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Matt Hirabayashi MD (@EyeFlyMD)
Приєднався 5 гру 2021
Current Refractive Surgery Fellow at Parkhurst NuVision sharing ophthalmology as I understand it. All videos are of my own surgeries posted with consent.
ICL Exchange
Here is a somewhat difficult ICL exchange in a patient with a floppy iris but the case highlights some important techniques. Despite being extremely rare, exchanging ICLs is easy and effective. One of the most important tips is to avoid opening the forceps until ready to grasp the ICL as to not enlarge the wound and accidentally evacuate some OVD.
Переглядів: 121
Відео
Cap To Flap (converting SMILE Cap to a LASIK Flap)
Переглядів 9321 день тому
I think this is a cool procedure. To convert the cap from an old SMILE procedure to the flap of a LASIK enhancement for example involves a deep understanding of the architecture of both procedures. The flap will be a little thicker with a nasal hinge but otherwise lifts like any other LASIK flap. There is of course additional nuance but this is an introduction based on what I've learned so far.
SMILE Surgery FULL CASE with Narration
Переглядів 14321 день тому
Here is a routine, COMPLETE case of SMILE (small incision lenticule extraction) with narration. This is meant to accompany the other video and provide more context for the normal flow of the procedure.
Full Femtosecond Laser Cataract Surgery Case (Narrated)
Переглядів 128Місяць тому
Here is a full case (with the ORA and IOL loading portion edited out) of Femtosecond Laser-Assisted Cataract Surgery using the LENSAR ALLY system with full narration.
Femtosecond-Assisted Cataract Surgery with ICLs
Переглядів 33Місяць тому
Yes, it's very safe to perform FLACS in patients with ICLs, the laser penetrates the ICL easily.
EVO ICL Basics and Overview
Переглядів 305Місяць тому
This is a video produced for the World College of Refractive Surgery and Visual Sciences that covers the basics of the EVO ICL. It's a great intro to ICLs and a good place to start on your own EVO journey. This is incredible technology that everyone deserves access to.
SMILE Insights
Переглядів 213Місяць тому
Here are some insights on what I've learned about SMILE so far. SMILE is a very unique technique and feel compared to other vision correction surgeries.
ICL Loading with Lioli (Tutorial + Tips and Tricks)
Переглядів 402Місяць тому
Lioli makes an alternative for loading ICLs. Here is the method we use to load them with this system. It's about $4.50 per unit and definitely is faster to load. The most important thing is it doesn't require additional instruments to load ICLs this way. I don't personally feel the actual ICL insertion is better.
ICL Loading with MST (Tutorial + Tips and Tricks)
Переглядів 229Місяць тому
Here is how we load EVO ICLs using the MST system and re-usable STAAR injector. Loading ICLs properly is CRITICAL to clean, easy insertions so taking the time to load them straight and aligned is important.
IC-8 Yag (Don't Hit The Mask!)
Переглядів 62Місяць тому
Not all YAGs are the same! For special lenses like the IC-8, a common cruciate pattern is not possible and instead the circular approach is often used. It's very important not to hit the mask on the IC-8, the reaction is dramatic...
Routine YAG Capsulotomy
Переглядів 77Місяць тому
Yttrium-Aluminum-Garnet is a synthetic gemstone common as a diamond substitute in rings during the WWII era (before cubic zirconium). When doped with Neodymium, this crystal serves as the laser medium for the YAG lasers used in clinic.
Full EVO ICL Case with Detailed Narration, Annotations, and Insights (Technique Overview)
Переглядів 1 тис.Місяць тому
This is a full, unedited EVO ICL case with detailed narration and annotations based on what I’ve learned so far to serve as a possible tutorial or something I would have liked to see when first starting. ICLs are such remarkable and safe technology and every patient should have access to them.
Guess The IOL! (Recognize the modern IOLs)
Переглядів 99Місяць тому
Can you guess the IOL before it ulfolds? Test yourself to find out! This is a silly game but also practical as it serves as a great final check that you're implanting the correct lens especially at places like Parkhurst NuVision where we use every modern IOL option!
Choosing EVO ICL Power
Переглядів 77Місяць тому
Here is a short review of the PNV method for selecting EVO ICL power. Delivering consistently excellent outcomes relies on analyzing a lot of data but the results are incredibly rewarding.
Perfect EVO ICL Insertions (Avoid Flipping the ICL!)
Переглядів 2972 місяці тому
I don't think the EVO ICL needs to flip upside down when using the leading haptics as a predictor of final orientation. If the leading haptics don't look like right, I think it's faster to stop the insertion and reload rather than risk flipping it upside down and having to explant it.
Do You Need a Fellowship for Refractive Surgery? (My Experience So Far)
Переглядів 4142 місяці тому
Do You Need a Fellowship for Refractive Surgery? (My Experience So Far)
LIDRS (lens-iris diaphragm retropulsion syndrome) Explanation and Demonstration
Переглядів 1472 місяці тому
LIDRS (lens-iris diaphragm retropulsion syndrome) Explanation and Demonstration
LAL Insertion Technique (Both Haptics in One Motion)
Переглядів 642 місяці тому
LAL Insertion Technique (Both Haptics in One Motion)
EVO ICL: Avoid IOP Problems and Evacuate the OVD!
Переглядів 812 місяці тому
EVO ICL: Avoid IOP Problems and Evacuate the OVD!
Rachel's EVO ICL Journey! (I was my wife's Surgeon!)
Переглядів 2552 місяці тому
Rachel's EVO ICL Journey! (I was my wife's Surgeon!)
