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Retinal Surgery

Epi-Retinal Membrane Peel Surgery

An Epi-Retinal Membrane is a cellophane-like membrane that forms over the macula. It is typically a slow-progressing problem that affects the central vision by causing blur and distortion. It is seen most often in people over 75 years of age and occurs for unknown reasons, but may be associated with certain eye problems such as: diabetic retinopathy, posterior vitreous detachment, retinal detachment and trauma. If macular swelling is suspected, then an OCT scan and a fluorescein angiogram may be required to make the diagnosis.

Treatment:

A procedure called a membrane peel is performed when vision has deteriorated to the point that it is impairing the patient’s lifestyle. It is often done in conjunction with an eye procedure called a vitrectomy.

Retinal Detachment Surgery

A retinal detachment occurs when the retina is pulled away from its normal position in the back of the eye. A detached retina is a very serious eye problem that can cause blindness if not treated

Retinal detachment can occur at any age, but it is more common in midlife and later. Conditions that can increase the chance of a retinal detachment include eye problems such as nearsightedness, previous cataract surgery, glaucoma, severe trauma, previous retinal detachment in your other eye, family history of retinal detachment, or weak areas in your retina that can be seen by your ophthalmologist.

Symptoms include light flashes, floaters and/or a gray curtain or veil moving over the eye.

Treatment:

Retinal tears will usually need to be treated with laser surgery or cryotherapy (freezing), to seal the retina to the back wall of the eye again. Retinal detachments usually require urgent eye surgery to return the retina to its proper position in the back of the eye.

Macular Hole Surgery

The eye contains a jelly-like substance called the vitreous. With age, the vitreous shrinks and pulls away from the surface of the retina. In most cases, this pulling away or vitreous separation occurs without any negative effect. A patient may notice floaters but no significant visual damage occurs. In some individuals however, there may be an area where the vitreous is firmly attached to the surface of the retina. As the shrinkage and forward movement of the vitreous progresses, pulling can be exerted on the retina, and eventually a small hole may form in the central portion of the retina (the macula), known as a macular hole. This results in a defect or dark spot in the central vision with distortion and central vision loss resulting.

The severity of the symptoms is dependent on whether the hole is partial or full-thickness. The most common signs include eye problems such as blurred central vision, distorted or wavy vision or a central dark spot.

In the vast majority of cases macular holes develop spontaneously. As a result there is no known way to prevent their development through any nutritional or chemical means, nor is there any way to know who is at risk for developing a hole prior to its appearance in one or both eyes.

Treatment:

An operation, called a vitrectomy, can be performed to help limit the eye problems that a macular hole causes. The surgery is an attempt to help the macula lie flat on the back of the eye. If this is successful then often sight problems can be helped.

Vitrectomy For Floaters

Floaters result from aging changes in the vitreous gel. When the normal transparent jelly (vitreous) that fills the back of the eye contains opacities, they cast shadows on the retina, which are seen as strands or spots, or cobwebs, or insect-like images that drift across the vision. These are floaters, sometimes called muscae volanties or flitting flies. Most adults will notice some mild floaters in certain lighting conditions, especially in bright light or when looking at a white background.

What are the treatment options?

  1. Do Nothing.
    This is the normal recommendation for most patients who are able to learn to live with the symptoms. Floaters clear on their own without laser eye treatment almost all of the time. Even patients with persistent floaters usually adjust to them.
  2. YAG Laser
    If a large floater bothers you it can be broken into smaller ones that often move to parts of the eye where they are not so noticeable. If the floaters are too close to the retina, the risk may be too high in terms of damaging the retina or retinal blood vessels.  A clinical examination is required to determine whether Yag laser will be safe and effective.
  3. Vitrectomy Surgery.
    This procedure removes the floater surgically and may be appropriate if it severely affects your vision and makes life intolerable, or if your job makes floaters dangerous (e.g. if you are a bus driver).