Retina Consultants of Texas’ Post

Patellar chondral fracture: diagnosis and treatment A 14-year-old patient with gonalgia and repeated joint effusion for three weeks, with a slight sensation of joint blockage. An MRI was performed, which showed a chondral defect in the internal patellar facet associated with an intra-articular chondral fragment in the anterior recess of the intercondylar space. Chondral fracture is a complication of patellofemoral instability. It is more frequent between 9 and 15 years of age and has traditionally been considered an indication of early surgery. MRI is the technique of choice for its diagnosis, with a sensitivity and specificity of around 90% for chondral injuries. Treatment consists of fixing the fragment with headless compression screws or bioabsorbable pins. (Chondral Injury in Patellofemoral Instability. Cartilage. 2014 Jul; 5(3): 136–144. doi: 10.1177/1947603514530142)

💡 The 82-year-old patient presented with symptomatic mitral and tricuspid valve regurgitation following mitral valve repair (future band #30 mm) and CABG surgery 17 years ago. The patient also had a Watchman device implanted for paroxysmal atrial fibrillation one year ago. Transcatheter MV implantation was suggested due to pre-existing conditions and previous cardiac surgery. 💔 The case was challenged by the annuloplasty band. A Tendyne had never been implanted in such a small annuloplasty band diameter. After detailed preoperative planning, we were able to successfully implant a Tendyne 29S LP, the smallest Tendyne prosthesis available. ❕ Post-op echo showed no residual regurgitation, a mean PG of 2 mmHg and no LVOTO (5 mmGg). After effective treatment of the mitral valve, the tricuspid valve will be re-evaluated for further intervention. #TMVI #Tendyne #CardiacSurgery #CatchOfTheWeek17 Prof. Dr. med. Markus Krane, PD Dr. med. Hendrik Ruge, PD Dr. med. Keti Vitanova, Deutsches Herzzentrum München, Technische Universität München

Dear friends and colleagues, We, at the University of New Mexico Vascular Surgery, are excited to launch a UNM Vascular Surgery case series, where we will be sharing an intriguing case with you every 2 weeks. The primary goal of this initiative is twofold: to showcase the exceptional care and outcomes we provide to our patients in the Southwest region and to spark valuable discussions and opinions within our community. I trust that this series will not only captivate your interest but also encourage insightful dialogue among us all. Looking forward to embarking on this enlightening journey together. Warm regards, Ali Rana HERE WE GO - Case 1: 71 year old male with symptomatic extent 2 TAAA treated with a staged total endovascular reconstruction. This was our first off-the-shelf branched aortic repair and the 1st extent 2 TAAA TAMBE in the region. OR time for BEVAR stage: 152 minutes, flouroscopy 62 mins, 2052 mGy. With Zenith t-Branch not available to us in the real world America, I have a decent experience with making our own branches with physician modified endografts. TAMBE provides a much better alternative with reduced operative complexity although the monetary cost can be prohibitive. I do not, however, agree with routine use of branches in the paravisceral/pararenal AAA space and advocate that TAMBE should be limited to TAAAs. Please share your opinion. #EVAR #vascularsurgery #UNMvascularsurgery Gustavo Oderich MD Jesse Manunga Rafael Demarchi Malgor, MD, MBA FACS Sukgu Han Carlos Bechara Carlos Timaran Ross Clark, MD, MBA, RPVI

Tube Shunt Surgery for Glaucoma Tube shunt surgery, also known as glaucoma drainage device implantation or glaucoma tube surgery, is a surgical procedure used to lower intraocular pressure (IOP) in patients with glaucoma, particularly those in whom other treatments like medications, laser treatments, or trabeculectomy have failed or are not suitable. It involves the implantation of a small device that helps drain fluid from the eye, reducing the pressure that damages the optic nerve. 1. Purpose of the Surgery Tube shunt surgery is typically performed when: Medications and other surgical treatments (such as trabeculectomy) are insufficient to control intraocular pressure. There is a high risk of failure with traditional surgeries due to scarring or other factors. Complex types of glaucoma are present, such as: Neovascular glaucoma (glaucoma with abnormal blood vessel growth). Uveitic glaucoma (glaucoma associated with eye inflammation). Congenital or pediatric glaucoma. The goal is to preserve remaining vision by preventing further optic nerve damage caused by high eye pressure. #ophthalmologist #ophthalmicphotography #ophthalmosurgery #ophthalmologistgram #ophthalmologyresident #ophthalmologylife #ophthalmologyresidency #ophthalmolovers #eye #slitlampphotography #slitlampexamination #ophthalmology #retina #macular #maculardegeneration #macularpuckersurgery #volkswagen #ophthalmology #ophthalmologyresident #ophthalmologyresidency #ophthalmologynotes #ophthalmologylife #ophthalmologypearls #ophthalmicphotography #ophthalmologist #medical #medicalstudent #medicalschool #eyedoc #eyedoctor #optometrist #optometry #glaucoma #glaucomaawareness #glaucoma

. Exploring Joint Preservation Surgery: Arthroscopic and Beyond! Did you know that the most common form of joint preservation surgery is arthroscopic? This procedure involves a comprehensive "clean out" to remove pain mediators in the knee. From irritated synovium to bone spurs, the goal is to enhance motion in both the patellofemoral and tibiofemoral joints. Patellar mobilization plays a crucial role in regaining full knee extension. But that's not all! Joint preservation surgeries can get more specific, addressing localized arthritis with techniques like microfracture, autogenous osteochondral transfer, or fresh allograft. These surgeries may be accompanied by procedures like proximal tibial or distal femoral osteotomy, or even a meniscus transplant. These interventions are considered "joint preservation surgeries" and are recommended after a thorough clinical exam, radiographic workup, and MRI scans indicating suitability. Your journey to joint health starts with the right knowledge! https://medilink.us/baul #JointPreservation #ArthroscopicSurgery #Orthopedics

