macular surgery
Why Choose Dr Taneja?
- Dr Taneja routinely performs macular surgery for the management of epiretinal membrane and macular hole and is experienced in performing sub-retinal injections.
- He trains the next generation of ophthalmologists and retinal surgeons in macular surgery.
- He uses the latest small gauge technology to maximise patient comfort post-operatively.
- In the case of most macular hole patients, he is able to offer “non-posturing” post-operatively.
macular surgery
Procedure Information
- Macular surgery is usually performed under local anaesthesia with sedation.
- Patients are normally admitted overnight following surgery and discharged the following morning.
Epiretinal Membrane
- Epiretinal membranes are common, affecting about 5% of individuals.
- Whilst most epiretinal membranes do not cause significant problems, some patients may experience decreased vision, loss of depth perception and distortion.
- Patients with significant changes in visual function may benefit from vitrectomy and membrane peeling surgery.
- Vitrectomy is a micro-keyhole surgery in which the vitreous gel is removed.
- Following removal of the vitreous, fine forceps are used to peel the epiretinal membrane from the retinal surface.
- More than 90% of patients notice an improvement in vision following epiretinal membrane surgery.
Macular Hole
- Macular holes occur when traction (pulling) on the central retina results in a “gap” in the retina at its most sensitive location.
- This results in decreased vision and distortion.
- Spontaneous closure is uncommon.
- Surgery for macular hole is highly successful, with more than 95% of holes achieving closure following intervention.
- Surgery involves vitrectomy, peeling of the innermost layer of the retina (the ILM) and injection of a gas bubble.
- Vitrectomy is a micro-keyhole surgery in which the vitreous gel is removed.
- Following removal of the vitreous, fine forceps are used to peel the internal limiting membrane (ILM). Visualisation of the ILM is enhanced with vital dyes such as ILM blue.
- Gas is injected into the eye at the completion of surgery and is reabsorbed over a 2 week period (although long-acting gas may be used).
Sub-Macular Injections
- Sub-macular haemorrhage may result in catastrophic vision loss and is most commonly caused by either macular degeneration or retinal arteriolar macroaneurysm.
- Appropriate management varies from careful observation through to sub-retinal injection of a “clot-busting” agent (tissue plasminogen activator) and gas injection.
- Sub-retinal injections take place following vitrectomy.
- Vitrectomy is a micro-keyhole surgery in which the vitreous gel is removed.
- The sub-retinal space is accessed via a small gauge Teflon tipped cannula.
- At the completion of surgery, a gas bubble is injected into the eye.
- Patients are generally advised to posture following the surgery – this will be discussed on a case-by-case basis.
- The prognosis of patients presenting with sub-macular haemorrhage depends on many factors and can be discussed following a comprehensive examination.