Vitrectomy for Retinal Detachment
Vitrectomy is the surgical procedure that is widely used in the treatment of retinal detachment with large tears.
The surgery may require an overnight stay or sometimes it is done as an outpatient procedure that lasts for 2-3 hours. Vitrectomy is performed under local anaesthesia with an operating microscope. Three small incisions are made in the sclera (white outer wall of the eye) to infuse fluid in order to maintain the shape of the eye, for a fibre optic light and to insert the surgical instruments. The procedure involves the removal and replacement of the vitreous (clear gel that fills the back of the eye) with special saline solution which resembles the natural vitreous in the eye. Once the vitreous is removed, the retina can be accessed to treat the detachment by removing the scar tissue that is pulling the retina away from the underlying layers of tissue.
After the removal of vitreous gel, the fluid that has collected underneath the retina is removed to flatten the retina into normal position. Laser therapy (intense laser beam) or cryotherapy (freezing temperatures) is then used to scar and seal the retinal tear aiding to keep the retina permanently attached. A gas bubble or silicone oil is injected into the vitreous cavity (the cavity located behind the lens of the eye and in front of the retina containing the vitreous) to hold the retina in place while the scars from the laser and/or cryotherapy heal.
With newer surgical techniques and instrumentation, the surgery can be performed through tiny “self-sealing” incisions without the need for sutures. Surgical recovery generally takes about 6 weeks and vision recovery a little longer.
Treatment for Cataract
Surgery is the only treatment for cataracts and is recommended based on the severity of the disease and the impact it has on the daily activities of the patient. It is performed one eye at a time with a few weeks gap in between the two operations. The different types of cataract surgery are performed on an outpatient basis, under local anaesthesia.
Phacoemulsification uses ultrasound vibrations to break up the eye’s damaged lens. Your surgeon will make a small incision of about 3-5 mm on the side of the cornea, and insert a device to break up and suction out the lens. The lens will be replaced by a manmade lens. The incision heals on its own and does not require any eye patch or stitches. This surgery takes less than 30 minutes.
Microinscision Cataract Surgery (MICS)
Microincision cataract surgery (MICS) is a minimal invasive cataract surgery, performed by making an incision of less than 1.8 mm. The lens is removed by the phacoemulsification procedure and is implanted with a MICS intraocular lens. MICS is associated with decreased post-operative complications such as corneal aberrations (scratch on the corneal surface) and corneal astigmatism (irregular curvature of the cornea).
Secondary Lens Implantation
A complex cataract surgery or injury can sometimes make it difficult for the surgeon to immediately replace the damaged lens with a plastic lens in your eye. You may have to wear prescription lenses until your eye heals. Following this, your doctor will suggest a second surgery for lens implantation. This is called secondary lens implantation. Your surgeon will make a small incision in the white part of your eye (sclera) and insert a lens implant. The implant is stitched to the sclera and the incisions are closed with small stitches.
Small-incision Cataract Surgery (SICS)
Small-incision cataract surgery (SICS) involves an incision of around 6-7 mm made in the form of a tunnel through the sclera and cornea. The lens is removed and replaced with a rigid lens implant through this tunnel. No sutures are needed as the tiny incision will heal naturally by itself. It is a low-cost procedure compared to phacoemulsification and ensures good post-operative outcomes.