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Cataract Surgery | Mar 2014

My Favorite Video on Eyetube

CRST Europe Editorial Board members nominate videos that have made an impact on their surgical technique or practice.

Six years ago, Bryn Mawr Communications, the publisher of CRST Europe, embarked on a journey into ophthalmic education through videos. The result was Eyetube, which today houses a library of more than 5,300 videos and has 65,000 subscribers worldwide. Launched in March 2008, Eyetube was designed as an online resource for ophthalmic specialists to safely and securely archive and share their videos. The vast majority of the videos hosted on Eyetube are fully narrated in order to promote peer education. Each month, 23,500 people visit Eyetube and watch a total of 64,000 videos.

The staff of CRST Europe recently invited members of our editorial board to nominate a favorite video on Eyetube and describe its importance to their surgical technique or practice. Below are the nominated videos, and, in the articles that follow, several producers of these videos share their thoughts.

WORM DANCING ON THE RETINA

Nominated by Michael Amon, MD

eyetube.net/?v=guhigu.

“Worm Dancing on the Retina,” is my favorite video on Eyetube because of the rarity of the case and the surgical approach used by Samir El Baha, MD (Figure 1).

TOTAL RECONSTRUCTION

Nominated by Allon Barsam, MD, MA, FRCOphth

eyetube.net/?v=veliq.

I vote for “Total Reconstruction,” by Ike K. Ahmed, MD. As with many of Dr. Ahmed’s videos, this one demonstrates several techniques for dealing with complex anterior segment pathology (Figure 2). Dr. Ahmed constantly strives to raise the bar in what anterior segment surgeons can achieve, and he provides the viewer with proper technique and planning and he clearly describes how each step should be carried out.

DENSE CATARACT WITH FIBROTIC CAPSULE AND POSTERIOR CAPSULAR TEAR

Nominated by Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin)

eyetube.net/?v=pevop.

My nomination is for “Dense Cataract With Fibrotic Capsule and Posterior Capsular Tear,” by Robert J. Weinstock, MD. I have chosen this video because the instruction that Dr. Weinstock provides is excellent; once you have watched the video, you feel that you have learned something. I think videos on Eyetube should ideally provide viewers with surgical pearls so that the standard of surgery improves for all, and the case described by Dr. Weinstock achieves this. His narration is clear and well synchronized to the video. Posterior capsular tears with vitreous loss occur from time to time, and this video may help viewers manage the complication better.

PTERYGIUM EXCISION: ICEBERG TECHNIQUE

Nominated by Uday Devgan, MD

eyetube.net/?v=dohuk.

Although my passion is cataract surgery, the Eyetube video that I find myself watching over and over again is “Pterygium Excision: Iceberg Technique,” by Arun C. Gulani, MD. His concept is that the visible pterygium is merely the tip of the iceberg, and a complete pterygium removal—one with a great cosmetic result and a low likelihood of recurrence— requires a meticulous and careful approach.

Pterygia are uncommon in my private practice, but at the county hospital where I teach ophthalmology residents, we perform the Gulani iceberg technique every week. This is a must-see video that has certainly changed the way that I perform and teach pterygium surgery.

MAKING A DIFFERENCE IN ARMENIA

Nominated by Eric D. Donnenfeld, MD

eyetube.net/?v=rikid.

I am going to be a little selfish and select “Making a Difference in Armenia,” by Kerry D. Solomon, MD, and myself. We visited Armenia to perform microinvasive glaucoma surgery (Figure 3). Our video shows the surgical technique of performing iStent (Glaukos) implantation, but, more important, it captures the spirit and compassion of the doctors who work in Armenia and the total appreciation of the patients undergoing surgery. Making a difference in our patients’ lives is what we do every day as ophthalmologists, and this video captures that elusive and rewarding moment.

ESSENTIAL SURGICAL TECHNIQUES FOR VITRECTOMY

Nominated by A. John Kanellopoulos, MD

eyetube.net/?v=suvuse.

“Essential Surgical Techniques for Vitrectomy,” by Louis D. Nichamin, MD, is a must-see video for any cataract surgeon. In the video, Dr. Nichamin comprehensively overviews a pars plana anterior vitrectomy approach for the treatment of an inadvertent broken posterior capsule.

LITTLE FLUIDICS TIP

Nominated by Boris Malyugin, MD, PhD

eyetube.net/?v=linub.

