Vit-Buckle. Society. Forum for Innovation and Camaraderie Among the New Generation of Vitreoretinal Surgeons. Feature Story

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1 Vit-Buckle Society A Forum for Innovation and Camaraderie Among the New Generation of Vitreoretinal Surgeons The first annual stand-alone meeting of the Vit-Buckle Society will be held on April 12th and 13th at the Fontainebleau Miami Beach Hotel. By Rachel M. Renshaw, Editor-in-Chief 10 New Retina MD. winter 2012/2013

2 In 2007, a small group of vitreoretinal surgeons, Thomas Albini, MD; Rohit Ross Lakhanpal, MD; Derek Kunimoto, MD; Charles Mango, MD; and RV Paul Chan, MD, came together to start a new society that would focus on sharing innovative strategies for the surgical management of retinal disorders. This group, the Vit-Buckle Society (VBS), had its first meeting at the American Society of Retina Specialists (ASRS) in Palm Springs in December of We wanted to start a surgical video conference for younger surgeons, which didn t exist back then, Dr. Albini told New Retina MD. At our first meeting there were 15 retina specialists in attendance, including Timothy G. Murray, MD, MBA, who served as mentor, Audina Berrocal, MD; John W. Kitchens, MD; and Andrew Moshfeghi, MD, MBA, who volunteered to join the executive board to help organize future meetings. Howard Fine, MD; Eric Weichel, MD; and Sean Adrian, MD were among the presenters. What is VBS? When asked to define the society and its goals, Dr. Kunimoto, one of the founders of VBS said, Our mission statement sums it up well: The Vit-Buckle Society aims to provide an open forum for innovative vitreoretinal surgeons to share best practices, foster the development and use of novel surgical technologies and strategies for retinal diseases, and provide mentorship of emerging vitreoretinal surgeons. The VBS was initiated as a forum for vitreoretinal surgeons recently out of training to discuss, share, and learn from experiences of peers, Dr. Kunimoto said. We were already doing this on an informal basis throughout fellowship, and resolved to continue doing so in a more formal setting once we left fellowship. Dr. Kunimoto noted that in addition to being colleagues, the founding members and those who sit on the executive board of the VBS are also friends. The camaraderie, he said, extends throughout the entire society and reflects in the atmosphere of the meetings. The criteria for membership include the successful completion of a 2-year vitreoretinal surgical fellowship, 2 references from current members, and a surgical presentation submission. Although many of the members are alumni of the Bascom Palmer Eye Institute fellowship program, the membership is far more diverse and open to anyone who meets the criteria. Video-based Meetings The group has held several satellite meetings during Angiogenesis, the Association for Research in Vision and Ophthalmology meeting, American Academy of Ophthalmology meeting, and subsequent ASRS meetings. The first VBS dinner meeting in Palm Springs. Front row: The late Debra L. Cermak (Bausch + Lomb); Eric Weichel, MD; Rohit Ross Lakhanpal, MD; Thomas Albini, MD; and Derek Kunimoto, MD. Second row: Guy Jirawuthiworavong, MD; Odette M. Houghton, MD; Sean Adrean, MD; Eric Chen, MD; Sunir J. Garg, MD; Audina Berrocal, MD; Geeta Lalwani, MD; Ninel Gregori, MD; Zac B. Ravage, MD; and Steven Yeh, MD. Back row: Howard Fine, MD; Brandon Lujan, MD; Andrew Moshfeghi, MD, MBA; John W. Kitchens, MD; Timothy Murray, MD, MBA; Paul Gallogly, MD; Mark Weisbrod, MD; and Dennis O Brien (Bausch + Lomb). These meetings featured the presentation of several surgical cases with videos to illustrate surgical principles, Dr. Yeh told New Retina MD. The presentations, each approximately 5-7 minutes, have been followed by a discussion of the cases, during which audience participation is encouraged. A panel of faculty mentors, and seasoned vitreoretinal surgeons from both private practice and university-based settings, commented on other surgical and medical considerations, but the discussion is very collegial and completely open to audience participation, said Dr. Yeh. This format facilitates great camaraderie and improves the surgical armamentarium of vitreoretinal surgeons who are currently in fellowship or have recently finished fellowship. The content of the VBS dinner meetings has been broad in scope, according to Dr. Yeh, and has ranged from approaches to intraocular foreign bodies, management of subfoveal perfluoron, and giant retinal tears following myopic LASIK. Other hot topics have included approaches to the management of infectious retinitis-associated retinal detachments including progressive outer retinal necrosis, Nocardiarelated tractional detachments, Cytomegalovirus retinitis, viscodissection, extreme buckling, and small-gauge drainage of hemorrhagic choroidal detachment, he said. The focus is largely on surgical technique and the winter 2012/2013. New Retina MD 11

