This video demonstrates a safe, simple, quick, effective and inexpensive technique of performing endocapsular surgery and capsular bag fixation of IOL in phacolytic glaucoma. The technique involves aspiration of fluid cortex from capsular bag using a 26-gauge bent needle. After anterior capsulotomy with angled Vannas scissors the nucleus is delivered. Following removal of the residual cortex a PC IOL is inserted in the bag. A V-shaped anterior capsulectomy is completed using Vannas scissors. The entire procedure can be performed with minimal trauma to fragile lens capsule and zonular apparatus and it minimizes intraoperative outflow channel obstruction by soluble proteins, easing recovery.

Management of Acute Pupillary Block Glaucoma due to Placement of PC-IOL in AC

Author: Dr. Mandal Anil Kumar
Year of Publication: 1999

This video demonstrates the Management of acute pupillary block glaucoma following placement of an all PMMA posterior chamber IOL in the anterior chamber. The surgical technique employed was exchange of IOL with vitrectomy and surgical peripheral iridectomy.

TRT: 09:13 minutes

Trabeculectomy using Single Apical Suture for Scleral Flap Closure

Author: Dr Mandal Anil Kumar
Year of Publication: March 2004
Other title: ‘The Technique of Single Suture Trabeculectomy’
Duration: 13:33 min

In this video we demonstrate our technique of single suture trabeculectomy. A triangular scleral flap is dissected with 4 mm base at the limbus using 11 number blade. Dissection below the flap is done with 15 number blade. Half thickness of sclera is dissected upto corneo-limbal junction. A 10 -0 nylon suture is passed through the apex of the flap and the flap is retracted. The deep block of 1 x 2 mm is then excised using Vannas' scissors. We use Deweker's scissors for iridectomy . The 10 - 0 suture is then passed through the apex of the scleral bed & tied. Conjunctival closure is achieved with 8 -0 vicryl in a running mattress fashion. This technique is simple, safe, and highly effective to achieve good IOP control without antifibrotic therapy.

Trabeculectomy with Primary Air Injection to avoid Shallow Anterior Chamber in Weill-Marchesani Syndrome

Author: Dr. Mandal Anil Kumar
Year of Publication: March 2003
Duration: 11:50 min

Shallow anterior chamber is a common complication following trabeculectomy in Weil-Marchesani Syndrome. This video presents a simple technique of air injection into the anterior chamber at the end of trabeculectomy. The rationale is to mechanically create space between cornea and lens-iris diaphragm to maintain the anterior chamber depth and slow down aqueous flow through the bleb in the immediate postoperative period. Air is eventually replaced by aqueous maintaining anterior chamber depth. This technique is a sure shot means to prevent postoperative shallow anterior chamber.

Full Thickness Donor Scleral Patch Graft for Hypotony Maculopathy Following Glaucoma Filtering Surgery

Donor Scleral Patch Graft in the Management of Hypotony Maculopathy

Authors: Anil K. Mandal, Dr Rajat Maheshwari, Dr Sirisha Senthil
Year of Publication: 2008
Duration: 06:18 min

Hypotony maculopathy is an uncommon complication of glaucoma filtering surgery. Young age, male gender, myopia, and adjunctive use of antifibrotic agents are known risk factors for this condition. This video demonstrates the surgical technique of scleral patch graft done on a young male, who presented to us with hypotony maculopathy following glaucoma filtering surgery with Mitomycin- C. After surgical exploration, the unhealthy scleral bed was reinforced with preserved donor scleral patch graft and advancement of the conjunctival flap. Postoperatively, there was a reversal of hypotony with good intraocular pressure control and visual recovery.

Classical Surgical Technique of Ahmed Glaucoma Valve Implantation

Author: Dr. Mandal Anil Kumar, Dr Rajat Maheshwari
Year of Publication: 2008
Duration: 06:00 min

Glaucoma drainage devices are an alternative approach to reduce intraocular pressure in all types of refractory glaucomas, prior failed conventional surgery or significant conjunctival scarring. This video demonstrates the surgical technique of Ahmed glaucoma valve implantation on a patient with uncontrolled glaucoma, who underwent prior conventional filtration surgery. The recipient scleral bed was prepared to fix the plate and paracentesis performed to insert the drainage tube. The exposed tube was covered with preserved donor sclera. Postoperatively the patient had a good intraocular pressure control over a follow up period of 1.5 years.

Ahmed Glaucoma Valve Implant in Refractory Glaucomas

Author: Dr. Sirisha Senthil
Year of Publication: 2008
Duration: 07:23 min

Aqueous shunts or glaucoma drainage devices (GDD) are often used in complicated cases when conventional trabeculectomy fails or as primary procedure in refractory glaucomas. The use of implants in glaucoma surgery is increasing. It is a valved implant with fewer complications compared to other GDDs.

In this video we demonstrate the surgical technique, intra operative precautions and modifications of Ahmed glaucoma valve implantation in post penetrating keratoplasty glaucoma, refractory glaucoma in an anterior chamber pseudophakos and pediatric refractory glaucoma.

Exploring the Schlemm’s Canal

Author: Dr Mandal Anil Kumar
Year of Publication: 2001
Duration: 09:22 min

This intraoperative video demonstrates the surgical technique of dissecting the Schlemm’s canal under a partial thickness triangular scleral flap. This technique of exploration of Schlemm’s canal was utilized to perform external trabeculotomy that was then combined with trabeculectomy in the management of a 1-week-old child with congenital glaucoma. Six months and 3 years postoperative appearance of the child showed complete clearing of corneal oedema and normal visual acuity.

