
All the trainees receive a signed Certificate at the end of the Vitreoretinal Surgery Course done at our center.