Blogs : #Vitrectomy

Patients who may require retinal surgery include those with retinal detachment, severe diabetic retinopathy, macular holes, epiretinal membranes, or vitreous hemorrhage. Main retinal surgery techniques include vitrectomy, which removes cloudy or blood-filled vitreous gel while repairing the retina using laser treatment, gas injection, or silicone oil; another method is scleral buckling, which supports the retina externally to help it reattach to the eye wall. Technologies used in retinal surgery include micro-surgical instruments, surgical microscopes, intraocular laser systems, silicone oil or gas tamponade, and OCT imaging to assess retinal damage in detail. Retinal surgery is a complex and important treatment for patients with severe eye conditions such as retinal tears, detachment, or advanced retinal degeneration. Without timely treatment, these conditions may lead to permanent vision loss. Understanding surgical procedures, technologies used, and treatment indications can help reduce anxiety and allow patients and families to prepare physically and emotionally. Strict adherence to pre- and post-operative instructions also improves recovery outcomes and reduces the risk of complications.     Who Needs Retinal Surgery? Retinal surgery is considered when retinal damage becomes severe and cannot be effectively treated with other methods. Conditions requiring surgery include:   Retinal Detachment Retinal detachment is an ophthalmic emergency where the retina separates from underlying tissue, disrupting visual function. Without prompt treatment, permanent vision loss may occur. Symptoms include flashes of light, floaters, a dark curtain over part of vision, or blurred sight. Early diagnosis and surgical treatment by an ophthalmologist are essential.   Macular Degeneration Macular degeneration, especially wet AMD, involves abnormal blood vessel growth beneath the retina. These fragile vessels may leak blood or fluid, causing central vision distortion, blurring, or dark spots.   The disease can progress rapidly. Treatments such as anti-VEGF injections, laser therapy, or retinal surgery may slow progression and preserve vision.   Diabetic Retinopathy Diabetic retinopathy results from chronic high blood sugar damaging retinal blood vessels, leading to leakage, swelling, or bleeding. This causes blurred vision and, if untreated, permanent vision loss.   Treatment includes blood sugar control, laser therapy, intraocular injections, or retinal surgery depending on severity. Regular eye exams are essential for early detection.   Macular Hole A macular hole is a small defect in the central retina responsible for detailed vision. It may cause distorted central vision while peripheral vision remains normal.   Common causes include aging, vitreous traction, or eye injury. Surgery is often required to close the hole and improve vision.   Epiretinal Membrane Epiretinal membrane is a thin scar tissue layer on the retinal surface, often affecting the macula. It can distort vision, causing curved lines or double vision.   Mild cases may not require treatment, but severe cases affecting daily life may require surgical removal.   Vitreous Hemorrhage Vitreous hemorrhage occurs when blood leaks into the vitreous gel, causing hazy or dark vision. Severe cases may significantly impair vision.   Common causes include diabetic retinopathy, retinal tears, trauma, or abnormal retinal vessels. Treatment ranges from observation to laser therapy or vitrectomy surgery.     Preparing for Retinal Surgery Proper preparation helps reduce complications and supports faster recovery.   Consult your ophthalmologist thoroughly and disclose medical history, medications, and chronic conditions. Preoperative tests may include blood tests or ECG. Inform your doctor about all medications. Some drugs affecting blood clotting may need temporary discontinuation. Fasting for at least 6–8 hours before surgery is typically recommended. Arrange transportation and a caregiver for post-operative support due to temporary blurred vision. Retinal Surgery Procedures Retinal surgery involves various techniques depending on disease type and severity.   Vitrectomy This procedure uses very fine instruments inserted through small incisions in the white of the eye. The surgeon removes cloudy or blood-filled vitreous gel, treats underlying retinal conditions with laser therapy, and may inject gas or silicone oil to help reattach the retina. Dissolvable sutures close the incisions.   Scleral Buckling This technique places a silicone band or sponge on the outer eye wall to support retinal reattachment. It is commonly used for retinal detachment caused by tears.   The material typically remains permanently without complications. Some patients may require fluid drainage beneath the retina. Temporary redness or blurred vision may occur initially.     Technology Used in Retinal Surgery Modern retinal surgery combines surgical skill with advanced medical technology for improved safety and precision.   Micro-instruments: Extremely small surgical tools minimize incision size and speed recovery. Surgical microscope: Provides magnified visualization of delicate retinal structures. Endolaser: Treats abnormal vessels or seals retinal tears internally. Silicone oil or gas: Helps press the retina back into position during healing. OCT imaging: Provides detailed retinal scans before and after surgery. Postoperative Care Guidelines Proper self-care after surgery improves recovery and reduces complications.   