3 Geeta Lalwani, MD; Charles C. Wykoff, MD; and Efrem Mandelcorn, MD. varying degrees of experience with available technology. Attendees have the opportunity to benefit from vast collective experience with complex cases. Over the past 5 years, the number of presenters and attendees has grown quickly, and for many, the strong tradition of high-quality surgical discussion and the open forum for growth in regard to operating room IQ has made the VBS a mustattend dinner for many to work into a jam-packed schedule at the larger meetings. In 2009, Retina Today and Eyetube.net partnered with the VBS to produce a column that appears in each issue highlighting novel surgical techniques and technology. Each article is complemented with a surgical video that is housed on the VBS channel on Eyetube.net. Some of the presentations from past meetings are on this site. In 2013, the VBS will hold its first stand-alone meeting in Miami, which will be held over the course of 2 days, April Robert Neimitz (Synergetics); Michael Fanning (Synergetics); John W. Kitchens, MD; Brandon Busbee MD; Derek Kunimoto, MD; Jaime Gaitan, MD; Charles Mango, MD; and Steve North (Synergetics). Front row: Audina Berrocal, MD; and RV Paul Chan, MD. Back row: Thomas Albini, MD; John W. Kitchens, MD; Andrew Moshfeghi, MD, MBA; Rohit Ross Lakhanpal, MD; and Charles Mango, MD. 12th and 13th, at the Fontainebleau Miami Beach. The obvious question to many is this: Why another meeting? In short, says Dr. Yeh, because the unique format of the VBS helps make better surgeons. I am an avid football fan, and I often tell my fellows that like the playing field, the OR is for performance, not for practice, said Dr. Yeh. Practice and preoperative preparation should happen outside the OR and, as in football, this includes watching film. The VBS affords an opportunity to evaluate film from challenging and complex situations in a setting where there is an opportunity to discuss with a large number of colleagues with different levels of experience. Because vitreoretinal surgery requires the surgeon to make correct real-time decisions throughout the course of the procedure, it s important to be exposed to and consider new and unique situations, Dr. Yeh said. First Annual VBS Highlights Charles C. Wykoff, MD, the Chair for the Academic Program for the first annual VBS meeting in April, told New Retina MD that the reason that the leadership of the VBS decided to hold a stand-alone meeting was to fill a void that is often present in the larger retina meetings, which to a large degree focus on medical research and development. This will be a continuing medical education (CME)-based meeting that hones in on surgical topics and video cases. Presenters will bring both good and bad cases, and the format will be such that there will be plenty of time for discussion, he said. There will be 38 presentations over the course of 2 days, with 9 hours of CME credit. According to Dr. Wykoff, the presentations will be similar in format to past, smaller meetings, with more time devoted to the panel and audience participation than the presentations themselves. While medicine is largely based on evidence-based 12 New Retina MD. winter 2012/2013

