March 2017

Clinical Case of the Month

Seenu M. Hariprasad, MD

"I have used Leica microscopes for over 12 years. Leica's ability to customize their platform to my needs has been very valuable given my particular needs. As a retina surgeon I rely heavily on my microscope for highresolution visualization during surgery. Leica's introduction of an integrated OCT will serve as an important tool in my educational efforts and I believe that patient outcomes may be enhanced. This technology will surely aid us in our understanding of the vitreoretinal interface and other retinal pathologies requiring surgery."

Raj N. Patel, MD
Liliya Golas, MD

Case presented by: Seenu M. Hariprasad, MD, is Chief of the Vitreoretinal Service, Director of Clinical Research and Shui-Chin Lee Professor of Ophthalmology and Visual Sciences

Image and video provided by: Raj N. Patel, MD, Senior Vitreoretinal Fellow and Liliya Golas, MD, Junior Vitreoretinal Fellow

Technical assistance provided by: Denise Armiger-George, CRA, OCT-C

CASE VIGNETTE:

Patient is an 88 year old Caucasian Female who underwent successful cataract surgery in her right eye many years ago. She had done quite well until last week when she presented acute vision loss. Upon examination she was found to have an intraocular lens (IOL) with surrounding capsular material subluxed into the vitreous cavity. Given her european descent and lack of recent trauma we gave her the diagnosis of Pseudoexfoliation Syndrome. The surgical plan was to perform a 20/23 gauge pars plana vitrectomy with IOL explantation. During the case, intraoperative OCT proved its value as we were able to estimate the distance the IOL was above the retinal surface. This enabled us to lift the IOL with 23g Maxgrip forceps and remove it from the eye without any trauma to the retinal surface. Intraoperative OCT image guidance allowed us to proceed with confidence to ensure that our goal was successfully and safely achieved. Postoperatively, our patient did quite well and is recovering nicely. *This video includes audio

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