The 23rd Annual Advanced Vitreoretinal Techniques & Technology (AVTT) Symposium was held on August 25–27, 2022, at the Hyatt Centric in Chicago. The weekend was packed with fun and learning, including a hands-on wet lab experience, lectures on what’s trending in retina, and several lively debates. Although the meeting, organized by William F. Mieler, MD, is geared toward second-year vitreoretinal surgery fellows, it is open to residents and practicing retina specialists to reconnect and learn from some of the finest in our field. Below we highlight the key topics and discussion points from this whirlwind weekend.
TOP-NOTCH PROGRAM
Ethics in Clinical Ophthalmology
Day one started off with lectures geared toward the medical trainees, discussing the ethical issues ophthalmologists sometimes face. Topics included an introduction to step therapy and prior authorizations by George A. Williams, MD; incorporating clinical trials and research into clinical practice by Jennifer I. Lim, MD, and SriniVas R. Sadda, MD; and opportunities for global leadership experiences by R. V. Paul Chan, MD, MSc, MBA. Trainees were also given advice on how to tackle suspicion of malpractice in a partner, what to do when a patient requests an attending-only surgery, and contract negotiation.
The first morning could not have had a more perfect ending, with a lecture from Carol L. Shields, MD, on balancing the roles of doctor, researcher, and parent.
Testing New Products in the Wet Lab
The highlight of day one was the hands-on wet lab experience that commenced with a lecture detailing the fundamentals of basic vitrectomy settings and fluidics. Trainees were able to practice their skills on some of the latest systems, such as Bausch + Lomb’s Stellaris Elite and the newest viewing technologies from Oculus.
Residents and fellows also got a chance to try out the Ngenuity 3D visualization system (Alcon) under the direct tutelage of long-time AVTT supporter Dr. Williams and Maria H. Berrocal, MD. The wet lab also included experiences with several medication injectors (Figure), such as the Ozurdex (Allergan/AbbVie) station led by Robert A. Hyde, MD, PhD, and Alimera’s long-term steroid implant, Iluvien, demonstrated by Dr. Lim.
Figure. Multiple injectors and other surgical tools were available for fellows and residents to test drive.
Lecture Pearls
Days two and three were filled with lectures on the most up-to-date topics in retina. One of the most memorable talks was on the use of en face OCT in the pathoanatomy of macular diseases by David Sarraf, MD. Another favorite was a discussion led by Dr. Berrocal on performing 27-gauge vitrectomy, including several videos of her perfect dissection of proliferative membranes in diabetic patients.
Peter K. Kaiser, MD, kept things fresh with his presentation on drugs in the pipeline for AMD. Pooja Bhat, MD, and Ann-Marie Lobo-Chan, MD, MS, discussed uveitis and an update in systemic immunotherapy and molecular diagnostics.
Other key topics covered in the program were ocular oncology (featuring fascinating cases by Dr. Shields), retinopathy of prematurity, and inherited retinal diseases.
SPIRITED DEBATES
It wouldn’t be AVTT without lively and, at times, downright comical debates between some of retina’s finest. These discussions were the meeting’s pièce de résistance, as old friends went head-to-head on controversial topics in retina.
Will the next generation of 3D heads-up displays lead to improvements in our surgical outcomes? Yannek I. Leiderman, MD, PhD, supported this notion, while Dr. Chan argued that newer isn’t always better. Although these viewing systems are great for both education and ergonomics, more data is needed to evaluate their effect on surgical outcomes.
Drs. Sarraf (pro) and Sadda (con) turned from friends to foes on the topic of OCT angiography as an “essential” (key word) imaging modality for choroidal neovascularization.
Perhaps the most heated and amusing debate was between Drs. Mieler and Williams, as they discussed the utility of vitrectomy to treat floaters. What started as a friendly quarrel ended in a bloodbath as Dr. Mieler overwhelmingly convinced the crowd that “floaterectomies” are just asking for trouble.
Join in the fun and learning at next year’s symposium on August 18–20, 2023, in Chicago!
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