Medical & Surgical Vitreoretinal Fellowship

Erik van Kuijk, MD, PhD

Dara Koozekanani, MD, PhD

Sandra Montezuma, MD

Richard Johnston, MD

Geoffrey Emerson, MD, PhD

Hossein Nazari, MD

Justin Yamanuha, MD

Our program is focused on training exceptional surgeons who will be confidently diagnosed and treat (medical and surgical) both straightforward and complex retinal challenges. The fellow starts participation in retinal surgeries on day one and rapidly gain autonomy in the clinic and the operating room. Our surgical volume is several times above the required numbers for a vitreoretinal surgery fellowship training program and includes some of the most complicated cases that a vitreoretinal surgeon may face in their carrier. Some of these complicated cases that our fellows are involved in include:

• Complex tractional retinal detachments caused by diseases like diabetes and vitreoretinal complications of ocular trauma
• Both straight forward and complex retinal detachment surgeries including those needing primary scleral buckling or combined pars plana vitrectomy and scleral buckling
• Combined vitreoretinal/anterior segment and vitreoretinal/glaucoma surgeries including those the need temporary keratopresthesis placement
• Surgical management of complex ocular traumas involving posterior segment of the eye
• Medical and surgical treatment of pediatric retinal diseases including retinopathy of prematurity
• Medical and surgical treatment of intraocular tumors involving brachytherapy treatment approaches as well as collaborations with Radiation Oncology for team-based approaches
• Diagnosis and management (including surgical treatment) of complex uveitis conditions
• Medical and surgical management of the surgical complications of anterior segment surgeries including secondary intraocular lens implantation techniques
• Opportunities to perform complex cataract and combined cataract and vitrectomy procedures

While our program’s focus is on training outstanding vitreoretinal surgeons, a strong medical retina and uveitis clinic supports our fellows training on the medical aspects of retinal diseases. The fellow has extensive exposure to the medical management of common retinal diseases as well as some of the most challenging medical retina conditions a retina physician may face. Clinical training encompasses retinal degenerative diseases with numerous opportunities for intravitreal injections, inherited retinal diseases, in-office care of peripheral retinal pathologies including pneumatic retinopexy and laser retinopexy using both slit-lamp laser delivery system and indirect ophthalmoscopy lasers. Our clinic is equipped with photodynamic therapy (PDT) laser for the patients who need this treatment modality and our fellow has the opportunity to participate in it. We are proud of having state of the art retina imaging facility and fellows will learn to interpret imaging data from a variety of modalities including ultrasonography, fluorescein and indocyanine green angiographies utilizing the conventional and ultra-widefield imaging systems, spectral-domain optical coherence tomography (OCT), OCT angiography, and electrophysiological tests. These are some of the highlights of our medical retina training opportunities:

Comprehensive medical retina –- We see thousands of new referrals and return patients with a wide variety of prevalent and rare retinal conditions.

Ocular Oncology -- 

Inherited Retinal Diseases Clinic --

Pediatric Retina -- fellows will have exposure to various aspects of pediatric retinal diseases such as retinopathy of prematurity (ROP), inherited retinal dystrophies, and pediatric retinal detachments. There will be opportunities to participate in an examination under anesthesia and perform and interpret pediatric fluorescein angiography using RetCam imaging system and learn staging of ROP and treat this disease using intravitreal injection as well as indirect ophthalmoscopic laser application.

Uveitis -- During the 2-year Vitreoretinal Fellowship, there will be opportunities to see patients with the following conditions:

• Journal club
• Grand rounds
• Fluorescein angiography conference
• Informal discussion at the end of clinic and operating room day

Although our program is a surgical and clinical oriented training program, there is an ample opportunity to participate in clinical research. Fellows are encouraged to discuss research ideas with program faculty and conduct research projects during their fellowship period. Fellows present at our department's annual research day for a chance to receive feedback from faculties and compete with other fellows for annual fellow research award.

Fellows are Clinical Instructor of Ophthalmology within the department and are expected to participate in teaching the residents and medical students who rotate with our service. Fellows teaching responsibilities include giving 2-3 didactic lectures to residents, presenting in grand round, presenting in fluorescein angiography conference and journal club, and hands-on teaching in clinic and operating room.