Vision Science and Eye

Biography

Biography: Faisal Fayyad

Abstract

Key points

What is bi-manual surgery?

We use both upper ports as active ones i.e. we utilize the upper left port to insert active instruments (like cutters, forceps and scissors). However, we need a light source to substitute for the endo-illuminator.

Indications

Proliferative diabetic retinopathy

Rhegmatogenous retinal detachment

RD complicated with PVR

Trauma

Dislocated lens/ IOL

ROP

Advantages

Better surgical control

Reduced frequency of instruments change during surgery and less iatrogenic complications

Reduce overall time of surgery

Difficult cases become more amenable to surgery

Minimize need for an assistant

Chandelier Lights

My preference is to use a 2 twin lights to eliminate the need to reposition the fiber and minimizes the shadow seen with single-fiber chandelier endo-illumination because the illumination comes from 2 different directions.

Advantages of Chandelier

The working distance for light irradiation is important, and holding the light probes as far away from the retina as possible increases safety.

The self-retaining nature of chandelier endoilluminators frees up my hand from holding a light probe, allowing true bimanual manipulation during surgery.

Conclusion

Bimanual approach is the safest and the most effective approach in the management of complicated diabetic vitrectomies.