Retinal conditions not amenable to in-office techniques are managed in an operating room. The great majority of cases are performed at an outpatient facility near CPE. We have found that operating at a facility emphasizing orthopedics (primarily joint replacement) surgery provides for unparalleled safety, especially in terms of reducing post-operative infection risks. The more commonly performed procedures include:
The gel in the cavity behind the pupil and lens can be removed through very small, often self sealing, openings in the white sclera. Vitreous is not required for normal visual function, however it does slow the rate at which cataracts develop. A vitrectomy may be indicated to remove opacities blocking vision (e.g. non-clearing hemorrhage) and/or to gain access to retinal lesions such as macular pucker or retinal detachment.
A buckling procedure may be indicated to support weakened or torn peripheral retina. It can be a stand-alone procedure or combined with vitrectomy depending on the severity of pathology being treated. Buckling materials are carefully positioned well behind the lids and are generally left in place for life. An unavoidable side effect of scleral buckling is its effect on the refractive state of the operated eye; myopia and/or astigmatism is often induced to some degree. However, this is considered a relatively small drawback when an eye is saved from irreparable blindness.
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