Microsoft word - prospect.doc
F. Fankhauser MD
S. Kwasniewska MD
These videosequences represent treatments performed by
using the Nd:YAG laser in the photo-disruptive (Q-switched) and thermal (free-running or continous-wave) modes.
Most of these operations were performed at the University Eye Clinic
in Bern using the Microruptor 2 (Meridian AG, Thun, Switzerland,
website: www.meridian.ch). The enormous body of material amassed over
the years has been contracted into four DVDs with the help of Georg Fivian.
The following titles, which are available from Georg Fivian (website:: www.fivian.ch) are presented here:
(Please make use of the “pause button” if you wish to observe details on a
DVD 1 : Introduction
: Here, the severing of various membranes remaining after the
extraction of cataracts in pseudophakic eyes is shown. Although such
membranes are basically the same, they differ in details, and the irradiation technique has to be adapted to each local peculiarity.
: Initially illustrated is a case of mydriasis, which is due to a
hyperplastic pigment epithelium. Following the dissection of this layer, the
pupil can once again be fully dilated. Secondly, the severing of various types of membrane remaining after the extraction of a cataract in pseudophakic eye
is shown. Thirdly, the cutting of various vitreal strands is demonstrated.
Some of these structures interfere with vision; others pose a threat to the
: Here, various aspects of antiglaucomatous iridectomies are
demonstrated. In one case, the cornea has been rentered opaque (exept at the
lowermost aspect) by trauma.Here an optical iridectomy yields a good visual
: This sequence demonstrates two cases of classical trabeculoplasty,
according to the Wise-Witters technique.
: Initially, the dissection of an anterior synechia is shown. Secondly,
various vitreal strands are severed. Thirdly, transscleral cyclocoagulation is
performed using an optical probe in the contact mode. Fourthly, an optical probe, firing perpendicularly is used for retinopexy. The retinal impacts are
visible and can be inspected on a static image by pressing the “ pause
The “Introduction DVD” closes with an extensive list of relevant
Various pathologies 1
: Two first two sequences demonstrate the disruption of retrolental
membranes in pseudophakic eyes. The third sequence illustrates the
dissection of a membrane in an eye that has undergone corneal grafting. This
sequence demonstrates that irradiation can be succesful even in highly
complex situations. Such is also shows the case in the next sequence. This
demonstrates the cutting of a McCannel suture, which has displaced an iris-
: Here, various types of membrane remainining after extraction of a
cataract are disrupted. Initially, a pupil-constricting ring of Soemmering is
dissected. Secondly, a membrane interfering with the mobility of the pupil is
severed. Thirdly, the disruption of various vision-obscuring membranes is
: Here, a photomydriasis analogous to that shown in part 22 on the
“Introduction DVD” is demonstrated. Subsequently, the disruption of
various iris-lens synechia, and of
membrane–lens and membrane- vitreal body adhesions is performed.
: Initially, a basal and sector iridectomy is shown in detail. Secondly,
the lysis of an iris-lens synechia in a clear lens is performed. Thirdly, the
lysis of an iris border adherent to a clear lens is demontrated. And in the
final sequence, the lysis of goniosynechiae in a buphthalmic eye is to be
Various pathologies 2
: In the first case a heavily pigmented after cataract membrane is
disrupted. In the second case, various thick vitreal membranes are severed.
Here, several vitreal membranes and strands of varying complexity
Initially, highly complex vitreal membranes are dissected. Then,
several anterior synechiae are lysed.
: In this cases, vitreal haemorrhages between the retina and a posterior
vitreal membrane are managed. Following dissection of the posterior vitreal
membrane, the blood flows into the vitreous and is resorbed.
Various pathologies 3
: In the first case, several after cataract membranes are dissected. In
the second case, a heavily pigmented post-cataract membrane is disrupted.
: This case is illustrated in “Introduction DVD”.
: This case is illustrated in “Introduction DVD”.
: Here, a hyperplastic fibroma of the orbit is removen, and the skin
graft is taken from one of the patient’s arms.
: In this sequence, a severe blepharochalases is removed.
In this instance, the loss of blood is minimized, by the use of a laser scalpel.
: The experimental and clinical application of the
Nd:YAG laser is shown.
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