One of the most interesting videos on Eyetube is “Little Fluidics Tip,” by Thomas A. Oetting, MD. Although Brian C. Little, BSc, MA, DO, FRCS, FRCOphth, is credited for the idea pictured in the video, Dr. Oetting beautifully demonstrates how withdrawing the chopper at the moment of the last nucleus fragment removal dramatically improves anterior chamber stability by limiting outflow and decreasing the chance of the posterior capsule trampolining toward the phaco tip (Figure 4). It is not only the usefulness of this small trick that makes the video important; it also demonstrates the improvement in surgical performance that can be achieved by paying attention to little things most of us do not recognize until someone with a bright, attentive mind exposes it to the public.

GLUED IOL LIVE SURGERY

Nominated by Erik L. Mertens, MD, FEBOphth

eyetube.net/?v=kifag.

My favorite video on Eyetube is “Glued IOL Live Surgery,” by Soosan Jacob, MS, FRCS, DNB. This video beautifully demonstrates the technique that Amar Agarwal, MS, FRCS, FRCOphth, popularized for fixation and centration of a three-piece IOL.

During live surgery, Dr. Jacob glues the haptics into a scleral tunnel and under a sclerolimbal flap. During any live surgery procedure, there is extra stress for the surgeon to show his or her technique while commenting on how the surgery should be done. Dr. Jacob’s video excellently shows the steps she performed in this successful surgery.

SIEPSER SLIDING KNOT DEMO

Nominated by Khiun F. Tjia, MD

eyetube.net/?v=rireg.

“Siepser Sliding Knot Demo,” by Garry P. Condon, MD, is my favorite video. I watched it many times preparing for a complicated case that was referred to me, as I wanted to use Dr. Condon’s technique to secure a dislocated IOL.

This is a highly educational video, as Dr. Condon clearly explains the suturing technique on a paper model. I saw Dr. Condon present this technique many years ago, and I looked it up on Eyetube as a resource to help me prepare for managing a complicated situation. Watching the video helped me achieve the required outcome for my case.

Michael Amon, MD, is Professor and Head of the Department of Ophthalmology, Academic Teaching Hospital of St. John, Vienna, Austria. Professor Amon is a member of the CRST Europe Editorial Board. He may be reached at tel: +43 1 211 21 1140; e-mail: amon@augenchirurg.com.

Allon Barsam, MD, MA, FRCOphth, is a Consultant Ophthalmic Surgeon at Luton & Dunstable University, The Western Eye Hospital, Imperial College Healthcare NHS Trust, and Focus Clinics in London. Dr. Barsam is a member of the CRST Europe Editorial Board. He may be reached at e-mail: eyes@allonbarsam.com.

Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin), is a Consultant Ophthalmologist at the Wellington Eye Clinic and UPMC Beacon Hospital, Dublin, Ireland, and an Associate Chief Medical Editor of CRST Europe. He may be reached at e-mail: abc@wellingtoneyeclinic.com.

Uday Devgan, MD, is in private practice at Devgan Eye Surgery and is the Chief of Ophthalmology at Olive View UCLA Medical Center and an Associate Clinical Professor at Jules Stein Eye Institute, UCLA School of Medicine, in Los Angeles, California. Dr. Devgan may be reached at tel: +1 800 337 1969; e-mail: devgan@gmail.com.

Eric D. Donnenfeld, MD, is a Professor of Ophthalmology at New York University and a trustee of Dartmouth Medical School in Hanover, New Hampshire. Dr. Donnenfeld is a member of the CRST Europe Global Advisory Board. He may be reached at tel: +1 516 766 2519; e-mail: ericdonnenfeld@gmail.com.

A. John Kanellopoulos, MD, is the Director of the LaserVision.gr Eye Institute in Athens, Greece, and is a Clinical Professor of Ophthalmology at New York University School of Medicine. He is an Associate Chief Medical Editor of CRST Europe. Dr. Kanellopoulos may be reached at tel: +30 21 07 47 27 77; e-mail: ajkmd@mac.com.

Boris Malyugin, MD, PhD, is a Professor of Ophthalmology, Chief of the Department of Cataract and Implant Surgery and Deputy Director General (Research and Development and Education) at S. Fyodorov Eye Microsurgery Complex, Moscow, Russia. Professor Malyugin is a member of the CRST Europe Editorial Board. He may be reached at tel: +7 499 488 85 11; e-mail: boris.malyugin@gmail.com.

Erik L. Mertens, MD, FEBOphth, is Medical Director of Medipolis, Antwerp, Belgium. Dr. Mertens is a Co-Chief Medical Editor of CRST Europe. He may be reached at tel: +32 3 828 29 49; e-mail: e.mertens@medipolis.be.

Khiun F. Tjia, MD, is an Anterior Segment Specialist at the Isala Clinics, Zwolle, Netherlands. Dr. Tjia is Editor Emeritus of CRST Europe. He may be reached at e-mail: kftjia@planet.nl.

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