Retina Surgery & Treatment
The retina is a thin sheet of nerve tissue in the back of the eye where light rays are focused and transmitted to the brain. The vitreous is a gel-like substance that fills the eye and is connected to the retina, optic nerve and many blood vessels.
Conditions of the the retina and vitreous can lead to loss of vision and blindness. Some of these conditions include the following:
- Retinal tear
- Retinal detachment
- Macular degeneration
- Diabetic retinopathy
Early detection and treatment is essential before vision is lost and to prevent further deterioration. Sometimes retina surgery is necessary to alleviate some of these conditions.
Retina-Vitreous Surgery / Retina Surgery
Our practice is the first in Los Angeles area to have the Alcon Heads Up system. Alcon’s NGENUITY® 3D Visualization System (AKA “Heads-Up” system) allows retinal surgeons to operate looking at a high definition 3D screen, instead of bending their necks to look through the eye-piece of a microscope.
Traditional vitrectomy surgeries range from 30 minutes to over three hours in length to complete, therefore the better posture during surgeries may reduce fatigue and thus benefit the patient. This microscope-free design is engineered to improve surgeons’ posture. The easier it is for surgeons to perform these long, delicate surgeries, the better they can perform for our patients who count on us to provide them with the best possible care. The NGENUITY 3D Visualization System offers greater depth and detail views during surgery. This system provides surgeons with better visualization while operating on the back of the eye, which may improve patient outcomes.
The system is designed to facilitate collaboration and teaching in the operating room. Offering an immersive panoramic surgical view, the NGENUITY 3D Visualization System allows the operating team to see exactly what the surgeon is seeing in real-time.
Problems with the retina and vitreous can lead to vision loss and blindness. Retina surgery can correct problems before vision is lost or prevent further deterioration from occurring.
The vitreous is the clear, gel-like substance that makes up the center of the eye, accounting for approximately two-thirds of the eye’s volume, giving it its shape. Because of its large, soft consistency, the vitreous is commonly affected by various diseases that may cause it to cloud, fill with blood or harden, making it difficult for light to properly reach the retina. This may lead to blurred vision, tears or other serious conditions.
Patients with disease or injury to the vitreous may benefit from a vitrectomy (a type of retina surgery). This procedure removes the vitreous by suctioning it out with tiny instruments that are inserted into the eye. After removal, your doctor may treat the retina with a laser, cut or remove scar tissue, flatten detached areas of the retina, or repair holes or tears in the retina. Patients may experience mild discomfort and redness for several days after this procedure, and often have their eye patched for the first day.
Although results vary depending on the individual condition treated, most patients experience improved visual acuity after this procedure. Vitrectomy is most effective in treating conditions such as macular hole, retinal detachment, diabetic retinopathy, vitreous hemorrhage or an injury or infection in the vitreous.
Although this procedure is considered safe, there are certain risks associated with any surgical procedure. Some of these risks include retinal detachment, fluid buildup, growth of new blood vessels, infection and further bleeding into the vitreous gel. Patients can minimize these risks by choosing an experienced doctor to perform their procedure.
Diabetic retinopathy is a complication of diabetes. The length of time a patient has diabetes will determine the likelihood of developing diabetic retinopathy. Over 40 percent of patients in the United States, diagnosed with diabetes, have a form of diabetic retinopathy. Diabetic retinopathy is the most common diabetic eye complication and a leading cause of blindness in American adults.
Diabetic retinopathy causes the blood vessels that supply nourishment to the retina, the light-sensitive lining in the back of the eye where vision is focused, to weaken. These weakened vessels can leak, swell or develop thin branches, causing a loss of vision.
During any stage of diabetic retinopathy a condition known as macular edema can develop. Macular edema is the buildup of fluid in the macula, the light-sensitive part of the retina that allows us to see objects with great detail. As the macula swells vision becomes blurred. About half of the people with proliferative retinopathy are diagnosed with macular edema.
Treatment of Diabetic Retinopathy
Other than controlling blood pressure, blood cholesterol and the levels of blood sugar, treatment is not needed during the first three stages of diabetic retinopathy. The fourth stage, proliferative retinopathy is treated with a laser surgery procedure known as scatter laser treatment. During the procedure the abnormal blood vessels are ablated causing them to shrink. This procedure works best once the blood vessels begin to bleed. Severe blood vessel bleeding may need to surgically corrected with a vitrectomy procedure to remove the blood from the eye.
Treatment for macular edema usually includes a laser procedure called focal laser treatment. During this procedure, several hundred small laser burns are placed in the areas of retinal leakage around the macula to prevent leakage from occurring and reduce the amount of fluid in the retina. This helps reduce the risk of vision loss and may improve lost vision in a small number of cases. Focal laser treatment is performed in your doctor’s office and can usually be completed in just one session.
Diabetic Evaluation & Treatment
Diabetic eye conditions can be detected through a comprehensive eye exam. A comprehensive eye exam involves a visual acuity test to measure vision at various distances, and a dilated eye exam to examine the structures of the eye for any signs of disease. During this test, your doctor can examine the retina and optic nerve with a special magnifying lens. Tonometry may also be performed during a comprehensive eye exam to measure the pressure inside the eye with a special instrument.
Eye exams should be performed at least once a year or as soon as any potential problems are detected in order to ensure early detection of any serious conditions. Early detection is the strongest protection against diabetic eye diseases.
Sometimes research studies are performed to learn about additional possibilities for treatment.