Dr. Aleksandra Rachitskaya, Cole Eye Institute, Cleveland Clinic, participated in Alcon’s Retina Exchange Broadcast on July 10th. RetinaLink is pleased to highlight one of Dr. Rachitskaya’s surgical videos from the broadcast. Her pseudophakic patient presented with a total bullous retinal detachment (RD). She described that due to bullous nature of the RD, it was challenging to see the break before surgery. After placing a scleral buckle and performing vitrectomy, perfluorocarbon liquid was injected and the periphery started to flatten out. A small anterior break was found. Interestingly, the intraoperative OCT showed a small macular hole which was not visible pre-op. Dr. Rachitskaya hypothesized that there might be a higher prevalence of similar small macular holes that close spontaneously after vitrectomy in patients with bullous macula-off retinal detachments and that these changes might explain, to some degree, the post-operative vision. This hole was identified only because intraoperative OCT was performed. Gas was used at the end of the case. The post-operative OCT showed a closed macular hole.
RetinaLink continues its ongoing series #ilooklikearetinasurgeon. Dr. Rachitskaya shares with us why she decided to go into retina, her mentors and what is most challenging professionally.
RetinaLink (RL): Why did you decide to become a retina specialist?
Aleksandra Rachitskaya, MD (AR): The field of retina is for those who don’t shy away from challenges and embrace change. I finished my retina fellowship in 2014, and even in this short time, I have been amazed at the progress in our field. Advancements in imaging technology, for instance, are making surgery more efficient and advancements in gene therapy and prosthesis technology are giving hope to patients who used to be told, “You are going to go blind and there is nothing that can be done.”
There is nothing more inspiring than working through a difficult case and trying a new surgical technique for the first time. The field of retina allows me to grow, succeed, to be humbled–all at once and not necessarily in that order. Someday I feel as if I have conquered the world. But I know that there is always a more difficult TRD, a more complex novel vision restoring treatment, or another fascinating research question that will keep me challenged and engaged.
RL: Who is your female mentor(s)?
AR: I always advise residents to choose a subspecialty with the people whom they would most like to see day in and day out as colleagues. I chose retina because of the many female retina surgeons whom I admire. There are too many to name in one paragraph, and each one of them mentored me, whether they were senior residents, retina fellows, chief residents, or attendings. Bascom Palmer Eye Institute has a significant number of women on its retina service and each of them made me feel that I could succeed in surgical retina and each one served as a hard-working, patient-oriented, and goal-driven role model. I am particularly grateful to Dr. Nina Berrocal who not only taught me as a resident and fellow, but also showed me what I am capable of. I vividly recall the first time she left me alone in the OR and told the circulator not to call her unless I was in trouble. I still remember every step of that surgery and every post-op visit and the feeling of excitement at my first attached retina!
RL: What is most challenging professionally?
AR: We are not always able to get the anatomic or visual outcomes that we wish for. These cases are challenging both for my patients and me. I continue to learn to embrace these failures, to learn from them, to teach from them, and to be there for my patients.
Dr. Aleksandra Rachitskaya can be reached via e-mail – firstname.lastname@example.org