Dear
Colleague, We have a Care Share plan to offer you. The patients you refer to us for specialised surgery would go back to you, within a day or two after surgery. They will be suitably instructed to clean their own eyes and follow necessary instructions for post operative medication. However, few post operative check ups after the surgery at preplanned interval, when certain points have to be noted, to ensure smooth post operative course can be undertaken by you. We shall provide you with information concerning the surgery and precise procedures of post operative care for each type of patients. Once you agree to Share the post operative Care of our Common patients, you deserve to Share the fee that the patients pays us for the surgical procedure and post operative care. This way, not only patient would save money by returning home early but our hospitalisation cost is also reduced. Since you will be compensated by us, on behalf of the patient, you may not charge fees during a period of usually month following surgery. However, to be an efficient partner in patient care, arising out of a specialised surgery, it will be necessary for you to be entirely familiar with the surgical procedures and the nature and genesis of possible complication. We shall, not only provide necessary literature but would welcome you to watch the surgery of some of your patients, to get a first hand information on the surgical procedure. That will also help us, personally, to know each other, making future interaction informal and cordial. As you know, I carry out all vitreo-retinal surgeries and Dr. Rajinder Kalsi Patnaik is responsible for small incision cataract surgery by phaco-emulsification. Both are involved in Medical Retina - Fluorescein Angiography and Laser. While we shall be sending you detailed literatures on several new and dramatic applications of Vitreous Surgery a few advance informations may be useful. 1.Trauma : Vitreous Surgery has completely changed the prognosis of trauma - specially of penetrating variety with or without intraocular foreign bodies. So much so that, the new approach is, not to excise any eye, however badly it appears to have been injured. The absence of perception of light, in the presence of intraocular haemorrhages need not be interpreted as a lost case. It is surprising how often we get lucky in such cases. The wound is repaired as best as one can and as soon as one can. In case intraocular infection is suspected or a retained intraocular FB is detected or suspected, an intravitreal injection of suitable antibiotics could be vital. Then the patient should be sent to an established Vitreo-Retinal surgeon for a substantive vitreo-retinal surgery around the 10 day after injury (7-14 days). 2. Intraocular Foreign Bodies Similarly, the long term prognosis for retained IOFB has undergone unbelievable improvement through vitreous surgery. The procedure provides a precise and controlled mode of surgery with excellent results never imagined few years back. 3.Diabetic Retinopathy: While Laser treatment after fluorescein angiography is the main stay of treatment of DR worldwide, late cases or badly managed cases with nonresolving vitreous haemorrhages or traction retinal detachments need not be abandoned as hopeless cases. Many of these cases can be helped by Vitreo-Retinal Surgery. 4.Complicated or Failed Cases of Retinal Detachment Though more than 90% of all cases of Retinal Detachments can be successfully managed by buckling procedures, complicated or cases of failed RD surgery, now can be successfully treated by vitreo-retinal surgery. Other newer application Vitreous Surgery include Nonresolving vitreous haemorrhage, (Eales disease, BRVO etc.) macular pucker, macular holes, endophthalmitis. 5. Similarly, dislocated lens, lens nucleus or IOL can be handled safely only by parsplana Vitreous Surgery. 6. Cataract Surgery: Small Incision cataract surgery by ultrasonic phaco-emulsification with IOL is the Technique of Choice world wide. It may be noted that Laser Phaco is experimental, unapproved and its, side effects are unknown. As of today is an inferior mode of phaco emulsification compared to standard and proven ultrasonic phaco. She has one of the largest series of cases of Phaco in such complicated cases Cataract as in vitrectomised eyes, Diabetic Eyes, Eyes of High myopia and Eyes operated for retinal detachments. In case you are interested to join this Care Share Plan kindly let us know, so that we may work out the details. With kind regards, Retina Associates, E-Mail < patnaik @ nde.vsnl.net. in> (BIJAYANANDA PATNAIK) |