4 VBS meeting attendees. Audina Berrocal, MD; Lejla Vajzovic, MD; and Sander Dubovy, MD. view the video archive To view the video archive of the Vit-Buckle channel on Eyetube.net, visit or scan the QR code. Charles C. Wykoff, MD; Audina Berrocal, MD; and Thomas Albini, MD. peer-review literature, most surgical procedures don t have the same level of evidence behind them. Because surgical techniques and outcomes are based more on experience, having a forum for discussion helps surgeons develop new ideas from others who might be doing things a little bit differently, Dr. Wykoff said. The program is broken down into 5 sections: (1) retinal detachments (rhegmatogenous and tractional); (2) macular holes and membrane peeling; (3) unusual surgical scenarios (eg, intraocular lenses, pediatric retinal diseases, uveitis, ocular tumors); (4) surgical details (fluidics, complications); and (5) real-world medical strategies (eg, anti- VEGF dosing strategies) and the future of retina (eg, stem cells, viral vectors). This last section will also touch on interaction with industry and entrepreneurship. Stanley Chang, MD, will be the keynote speaker on Saturday evening, discussing the complications of modern vitrectomy. Additionally, Allan Kreiger, MD, recipient of winter 2012/2013. New Retina MD 13

5 Dr. Vajzovic suggests that fellows who are interested in presenting a surgical case contact either Dr. Wykoff, Dr. Albini, or Dr. (Audina) Berrocal. Thomas Albini, MD, moderates the first VBS dinner in Summary Over the past 5 years since the VBS was first formed, the executive board has worked to refine the group s focus so that its original mission is met. Future goals include continued growth in membership and the continued commitment to staying at the forefront of surgical technology and techniques. In 5 years, many of us will be handing over the reigns to the next generation of vitreoretinal surgeons. Our hope is that the VBS continues onward as a forum for young vitreoretinal surgeons to share, learn, and discuss the things that are important to them, said Dr. Kunimoto. The first annual meeting is another step in this direction. We have tapped resources and individuals across the country, representing practices, academic centers, and industry coast to coast, and assembled an academic program that will be a unique meeting format, most notably in the amount of time dedicated to discussion. We hope that many readers of New Retina MD will consider attending, as they are in our target demographic, Dr. Kunimoto said. n For more information on the first annual VBS meeting, contact Medical Conference Planners, Inc. at vbs@medconfs.com or visit Engaged audience at the VBS dinner during the 2012 ASRS. the VBS lifetime mentorship award, will also present during the program on scleral buckling, which Dr. Wykoff noted is important because many training programs are trending away from the technique. Fellows Program The meeting is also open to vitreoretinal fellows, and although fellows will not be on the main program, on Friday evening, they will have the chance to present their own cases. Lejla Vajzovic, MD, who is in the Duke fellowship program said that the VBS offers an environment that is unique compared with the bigger retina and ophthalmology meetings. All of us in fellowship are trying to establish ourselves in the field of retina and many of us are in the job search. The VBS meetings are unique in that they offer us the opportunity to talk with our colleagues who have been through this process. It s very helpful to hear about others experiences and also find out where there are job opportunities available, she said. The smaller, less formal environment makes it easier to have meaningful conversations with other individuals. Thomas Albini, MD, is an Associate Professor of Clinical Ophthalmology at the Bascom Palmer Eye Institute. He specializes in vitreoretinal diseases and surgery and uveitis. He is the Membership Chair of the VBS and a New Retina MD Editorial Board member. He may be reached at or via at talbini@med.miami.edu. Derek Kunimoto, MD, JD, is a retinal specialist at Retinal Consultants of Arizona in Phoenix. He may be reached at derek_kunimoto@yahoo.com. Charles C. Wykoff, MD, PhD, is a member of the Retina Consultants of Houston and a Clinical Assistant Professor of Ophthalmology with Weill Cornell Medical College, Methodist Hospital, Houston. He may be reached at ccwmd@houstonretina.com. Lejla Vajzovic, MD, is a vitreoretinal surgical fellow at Duke University Eye Center in Durham, NC. She may be reached at lejla.vajzovic@gmail.com. Steven Yeh, MD, is Assistant Professor of Ophthalmology Section of Vitreoretinal Surgery & Diseases at Emory Eye Center in Atlanta. He may be reached at steven.yeh@emory.edu. 14 New Retina MD. winter 2012/2013