Macular Hole Surgery
WHAT IS THE MACULA?
The macula is the part of the retina that enables us to make out things clearly and see colours. Rays of light enter the eye and are focused on the macular area of the retina. A picture is then produced and sent along the optic nerve to the brain for interpretation. This is rather like the film in a camera being developed so that pictures can be produced.
WHAT IS A MACULAR HOLE?
A macular hole is as it sounds, a hole in the macula. Usually the macula is attached to the inner surface of the eye. If there is a hole then fluid can get underneath it. When this happens the macula cannot compose a clear picture from the incoming rays and the vision becomes blurred and distorted.
WHY DOES IT HAPPEN?
A macular hole is caused by an ageing process in the eye and is most commonly found in patient's aged between 60-75 years. It is more common in females. The eye contains a clear jelly like substance called vitreous humour, which is attached, in parts to the retina. Because of the ageing, the vitreous humour shrinks and this can pull on thin areas of the retina in the macular area and cause a hole to appear.
WHAT IS THE TREATMENT?
An operation is required to remove the vitreous humour in order to reduce the pulling forces on the retina. A bubble of gas is injected into this space by the surgeon. This operation is called a VITRECTOMY. The surgery can be performed either under a local, or general anaesthetic and involves the removal of vitreous gel and injection of a gas bubble. It is highly likely that you will develop a cataract (an opacity or misting within the lens of the eye) after vitrectomy and gas. Therefore removal of cataract and insertion of lens implant is often performed at the same time as the vitrectomy for the macular hole repair. This avoids having subsequent cataract surgery within two years after vitrectomy. We also want to assure you that the surgeon does not take your eye out of its socket to perform the operation.
WHAT HAPPENS AFTER THE OPERATION?
You may be discharged the same day, or remain in hospital for 24-48 hours. Following the operation you will be required to adopt a face down posture which we call posturing. This position helps the bubble to float towards the macular hole and flatten it. Posturing is an extremely important part of your treatment. You will need to posture for about 10-14 days, or until your consultant advises you to stop. Further information on posturing is available and the staff will support you in achieving the best posturing position.
WHAT WILL MY VISION BE LIKE AFTER THE OPERATION?
Your vision will be blurred for 2-3 weeks following the operation. You may be able to see the bubble which will appear as a wobbly black ring in your line of vision. The bubble will move as you move and gradually get smaller or break into smaller bubbles, which in turn will be totally absorbed. The bubble will eventually be replaced by the natural fluids produced in the eye.
WHAT ARE THE BENEFITS OF SURGERY?
Vitrectomy surgery for macular hole often improves or stabilises vision and distortion. Vision after surgery depends on how damaged the vision was before surgery.
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| B08000603 |
