Retina is the inner layer of the eye wall. Retinal detachment threatens the vision and it mainly occurs as a result of the tear produced on the retina during posterior vitreous detachment process. People with direct and serious injury into the eye or with high myopia have an increased risk of retinal detachment. Other rare causes could be indentified

Vitrectomy is the most common procedure to treat a retinal detachment. It consists in using 3 small ports for the micro-instruments to remove the gel (vitrectomy), to place the retina back into its anatomical place and treat the retinal tears with laser. At the end of the procedure a bubble of gas or silicone oil is left to support the retina on place until the tears are healed and retina is attached into the back of the eye again. The procedure is usually done under local anaesthesia, it lasts up to 1.5 hours and is a day surgery

Bubble of gas or Silicone Oil is used at the end of the procedure to hold the retina on place

The bubble of gas is a contraindication to fly on airplan up to 10 weeks after surgery depending on the gas (short lasting gas lasts for 2 weeks and long lasting gas for 10 weeks). The bubble of oil will need further 30 minutes procedure to be removed within 2-3 month

Positioning of the head such as face down for 2 days and then right or left side, depending on the tear localization, may be required. Day time positioning requires maintaining it during 45-50 minutes every hour having a rest for 10-15 minutes

The most common side effect of the surgery is a cataract. Therefore the cataract surgery is frequently performed at the same time of the procedure and refractive target is discussed prior to surgery

The eye pad placed on the operated eye needs to be removed the following day after surgery and the eye drops given after surgery will have to be used for four weeks. The vision is expected to be blurred due to bubble of gas for the first two weeks

Once the bubble is disappeared the vision should improved. Macula off (detached central part of the retina) usually gives worse visual recovery comparing to Macula On retinal detachments

Optician review will be required to adjust the best glasses or contact lenses correction after the eye is recovered from the operation

Follow ups will be arranged week 1, week 3-4, week 8 and week 12-16

General risks such as infection or severe bleed are very low, but still need to be taken in consideration and patient have to report as soon as possible a severe pain, significant deterioration of the vision or very inflamed eye. The risk of redetachment could be related to the scar tissue on the retinal surface, long standing retinal detachment, high myopia, multiple tears, etc. However, 9 out of 10 patients will have a successful retinal detachment surgery with only one procedure

Age is the most common cause of macular hole. As we get older, the vitreous begins to shrink and pull away from the retina. Sometimes the vitreous can stick to the retina, this causes the macula to stretch and a hole to form. The symptoms may not be noticed until the problem is too advanced if the fellow´s eye vision is good and if vision is not checked separately in both eyes. Vitrectomy surgery is required to close the macula hole and consequently improve the vision. Visual recovery will depend on how long the problem was untreated and the vision may not be improved significantly if the problem existed for longer than 6 month

The surgery consists in using 3 small ports for the micro-instruments to remove the gel (vitrectomy), remove the internal limiting membrane and inject short lasting gas ( 2 weeks) to help to close the macular hole. Positioning face down for 2 days is advised (45-50 min every hour having a rest 10-15 min daytime and sleeping right or left cheek to pillow) Sleeping on the back should be avoided for 2 the first 2 nights . The eye pad needs to be removed and eye drops will be started the following day after surgery. Vision is expected to be blurred due to the bubble of gas for the first 2 weeks

General risks of Infection, Bleed, Retinal detachment are very low but will be discussed prior to surgery

Follow ups will be arranged week 1, week 3-4 and week 8 

Epiretinal membrane is a scar tissue on the surface of the retina, which causes swelling of the retina. When is interferes with the vision or causes distorted images, surgery may be required to remove the scar tissue and release the retina 

The surgery consists in using 3 small ports for the micro-instruments to remove the gel (vitrectomy), remove the epiretinal membrane and inject the bubble of air or short lasting, 2 weeks, gas. No positioning is required and the vision should be back to normal after 1-2 weeks. However, the distorted vision will be improving gradually during the following 2 months of the surgery. Some people continue improving vision during several months following the surgery

General risks of Infection, Bleed, Retinal Detachment are very low but will be discussed prior to surgery

Vitreomacular traction surgery is a condition where the vitreous is stick to the retina. The macula is pulled and elevated by the gel. The surgery (vitrectomy) is advised to correct this condition when the vision is deteriorated, patient is very symptomatic for distorted images or macula hole is developed. Generally, the initial attitude with early stages of vitreomacular traction is watch and wait the gel is pulled away by itself, which happen in some cases

The surgery for vitreomacular traction is very similar to macular hole surgery. 

The surgery consists in using 3 small ports for the micro-instruments to remove the gel (vitrectomy), remove the epiretinal membrane if exist and inject the bubble of air or short lasting bubble of gas. Positioning face down as for Macular Hole surgery is advised for 2 days, sleeping right or left cheek to pillow for 2 days as well. Vision should be back to normal after 2 weeks. OCT retinal scan is required to assess the macula after 2 weeks

General risks of Infection, Bleed, Retinal Detachment are very low but will be discussed prior to surgery

During the consultation I have to examine both the front and back of your eyes

I usually use pupil dilation drops so that I can examine the lens and the retina, including the optic nerve. Your vision will be blurred during at least 2 hours (up to 6 hours) after drops, so you will not be able to drive after consultation for that period of time

OCT scan of the retina could be done the same day of the consultation and it gives an accurate information of the shape and size of the macular hole and helps to predict the surgical results and, also, to choose and plan the surgical technique of the repair