If gas or silicone oil is injected, patients may need specific positioning such as face-down or side-lying. Use prescribed eye drops exactly as directed. Avoid water exposure to the eye during the first week and refrain from rubbing the eye. Avoid air travel if gas is present due to pressure changes. Avoid heavy lifting, strenuous activity, and contact sports. Rest adequately and limit intensive visual tasks. Expected Results and Recovery Time Retinal surgery helps correct abnormalities and prevent future vision loss. Outcomes depend on disease severity. Some patients see improvement quickly, while others may take months. Typical recovery lasts about 1–2 weeks, with activity restrictions during healing.   Cost of Retinal Surgery Costs vary based on surgical technique, technology, and individual treatment needs. Fees typically include surgeon costs, operating room charges, medications, and intraocular lens expenses if required.   Retinal Surgery Technology at Bangkok Eye Hospital Bangkok Eye Hospital utilizes advanced PPV (Pars Plana Vitrectomy) technology with the Constellation Vision System, internationally recognized for treating complex retinal conditions such as detachment, diabetic retinopathy, and macular disorders.   The ULTRAVIT® vitrectomy cutter operates at extremely high speeds, allowing gentle vitreous removal with minimal retinal traction. Intelligent intraocular pressure control maintains stable eye pressure throughout surgery, reducing complication risks.   High-resolution Xenon illumination enhances visualization of delicate retinal tissue, while PurePoint® endolaser technology precisely treats tears or abnormal vessels. These integrated technologies allow comprehensive retinal repair in a single procedure.   Small-gauge surgery results in tiny self-sealing incisions, minimizing irritation and accelerating recovery. Postoperative positioning may still be necessary if gas or silicone oil is used.   Why Choose Retinal Surgery at Bangkok Eye Hospital? Bangkok Eye Hospital provides comprehensive retinal surgery services using advanced technology and experienced specialists from the Retina Center. Patients receive:   Comprehensive eye examinations for precise treatment planning. Advanced technologies such as micro-surgery tools, laser therapy, and OCT imaging. Close postoperative monitoring and rehabilitation support. Personalized treatment advice tailored to lifestyle and eye condition. Comfortable care throughout surgery and recovery. Summary Retinal surgery is essential for conditions such as retinal detachment, macular holes, or diabetic retinopathy. Modern techniques including vitrectomy and scleral buckling, supported by advanced technology, enhance safety and treatment outcomes. Patients should follow preoperative instructions, arrange post-surgical care, and attend follow-up appointments. Recovery typically takes 1–2 weeks depending on severity. Consult Bangkok Eye Hospital for comprehensive retinal care.   Related Articles What Causes Retinal Holes? Symptoms and Treatment Options Signs of Retinal Swelling You Should Not Ignore Diabetic Retinopathy Symptoms and Prevention Frequently Asked Questions (FAQ) Common questions about retinal surgery to help patients prepare confidently.   What symptoms occur after retinal surgery? Temporary blurred vision, mild irritation, tearing, floaters, or flashes may occur. Severe pain or worsening vision should be reported immediately.   How long is hospitalization required? Typically 1–2 days depending on surgical complexity and patient condition.   Why must patients lie face-down after surgery? Face-down positioning helps gas or silicone oil support retinal reattachment, improving healing and visual outcomes.

Age-related Macular Degeneration (AMD): Symptoms, Diagnosis and Treatment Options KEY TAKEAWAYS Age-related Macular Degeneration (AMD) causes a gradual loss of central vision. It is commonly found in people aged 50 and older and is divided into two main types: Dry AMD (most common) and Wet AMD (more severe). Key warning signs include blurry central vision, distorted images, altered colors, or seeing straight lines as wavy or bent. Current treatment technologies include injections (Anti-VEGF), laser therapy to destroy abnormal blood vessels, surgery, and emerging technologies like Gene therapy and Stem cell therapy. Age-related Macular Degeneration (AMD) is a disease caused by the deterioration of cells in the central area of the retina (Macula), which is the most critical part for vision. This leads to a gradual loss of central vision. It may start with blurry central vision, distorted images, or altered colors, eventually leading to a complete loss of central vision. Generally, AMD is commonly found in people aged 50 and older, and the risk increases with age. Other risk factors include smoking, high blood pressure, obesity, and genetics. Make an Appointment / Consult an Expert โทร 02-511-2111 Line 📅 Book Online 📌 Table of Contents ▶ Two Types of AMD ▶ What Are the Symptoms of AMD? ▶ How to Reduce the Risk of AMD ▶ How Do Ophthalmologists Diagnose AMD? ▶ AMD Treatment Options ▶ Pros and Cons of Each Treatment ▶ New Technologies in AMD Treatment ▶ Frequently Asked Questions (FAQ) Two Types of AMD Dry AMD: The most common type (about 80-90%). It is caused by the accumulation of waste products in the retina, leading to the gradual deterioration of light-sensitive cells