The retina is a layer of neural tissue that’s only some two hundred microns thick. It allows the transmission of visual signals to the brain. The major retinal diseases needing surgery are described below.
- Retinal detachment is a condition in which the retina detaches from the posterior part of the eye, usually associated with a retinal tear in the periphery. It needs urgent care. The main risk factors are age, myopia, history of cataract surgery or history of ocular trauma. An intervention can be done by an ab externo approach (scleral buckling) or ab interno, by a vitrectomy.
- Epiretinal membranes are characterized by the forming of a "membrane" (resembling a layer of skin) on the surface of the retina. This membrane will eventually cause some folding of the retina that can translate into visual symptoms, such as loss of visual acuity and distorted vision (which is also called metamorphopsia). Vitreo retinal surgery allows us to peel off this membrane. Visual acuity is slowly and steadily improved after the procedure.
- A macular hole is the presence of a hole in the center of the retina that causes an important visual impairement. Vitreo macular surgery can help to close the hole with the help of an expansive gas that is injected into the eye and that stays in the vitreous cavity for some weeks. Flying or travelling in altitude are forbidden as long as the gas stays within the vitreous cavity.
- Vitreo retinal traction is a traction localized in the retina, that causes a progressive decline in vision. Vitreo retinal surgery allows for the retina to regain normal morphology by taking away this traction.
Vitreo retinal surgery techniques have advanced quite a lot these last few years: the anesthesia is sometimes simplified (local anesthesia), the instruments used are thinner (their caliber is 0.5 mm for 25G instruments), retinal visualisation is also much better with panoramic view systems available. With all of these combined technological advances, surgical procedures are done faster, which translates into more overall comfort for the patient.