This week in the OR covered the breadth of the anterior segment: from cornea transplants to cataract surgery, and scleral-fixated IOLs to EVO ICL! I'll be highlighting each different surgery in upcoming posts. Today is DMEK! What is DMEK? Descemet Membrane Endothelial Keratoplasty (DMEK) is a surgical technique designed to treat conditions affecting the cornea, particularly Fuchs' endothelial dystrophy and other forms of corneal decompensation. Unlike traditional corneal transplants, DMEK focuses on transplanting only the innermost layer of the cornea, known as the Descemet membrane + endothelium, which leads to faster recovery times and improved visual outcomes. Why Choose DMEK? 1. Minimally Invasive: The DMEK procedure is less invasive than other corneal transplant techniques, resulting in reduced risks and complications. 2. Faster Recovery: Patients typically experience quicker visual rehabilitation, often achieving improved vision within days post-surgery. 3. High Success Rate: DMEK boasts a high graft survival rate, ensuring long-term benefits for patients. For more information about DMEK cornea transplant surgeries or to schedule a consultation, please contact Dr. Barry or visit samuelbarrymd.com Together, let’s pave the way for a brighter future in eye health! 👁️✨ #Ophthalmology #CorneaTransplant #DMEK #EyeCare #VisionRestoration

Have inflammatory reactions already been associated with Yxoss CBR®? The most common complications after oral surgery or oral-maxillofacial surgery include postoperative infections. Here, the usual treatment recommendations apply. In generally, however, an inflammation can be a natural process in the course of wound healing (inflammatory cascade in the course of secondary wound healing). Yxoss CBR® is biocompatible. Product-related reactions have not been observed and are therefore not expected. Infections due to inadequate hygiene (especially in the oral cavity) can negatively affect the healing process. #reoss #customizedsolutions #yxosscbr

💔 The 77-year-old patient presented with symptomatic severe MV regurgitation due to PML prolapse. Initial therapy with transapical neochordal implantation was unsuccessful and the patient underwent open heart surgery. 👀 After exposure, the valve appeared myxomatous altered with bileaflet prolapse and multiple ruptured chordae. The P3 segment showed a significant tear.   ✂ MV repair was performed with a 30 mm Simulus annuloplasty ring and placement of neochordae at P1, P2, and A2. The P3 segment was resected and a P2 sliding plasty was performed. ❔ What is your experience with open heart redo mitral valve surgery after transapical neochordal implantation? #CardiacSurgery #MVrepair #Neochordae #CatchOfTheWeek8 Prof. Dr. med. Markus Krane, Prof. Dr. med. Bernhard Voss, PD Dr. med. Keti Vitanova, Deutsches Herzzentrum München des Freistaates Bayern - Klinik an der Technischen Universität München, Technische Universität München

Ophthopedia Update:Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy in Eyes With Prior Failed Glaucoma Surgery: Précis: This study concludes that GATT can be an effective and safe surgical alternative for managing IOP in eyes with prior failed glaucoma surgeries, associated with minimal complications. Purpose: To report outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior failed glaucoma surgery. Patients and Methods: A retrospective study involving 30 eyes of 30 patients, all of whom had open angles on gonioscopy, experienced prior glaucoma surgery failures, and subsequently underwent GATT. The primary outcome measure was success defined as complete when the intraocular pressure (IOP) was >5 and ≤21/16 mm Hg without glaucoma medications and qualified with medications. Results: The mean age was 51.8±16.1 years. Twenty-one eyes underwent GATT and 9 eyes underwent phaco-GATT. Twenty-seven eyes had failed trabeculectomy and 3 eyes had failed glaucoma drainage device. Post-GATT, the IOP decreased from 27.1±7 to 16.9±6 mm Hg (P #Ophthalmology #Eye #Ophthotwitter

The critical role of neuromonitoring in thyroid surgery: why Avalanche SI 2 is the ideal solution 💡 Thyroid surgery is a delicate procedure where precision is crucial to avoid complications, particularly the risk of damaging the recurrent laryngeal nerve (RLN), which can lead to vocal cord paralysis. Intraoperative neuromonitoring (IONM) plays a pivotal role in safeguarding these nerves, ensuring the best possible outcomes for patients. The Avalanche SI 2 by Langer Medical is specifically designed to enhance the safety and efficacy of thyroid surgeries. This advanced neuromonitoring device offers real-time monitoring and immediate feedback, helping surgeons identify and protect the RLN during the procedure. Its intuitive interface and precise measurements allow for continuous nerve monitoring, reducing the risk of postoperative complications and improving overall surgical success. ✨ At Axiom Devices, we understand the unique challenges of thyroid surgeries, and that’s why we recommend the Avalanche SI 2. It's not just a device—it’s a commitment to patient safety and surgical excellence. 💎 Discover more about how the Avalanche SI 2 can enhance your thyroid surgery practice. https://lnkd.in/ekj_vhXv. #AxIOMDevices #ExcellenceinIOM #PatientSafety #ThyroidSurgery #Neuromonitoring #SurgicalInnovation #AvalancheSI2 #LangerMedical