Award: Quality Teaching ASCRS 2002 Film Festival

Modifications in Trabeculectomy 07:05

Author: Dr. Sirisha Senthil
Year of Publication: 2008
Duration: 07:05 min

Even though trabeculectomy is an effective surgical procedure for lowering the intraocular pressure, issues such as post-operative hypotony and sub-conjunctival scarring with failed filtration continue to challenge the surgeon. It is possible to achieve better outcomes by suitably modifying the surgical technique to meet the demands of the situation. This surgical video demonstrates modifications in trabeculectomy such as trabeculectomy with releasable sutures, tenonectomy and use of wide area application of Mitomycin C.

Management of Intracameral Bleeding during Surgery for Infantile Glaucoma

Author: Dr.Anil K.Mandal
Duration: 07:56 min
Year of Publication: April 2006

This intraoperative video demonstrates the management of severe intracameral bleeding during trabeculotomy on the left eye of a four-month-old child during acute onset infantile glaucoma.

Surgical Management of a Child with Congenital Glaucoma and Fetal Hydrocephalus

Author: Dr.Anil K.Mandal, Dr Sunayana Hegde
Duration: 07:51 min
Year of Publication: 2008

The outflow of aqueous and the outflow of cerebrospinal fluid do have a comparable mechanism. The authors managed a six-month-old child with an unusual association of congenital glaucoma with fetal hydrocephalus. This video demonstrates the surgical technique of primary combined Trabeculotomy-Trabeculectomy on the child who had undergone VP shunt surgery for hydrocephalus. The surgical landmarks and anatomy of the limbal region was carefully identified to perform combined Trabeculotomy-Trabeculectomy technique under a partial thickness scleral flap. Postoperatively the corneal edema cleared completely but the visual outcome was poor as the child was having advanced glaucomatous disc damage.

Surgical Management of Congenital Glaucoma in Phakomatosis Pigmentovascularis

Author: Dr. Mandal Anil Kumar
Year of Publication: 2002
Duration: 09:41 min

Phakomatosis pigmentovascularis as characterized by nevus flammeus and oculodermal melanocystosis is found almost exclusively in Asians and strong predisposition for congenital glaucoma. The cause being multifactorial, results of surgical therapy are often disappointing. The present video highlights surgical technique of primary combined trabeculectomy-trabeculectomy performed successfully in 2-weeks-old child. While trabeculotomy overcomes the congenital angle abnormality, trabeculectomy creates alternative outflow channel bypassing the episcleral venous system. It offers good chance of success in achieving long-term lowering of IOP.

Surgical Management of Infantile Glaucoma with Secondary Corneal Hydrops

Authors: Dr A K Mandal and Dr Debasish Chakraborti
Duration: 07:01 min
Year of Publication: 2007

Management of infantile glaucoma with acute hydrops is challenging. We demonstrate the surgical management and outcome of two such children of infantile glaucoma with secondary corneal hydrops. The intraoperative video of first child shows the surgical technique of primary combined Trabeculotomy and Trabeculectomy on the left eye. The right eye developed acute hydrops after one month and managed in the same way. The second child underwent simultaneous bilateral surgery because of acute hydrops on both eyes at presentation. Six months postoperatively, both the children showed complete clearing of corneal edema and normal age-appropriate visual acuity. However, there were prominent Haab’s striae in the pupillary area on left eyes of both the children.

Microsurgical Technique and Results of Combined Trab and Trab for Developmental Glaucoma

Author: Dr Mandal Anil Kumar
Year of Publication: 1997

Presents the microsurgical technique of primary combined trabeculotomy-trabeculectomy for developmental glaucoma. Outlines a trabecular block under a limbus-based scleral flap; gradually deepens a central radial incision across the scleral spur to open the external wall of Schlemm's canal; then performs trabeculectomy in the usual manner.

TRT: 8:33 minutes
Award: Best of Show Award, AAO Annual Meeting 1998

Gonioscopy: Learn and Teach

Authors - Dr Kantamaneni Kalyani Prasad, Dr Garudadri Chandra Sekhar
Year of Publication: April 2001
Duration: 16:24 minutes

This video demonstrates normal angle anatomy. It illustrates gonioscopic features of certain types of glaucoma like Axenfeld-Reigers Syndrome, Pseudoexfoliation Syndrome, Neovascular Glaucoma and also post-Trabeculoplasty Peripheral Anterior Synechiae, Foreign Body in the angle, Tumor Seedings in the angle and Closed Trabeculectomy Osteum. Role of Indentation Gonioscopy in appropriate diagnosis of angle closure glaucoma is also highlighted.

Award: Best of Show Award, AAO Annual Meeting 2001

Laser Iridotomy

Author: Dr. Garudadri Chandra Sekhar, Dr. Kantamaneni Kalyani Prasad
Year of Publication: August 2002
Duration: 09:15 min

Angle closure glaucoma is a common cause of blindness in India for which laser iridotomy is the definitive treatment. Though most ophthalmologists are familiar with Nd:YAG capsulotomy, the iridotomies performed are less both because of under diagnosis and lack of training in performing an iridotomy.

This video explains properties of Nd:YAG laser as relevant to performing an iridotomy and demonstrates the technique of iridotomy in eyes with angle closure glaucoma. The indications and technique of combining Argon laser with Nd:YAG laser in iridotomy is also presented.