SURGICAL RETINA MANAGEMENT
Retinal conditions can affect the retina (including the macula) and the vitreous, which is the clear, jelly-like fluid inside your eye. Our state of the art practices in Midrand, Johannesburg and Pretoria are fully equipped to assist with the surgical management of retinal conditions.
A vitrectomy involves removing the vitreous gel using keyhole surgery so that stitches are not needed. The procedure itself takes around 30 to 45 minutes.
Once Dr Boitumelo Khantsi has removed the vitreous, it is replaced with a bubble of gas or with sterile saline. We may use silicone oil if the retina detachment was present for a long time or retinal scarring is present.
Because gas and oil bubbles float upwards, you will need to keep your head in a specific position for several days after the surgery to place the bubble in the correct position, while the retina is healing. The silicone may remain in the eye for months, but Dr Boitumelo Khantsi can also remove it once the retina has healed.
A protective eye patch is necessary for about 24 hours afterwards, followed by eye drops and ointment. Generally, patients can resume their regular activities after a day or so, although this can vary from person to person.
A vitrectomy may be needed to treat:
- Epiretinal membrane (macular pucker)
- Vitreous haemorrhage
- Retinal detachment
- Macular hole
- Macular oedema
- Severe cases of floaters
Other surgical solutions for retina management include:
Retinal Tear Surgery – Pneumatic retinopexy: A gas bubble is injected into the eye and stops fluid from passing through the hole or tear in the retina, allowing it to reattach. Laser or freezing treatment is performed between 1 to 3 days after the gas injection to seal the retinal tear.
Detached Retina Surgery – Cryo–buckle surgery: We stitch a band of solid silicone rubber to the surface of the white of the eye (sclera) under the conjunctiva (transparent layer covering the sclera), where you can’t see it. This material ‘buckles’ the sclera (wall) of the eye inwards against a small internal layer of tissue known as the retinal pigment epithelium (RPE), which in turn pushes the detached retina against the wall of the eye. We then apply a Freezing treatment (cryo) to scar the tissue around the retina, which creates a seal between the retina and the wall of the eye and closes up the tear or hole.