The 25th Annual AVTT and Fellows’ Course: A Summary

The 25th Annual Advanced Vitreoretinal Techniques & Technology (AVTT) Symposium and Fellows’ Course was held on August 9 – 11, 2024, at the InterContinental Chicago. The course was organized by William F. Mieler, MD, and included local faculty from the University of Illinois, Chicago; Northwestern University; the University of Chicago; and other retina, uveitis, and oncology specialists from around the country. Although the course was geared toward second-year vitreoretinal surgical fellows, first-year fellows, medical retina fellows, residents, and practicing ophthalmologists also joined in to learn from the expert faculty.

THE PRACTICE OF RETINA

The first day focused on best practices in vitreoretinal medicine, with discussions on ethics, leadership, and different types of practices. George A. Williams, MD, spoke about prior authorizations and risk management for the retina surgeon: not if but when you will face an audit. R.V. Paul Chan, MD, MSc, MBA, discussed leadership and global ophthalmology, including the AAO Leadership Development Program, and Jennifer I. Lim, MD, presented on the importance of advocacy, citing a recent example of South Dakota’s expansion of optometric lasers and injections.

In the afternoon, Peter K. Kaiser, MD, took the stage to discuss vitrectomy fluidics, followed by Yannek I. Leiderman, MD, PhD, who shared ways fellows can prepare for peak surgical performance—it begins prior to and outside of the OR, he said.

Next, attendees headed to the wet lab where residents and fellows practiced techniques on different vitrectomy machines with various instructors (Figures 1 and 2). The day concluded with dinner and a breathtaking boat cruise along the shores of Lake Michigan and on the Chicago River.

<p>Figure 1. During the wet lab, Alexis K. Warren, MD, a recent graduate of the University of Illinois, Chicago’s fellowship program and on faculty at the University of Chicago, works with University of Illinois, Chicago resident Patricia Bai, MD, at a wet lab station.</p>

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Figure 1. During the wet lab, Alexis K. Warren, MD, a recent graduate of the University of Illinois, Chicago’s fellowship program and on faculty at the University of Chicago, works with University of Illinois, Chicago resident Patricia Bai, MD, at a wet lab station.

<p>Figure 2. During the wet lab, Justine Cheng, MD, who recently joined the University of Illinois, Chicago after training at Casey Eye Institute at Oregon Health & Science University, provides vitrectomy tips to AVTT attendees.</p>

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Figure 2. During the wet lab, Justine Cheng, MD, who recently joined the University of Illinois, Chicago after training at Casey Eye Institute at Oregon Health & Science University, provides vitrectomy tips to AVTT attendees.

CLINICAL TIPS AND TRICKS

Day two kicked off with presentations on imaging. David Sarraf, MD, discussed the use of en face OCT in macular diseases, and Jasmine H. Francis, MD, FACS, gave pearls on distinguishing benign from malignant tumors. There were several talks on surgical techniques, including top tips for managing dislocated IOLs shared by Dr. Williams; Judy E. Kim, MD; and Felix Y. Chau, MD. Sunil K. Srivastava, MD, discussed the management of tractional retinal detachments, and Dr. Chau shared his insights into endoscopic surgery.

The most exciting part of the day had to be the engaging and often humorous debates between colleagues and friends scattered throughout the program, with topics including the role of AI in retina practice (between Alexis K. Warren, MD, and Amani A. Fawzi, MD), corticosteroid usage for diabetic macular edema (between Dr. Warren and Justine Cheng, MD), the role of internal limiting membrane removal in epiretinal membrane peels (between Robert A. Hyde, MD, PhD, and Dr. Mieler), and vitrectomy for visually significant floaters (between Michael J. Heiferman, MD, and Dr. Chau). The energizing highlight of the day was the final debate between Dr. Williams and Dr. Mieler, who discussed their views on 3D heads-up displays in the retina OR. While there is interest in possible alleviation or prevention of neck and back pain, the pertinent issue was whether it leads to more efficient surgery and perhaps better surgical outcomes.

The final day began with updates on AMD. An important debate between Dr. Lim and Dr. Sarraf focused on the clinical utility of OCT angiography, which now has its own CPT code. The day concluded with the topics of uveitis, inflammation, infection, and toxicity. Dr. Srivastava discussed common mistakes to avoid as a retina specialist when caring for uveitis patients, Pooja Bhat, MD, gave pointers on pediatric uveitis, and Dr. Mieler touched on retinal toxicity due to recreational drug use, thus concluding a 3-day whirlwind tour of virtually all aspects of medical and surgical retina, uveitis, and pertinent aspects of ocular oncology as well.

We look forward to seeing many of you, along with the new group of vitreoretinal fellows, at the 26th Annual Chicago AVTT, August 22 – 24, 2025, at the Hyatt Centric Chicago Magnificent Mile!