and a slow decline in vision. Wet AMD: Less common (about 10-20%) but more severe. It occurs when abnormal new blood vessels grow under the retina. These vessels may leak fluid or blood, causing swelling and scarring in the retina, resulting in rapid vision loss. AMD is the third leading cause of vision loss in the elderly. Although there is currently no complete cure, there are treatment options and new technologies that can slow the progression and maintain the patient's quality of life. What Are the Symptoms of AMD? The symptoms of AMD depend on the stage of the disease. Dry AMD is divided into three stages: early, intermediate, and late. Symptoms typically worsen over time. Early dry AMD usually has no symptoms. In intermediate dry AMD, some people may still have no symptoms, while others may notice mild symptoms such as slight blurring in the center of their vision or difficulty seeing in low light. In late AMD (both wet and dry), many people notice that straight lines start to look wavy or bent. You may notice a blurry area near the center of your vision. Over time, this blurry area may expand, colors may not look as bright as before, and you may have more difficulty seeing in low light. Seeing wavy lines is a key warning sign of late AMD. If you notice this symptom, see an ophthalmologist immediately. How to Reduce the Risk of Age-Related Macular Degeneration? Several studies indicate that adopting the following habits may delay the onset of AMD (or slow down vision loss from AMD): Quit smoking or never start smoking Exercise regularly Maintain healthy blood pressure and cholesterol levels Eat a healthy diet, including leafy greens and fish How Do Ophthalmologists Diagnose AMD? Diagnosis typically involves a comprehensive eye exam, including pupil dilation, retinal examination, and retinal scanning using Optical Coherence Tomography (OCT). AMD Treatment Options 1. Medications and Supplements Vitamins and minerals: Taking vitamins C, E, beta-carotene, zinc, and copper may help slow the progression of dry AMD in some patients. Injections: Anti-VEGF (Vascular Endothelial Growth Factor) drugs are the primary treatment for wet AMD. These drugs help inhibit the growth of abnormal new blood vessels. 2. Laser Therapy Photodynamic therapy (PDT): Uses a laser combined with an injected drug to destroy abnormal new blood vessels. Laser photocoagulation: Uses a laser to directly destroy abnormal new blood vessels. 3. Surgery Blood removal surgery: In cases of severe bleeding in the eye, surgery may be required to remove the blood. Retinal transplant surgery: A new technology that is still in the experimental stage. Pros and Cons of Each Treatment Treatment Method Pros Cons Vitamins and Minerals Inexpensive and safe Not effective for everyone; may have minor side effects Injections Highly effective in treating wet AMD Requires regular injections into the eye; potential side effects Laser Therapy Effective at destroying new blood vessels May damage surrounding normal tissue; not effective for everyone Surgery May help treat certain complications Surgical risks involved; not effective for everyone Consult an Ophthalmologist for an AMD Treatment Plan There are several treatments for AMD, each with its own pros and cons. Choosing the right treatment depends on the type and severity of the disease, as well as the patient's overall health. You should consult an ophthalmologist for the best advice and treatment plan. Make an Appointment / Consult an Expert โทร 02-511-2111 Line 📅 Book Online New Technologies in AMD Treatment New injectable drugs: Longer-lasting injections that help reduce the frequency of treatments. Gene therapy: A treatment that involves inserting normal genes into retinal cells to repair damage. Stem cell therapy: Uses stem cells to generate new retinal cells. Summary: There are several treatments for AMD, each with its own pros and cons. Choosing the right treatment depends on the type and severity of the disease, as well as the patient's overall health. You should consult an ophthalmologist for the best advice and treatment plan. Make an Appointment / Consult an Expert โทร 02-511-2111 Line 📅 Book Online Frequently Asked Questions (FAQ) about AMD How many types of AMD are there, and which is more dangerous? It is divided into two main types: Dry AMD, which is the most common and progresses slowly, and Wet AMD, which is less common but much more severe, causing rapid vision loss due to bleeding or fluid leakage under the retina. What does seeing wavy or bent straight lines indicate? Seeing straight lines as distorted, wavy, or bent is a major warning sign of late-stage AMD. If you experience this symptom, you should see an ophthalmologist immediately for proper examination and treatment. Can AMD be completely cured? There is currently no complete cure, but there are treatment options (such as injections and laser therapy) and new technologies that can help slow the progression and preserve the patient's visual quality of life. บทความโดย รศ.นพ. อนันต์ วงศ์ทองศรี ประธานกรรมการบริหาร (CEO) และจักษุแพทย์ผู้เชี่ยวชาญ จักษุแพทย์ผู้เชี่ยวชาญด้านกระจกตาและการผ่าตัดแก้ไขสายตา (LASIK) ประสบการณ์ดูแลคนไข้มากกว่า 100,000 ดวงตา ประวัติแพทย์ นัดหมายปรึกษา *Note: This information is for educational purposes only and cannot replace professional medical diagnosis. Treatment outcomes may vary from person to person. If you experience any abnormal symptoms, please consult an ophthalmologist directly.