ACRC/Macula 2023: VR Surgery

Ahmad Al Moujahed, MD, PhD, MPH
Massachusetts Eye and Ear
Boston, MA

The last session of ACRC 2023 was titled “Advances in VR Surgery”.

First, Dr. Netan Choudhry from Vitreous Retina Macula Specialists of Toronto discussed different approaches for treating full-thickness macular holes (FTMH). These include topical therapy for small FTMH, particularly post cataract surgery, different ILM flap techniques (e.g., autologous ILM transplantation, autologous retinal transplantation, anterior or posterior capsule transplantation, and amniotic membrane graft), and hydrodissection. Dr. Netan also reviewed the CLOSE study group classification of FTMH.

Second, Dr. Ninel Gregori from Bascom Palmer Eye Institute discussed the different surgical approaches to gene therapy delivery. These include subretinal, intravitreal, and suprachoroidal approaches. She also discussed the advantages, disadvantages, and challenges of each approach. Then, she reviewed the immunologic complications of gene therapy. Finally, she briefly discussed using nanoparticles for gene therapy and their potential benefits over using viral vectors.

Third, Dr. Yoshihiro Yonekawa from Wills Eye Hospital talked about pediatric retina surgery. He reviewed the top four pediatric retina surgery rules, which are 1) do not make iatrogenic breaks (rely on the RPE), 2) anatomy is different from adult eyes, 3) the scleral buckle is your best friend, and 4) think about the entire patient.

Finally, Dr. Omesh Gupta from Wills Eye Hospital talked about the different secondary IOL approaches. The surgical approach depends of multiple factors, including patient age, co-morbid eye conditions, anatomic considerations, surgeon preference, and referring doctor preference. Dr. Gupta first reviewed the advantages of ACIOL, including the straight forward technique. Then, he reviewed the different techniques of scleral fixated IOLs: intrascleral haptic fixation (Yamane) and scleral fixation with suture (proline and Gore-Tex sutures using Akreos or EnVista IOL). Finally, he reviewed the advantages and disadvantages of each of these approaches.

We hope that you enjoyed RETINA Roundup’s coverage of this year’s Atlantic Coast Retina Club/Macula conference!