Prashant K. Parekh, MD, MBA | Retina

#Vitreoretinal Surgeon | @uiowaeye, Cinci Eye, @umiamimedicine @FIUbiomed alum | Chronicling what I learn along the journey (but tweets =/= medical advice)

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DavidKPeprah Antiquated term - modern trainees should know it as complexion-associated melanosis https://t.co/bJhspaBCnc

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@SuitedSurgeon @ErinShriverMD She’s the best! Sending positive vibes for you as you go through the process 💪🏽

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

I always screen patients for migraine especially after a negative cardiovascular work up. Perhaps a vasospasm-mediated mechanism. Migraine w/aura higher risk than w/o aura.

[American Journal of Ophthalmology @AJOphthalmology]

This is the first large study to show that migraine is associated with increased risk of a central, branch, and other types of retinal artery occlusion (RAO) after adjusting for all known risk factors of RAO.

https://t.co/4DelzD9Y7u

#retina #migraine #cardiology #neurology

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DGlaucomflecken “Glaucomflecken Matters.”

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@JohnMoralesNBC6 John, thanks for your consistent, elite level information. Can you compare/contrast the evolution of this storm to Hurricane Andrew?

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@ErinShriverMD @IowaMed @JaneGoodallInst @uihealthcare @uiowaeye Extremely well deserved - proud to have trained under you and other exceptional @uiowaeye faculty!

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@ohrnberger Paging @DGlaucomflecken - oh do we have JUST the patient for you.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DGlaucomflecken Pics of said poster or it didn’t happen.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@cataractsurgery @uiowaeye Could not agree more! Please let me know if I can be a resource during this evolving process.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DrLorraineEyeMD @n8radcliffe Consider specialty pharmacies in your region that source from the 3 major pharm suppliers (eg McKesson). They will typically auto-apply coupons and pre-fill CoverMyMeds req + fwd to you/staff 2 sign. ⬇️ burden on both staff (time) and patient ($). Typically free shipping also.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

This, along with reduction in chance of retinal folds, is why I seldom recommend strict face down positioning following vitrectomy.

[Ophthalmology @AAOjournal]

MRI imaging demonstrated that side positioning gives better contact between the gas bubble and the inferior and anterior retina than prone positioning even when the gas fill is only 70% of the vitreous cavity. N=3, MRI performed on post op day 1 https://t.co/MxO47U7QdY

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@VermaN21 @domsisti @Sarah_Mojarad @eemoin Haha!

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@domsisti @Sarah_Mojarad @eemoin Just curious: did any of your students actually agree with you?

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@OmarKelly Omar, as an MD, I must advise you that a pregnant woman should NOT be around cats/litter boxes (can transmit an infection called toxoplasmosis). This is important!

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@ArizonaRetinaMD 100% yes. Will you be using 23/25 ga standard setup w/standalone 27ga cannulae for haptic externalization? Have had good results w/ (pseudo)4 point fixation using MX60 - less concern for tilt or irreg astigmatism but check the suture orientation (above haptics) b4 tying down.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DGlaucomflecken @BradSpellberg @FungalDoc @ABsteward @IDSAInfo @JAMAInternalMed @JAMA_current Of note, another article I found interesting out of @Wills_Eye that addresses clinical Q: is it necessary to perform dilated fundus exam on EVERY pt w/+fungemia? If asymptomatic & reliable historian, probably not... but often is N/A to this pt population https://t.co/I11SJCLS4i

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DGlaucomflecken @BradSpellberg @FungalDoc @ABsteward @IDSAInfo @JAMAInternalMed @JAMA_current I think the prev comment refers to the recent JAMA Oph article https://t.co/TrCLEYqhWX where worse VA outcomes were assoc w/ intervention vs med mgmt alone. This is 2/2 treatment bias: pts w/significant vitreous &/or macular involv get tap/inject of vori +- PPV.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

@DGlaucomflecken @HeartOTXHeartMD @garand_f You just get a tickle out of the champagne bubbles, don’t try to kid yourself.

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

4) pull trochar cannula out BEFORE externalizing haptic
5) create flange (⬇️ risk dislocation) & tuck in
6) create iridotomy (⬇️ chance of reverse pupillary block)
7) second haptic is hardest to secure; if trouble viewing in vit cavity, push on the optic
#VBS2019 @RetinaToday

[Prashant K. Parekh, MD, MBA | Retina @ParekhMD]

Tips for sutureless intrascleral haptic fixation from Ashkan Abbey for the VR surgeon:
1) thorough PPV w/base shave @ sclerotomy sites (prevent vit incarceration when pulling haptic out)
2) inject IOL into vit cavity
3) MaxGrip forcep - grab tip of haptic in PARALLEL fashion