IOL Unfolding Comparison of Different Platforms
Переглядів 1242 місяці тому
IOL Unfolding Comparison of Different Platforms
Full Unedited EVO ICL Case with Annotations
Переглядів 7793 місяці тому
Full Unedited EVO ICL Case with Annotations
LIVE Unedited Cataract Surgery (Routine FLACS/Laser Case)
Переглядів 1363 місяці тому
LIVE Unedited Cataract Surgery (Routine FLACS/Laser Case)
ICL Tips and Tricks (5 Tips in 60 Seconds)
Переглядів 2784 місяці тому
ICL Tips and Tricks (5 Tips in 60 Seconds)
Suction Loss During LASIK Flap Creation (VISUMAX)
Переглядів 1834 місяці тому
Suction Loss During LASIK Flap Creation (VISUMAX)
Just land as if you were landing a glider let let it settle onto the surface grass or paved.BW
Will it pain during the surgery
SMILE is completely painless!
Awesome video, well done Dr. Hirabayashi!
dude stop playing video games
Awesome video, must watch for EVO surgeons. Well done Dr. Hirabayashi!
Hi matt. Where are you located?
Hello! Parkhurst NuVision in San Antonio, TX!
I love Piper more than Cessna
Hi sir. Where are you located?
I'm super proud of the great job you're doing this year Matt!
which quadrant is that?
IT is the best Q
great pearls
Hi Dr Matt. Love your videos. Im sure your did you best work on your lovely wive. Please do some more videos showing the Operating Room and the different machines/"toys" used in ophthalmology. Thank you. Really love the techy stuff.
Thanks for the kind words! I cover some of this in the recent video on fellowships but this is a great standalone topic! Thanks for the idea!
How you calculate the Evo icl number? Any formula!!
I made a video about EVO ICL power selection this morning!
Which chopper are we using in this case
Great pearls!!!! Great video!!
Thank you Dr. Trattler!
Which microscope are you using doctor. Kindly guide
now I'm hungry
Why was this done? I'm supposed to have an IC_8 inserted in Sept to replace a cataract and want all the info I can get!
I say lights, camera, action as well.
This is one of THE best videos on this topic
Very interesting. Thank you for posting this video. Question, what is OVD?
Hi We should press the optic down when in the cartirage as plunger may pass below and becomes jammed, sometimes cartrage don’t have the posterior ridge to support the haptic so look carefully while pushing the plunger to confirm you are not kinking the haptic
you're a god among men
Did this today! Except I only inserted the manipulator after docking the first three scrolls. I then needed to go through the main wound with the manipulator anyway to adjust the ring and center it, since my left hand sucks..
Ha! I have time logged in that C172 before it was sold. N91PA. Used to be part of the rental fleet at KGNV. Had some fun flights in that airplane.
Yes, keep the nose wheel off as long as possible. This will allow for the cost of many many $100 Hamburgers instead of paying thousands for a nosewheel overhaul.
Sweet!! Hope I can land like that after my training!!
2 perfect landings wow !
wow very bumpy on take off, like my discovery flight ua-cam.com/video/BBQUlnV97e0/v-deo.html
Very good video! :)
I understand spherical abberation and how it is one of the easier for people to accomodate to (if within certain limits), but can you elaborate on Focus? Where does this come from - and how can it be manipulated if at all in a surgery? Can people with higher amounts of the have an inability to focus on a certain plane or is there a shifting that is unstable? Thanks for any input on this.
the next cataract coach
Thanks for the video! Just curious; is this the Arrow that was purchased from Wings of Hope, by a flight club?
Hey Matt, do you fly enough to get your own plane or partner in one? Or just a hobby? Just curious
Those VASI lights indicate you did a good job on final. ~Phoenix, AZ
Having landed both I can tell you the Piper with it's wider mains is much easier to land. That said, if you can, learn how to land with the Cessna first. If you can land a Cessna, you can easily land a Piper - the other way around is certainly doable, just harder.
I found the Cessna to be much easier. It wants to stay in the air much longer than the Piper, which takes a lot more back pressure to land smoothly and properly flare in my opinion
I own a tapered wing Archer and you really need to hit the numbers if you don’t want the “ floating effect “
@@arthurbrumagem3844 True. I think that is the case with low wing a/c in general.
@@archerpiperii2690 the Hershey wing Piper will drop like a rock vs the taper wing
wider main?
Refractive surgery victim here. I really liked the trefoil demonstration because of how tilting the lens made one lobe converge and the others diverge is very similar to how it looks when trying to accommodate with trefoil on your own eye. I have a question: Why do we see discrete spokes of light and not a halo when looking at point lights having post CRS aberrations? Also, I wanna mention that the halo I see around things, with high contgrast things I can tell it's actually multiple images ghost images surrounding the main image. Also the ghosts distance from the main image is directly related to the aperture of the pupil, and there is an array of fainter ghost images up until the main ghost. Is it because the brain erases them, or is it like a function with maxima and minima where the maxima are what the brain picks up as images?
Sorry for question but why in right Seat?
I'm used to it from instructing!
I don't like the way I phrased "Piston." It's expressed in wavelengths of the wavelength of light and is essentially linear phaseshift, or where in the phase the wavelength encounters the retina essentially. It is analogous to moving the muscle light closer to and farther from the wall as above but I wanted to clarify further. As you can see, this is not clinically relevant though as point in phase doesn't affect the quality of the image.
I hate theory without demonstrations. Thank you very helpful
Nice! I’m in the bank of T-Hangars behind this one….
𝕡𝕣𝕠𝕞𝕠𝕤𝕞