Can A Hole In The Retina Be Repaired?

What is a Macular Hole?

A macular hole is a condition where a very pocket-size pigsty has developed right in the center of the retina in an area that is responsible for our sharpest vision. The part of the eye affected is called the macula. The macula is made up of special nervus cells that provide us with the abrupt cardinal vision we need for seeing fine item (reading and driving etc.). When a macular hole develops, you lot volition endure from symptoms such equally a nighttime surface area right in the middle of your vision, distortion, or general blurring.

The normal anatomy of the centre

*Image courtesy of the National Eye Institute http://www.nei.nih.gov

*Image courtesy of the National Eye Establish http://www.nei.nih.gov

Why do I have a Macular Hole?

We do non know why people develop macular holes. However, we practice know that it occurs more often in patients later in life (60's and older) and occurs more oftentimes in females. Macular holes are not related to macular degeneration. If you have a macular hole you have less than a 25% hazard of developing a macular hole in your fellow middle.

Assessment for Macular Hole

We are able to detect a macular hole during an eye examination. Sometimes, a special scan of the back of the heart (Optical Coherence Tomography) may be needed to confirm the presence of a macular hole. If a macular pigsty is present, your surgeon will probable recommend a surgical process to endeavor to close the hole and better your vision. Surgery is the merely style to treat a macular hole, at that place are no eye drops or medications that you can take that will help.

Outcomes of Macular Hole Surgery

Although a majority of our patients feel improved vision after surgery, in that location are a pocket-size percentage of patients that do non have an improvement in vision fifty-fifty afterward successful and uncomplicated surgery. Patients that practice non have a significant improvement in vision after surgery despite closure of the macular hole often take had their macular pigsty for a longer period of fourth dimension (greater than 1 year).

If you elect to go along with macular hole surgery, here are the outcomes that you tin expect: 1. 95% take a chance of macular hole closure with one surgery This assumes that you comply with face downwardly positioning afterward the surgery. Y'all need to go on in mind that our goal is to maximize the vision in your affected center. Even afterwards successful surgery, your vision volition likely never be every bit proficient as it was prior to the onset of your symptoms.

Risks of Macular Pigsty Surgery

There are several risks associated with macular hole surgery that you lot need to be fully aware of prior to electing to keep with surgery. The well-nigh common are every bit follows:

i in m risk of infection (endophthalmitis). Anytime surgery is performed on the eye infection is a possible complication. Sterile technique is used during the procedure to minimize chance of infection. Despite this, there is a very small chance that an infection can occur. If such an infection does occur it tin be treated, although it may leave y'all with worse vision or in severe cases lead to blindness.
1 in one thousand risk of bleeding. Anytime surgery is performed on the eye bleeding is a possible complexity. This can occur in or around the eye and tin can lead to permanent vision loss. We will review whatsoever medications you are taking prior to surgery to ensure you are not taking any blood thinners that tin can increase your take a chance of haemorrhage.
5% adventure of retinal tear or detachment. Anytime vitrectomy surgery is performed at that place is a small take chances of developing a tear in the retina which can pb to a detachment during or after surgery. We volition advisedly examine your eye at the stop of surgery to ensure you have no retinal tears. If you practice accept a retinal tear we will treat information technology at that fourth dimension with light amplification by stimulated emission of radiation handling.
Progression of cataract. If you accept not yet had cataract surgery, having vitrectomy surgery volition accelerate progression of cataract in that eye. Although not always the case, you can wait to need cataract surgery within a twelvemonth of vitrectomy surgery in the operated eye.

The Surgical Procedure

Macular hole surgery involves a vitrectomy and membrane peeling . We use the about advanced surgical equipment and techniques available for macular pigsty surgery. The surgery involves making iii holes in the center and using instruments to remove the jelly-like substance that usually fills the heart of the eye, called the vitreous sense of humor (vitrectomy). The removal of the vitreous inside the center does not cause any permanent harm. The vitreous is replaced by natural fluid produced within the eye. A thin membrane on the surface of the retina surrounding the macular hole is then physically peeled off the retina with a fine forceps (membrane peeling). The eye is and so filled with an inert gas which will slowly diffuse out of the eye over 4-vi weeks. The holes made in your centre are made in a fashion that allow them to close and heal on their own; usually no stitches are needed to shut them. The surgery commonly takes less than 1 hr to perform. It is typically performed the under local anesthesia so that you are awake and comfy during the procedure and have minimal complications from anesthesia postoperatively. If you are awake, information technology is very important for you lot stay still during surgery.

What should I expect following surgery?

After the surgery you will have an eye shield placed on your eye. Once you get to the recovery room you will be placed in a confront-downwardly position. Do not remove your heart shield until nosotros see y'all in the clinic the following solar day when we volition remove it for you lot. You will be given instructions on which eye drops to use and all your restrictions at this time. You do not need to use any eye drops the night later on surgery. Please bring all your eye drops to this commencement postoperative visit. Nigh patients have minimal discomfort after surgery. If you have some pain we recommend you take Acetaminophen (Tylenol). Avert Aspirin or Ibuprofen as this tin increment risk of haemorrhage. When your eye shield is taken off your vision will typically be more blurred because of the gas chimera in your heart. Your vision will ameliorate in one case the gas chimera dissipates in 4-six weeks.

Face Downwards Positioning

It is very important that you position confront down for the amount of time advised by your surgeon. You need to exist in this position and so the gas bubble remains in the advisable position to aid the macular hole close. If you do not position your macular hole may non close. We tin can provide you lot with information on renting massage tables that patients oft use to make face up down positioning more comfortable and easier.

Farther Data

If you lot have any questions or concerns regarding this or any other information please call our role at 614-464-3937.