Macular Hole Treatment in Mumbai

What is the treatment for a macular hole?

Treatment for a macular hole typically involves surgery as it is the most effective option.

Eye drops and glasses are not effective in treating this condition.

A new drug-based treatment option called ocriplasmin injection is being explored, however it remains in clinical trials and has only shown potential in certain cases. Ocriplasmin is not as effective as surgery and many patients who undergo the treatment still end up needing surgery.
Your retina specialist can advise on the options available to you. Some patients may choose not to have surgery and accept reduced central vision in the affected eye, especially if their vision in the other eye is unaffected. There is no one-size-fits-all solution and the decision to have surgery or not should be based on personal needs and priorities. It is important to have an open discussion with your consultant about your reasons for pursuing surgery or opting not to have it.

How does your Retina surgeon perform the macular hole surgery?

The majority of macular hole surgeries are performed under local anesthesia, where the patient remains conscious during the procedure. Local anesthetic is administered around the eye to numb it and eliminate any pain. Although the patient may not be able to see the details of the surgery, they might sense the presence of bright lights or movements in the operating room. It is important for the patient to lie flat and keep her head still during the procedure.
General anesthesia, where the patient is asleep throughout the procedure, is rarely given for macular hole surgery. In case of general anesthesia is necessary, the patient will be given specific instructions regarding their diet and fluid intake before the surgery.

What is Vitrectomy Surgery? How is it performed?

The procedure to repair a macular hole is called a vitrectomy and usually takes about an hour. The surgery should be performed by a skilled ophthalmologist who is trained in managing retinal diseases.
Before the procedure, eye drops will be applied to enlarge the pupil. During the surgery, small openings will be made in the eye to remove the vitreous and replace it with a special gas bubble.

This gas bubble will press against the macula to seal the hole. It is important to avoid flying for a specified period of time after the procedure as the gas bubble can cause increased pressure in the eye and result in visual loss.

Three types of gases are used

1. C3F8 is long acting can remain in the eye for up to 12 weeks
2. SF6 can remain in the eye for up to 4 weeks
3. C2F6 can remain in the eye for up to 8 weeks
4. Air can remain in the eye for up to 2 weeks

After the surgery, you will be informed which type of gas bubble was used. The surgeon might place small dissolvable stitches in the eye to close the opening. These stitches will typically dissolve over 4 to 6 weeks. A pad and shield will be placed over the eye to protect it and will be removed the next morning.

What happens after the procedure?

Following the procedure, your eye may feel uncomfortable, itchy, and gritty. It may also appear red or bruised and your vision may initially be poor. This is normal and can last 7 to 14 days. Eye drops will be provided to reduce inflammation and prevent infection, and you will be instructed on their usage. Pain relief can be achieved with paracetamol as directed by your eye specialist. Avoid rubbing your eye. The eye will take 2 to 6 weeks to heal, but your vision may continue to improve for several months.

What happens to your vision after the procedure?

Your vision will be impaired with the gas in your eye. As the gas disperses and is replaced by the natural fluid in your eye, you will start to see a wobbly line in your vision, like a spirit level. You will be able to see above the line, but the vision below it will be blurry. The line will gradually move downwards until only a small bubble remains, and eventually it will disappear completely.

It’s important to inform eye specialists about the presence of gas in your eye when undergoing procedures that involve nitrous oxide (such as childbirth or A&E treatment) or general anesthesia. This is to avoid any adverse reactions between the gas and nitrous oxide. It is recommended that you or a family member inform the midwife, A&E staff, or anesthetist about the eye surgery and gas in your eye before any treatment is administered.

Posturing

Posturing is a crucial aspect of recovery after your surgery, but also the most challenging. If you have received gas or silicone oil in your eye, posturing may be required for up to seven days. This involves lying or sitting in a position that keeps your face downward so that the bubble can float up and press the retina into place during healing. Your surgeon will inform you if posturing is necessary for your surgery and provide you with another informational leaflet to guide you.

Is a Lamellar macular hole the same as a macular hole?

No, a lamellar macular hole is not the same as a macular hole. A macular hole is a full thickness defect in the macula, while a lamellar macular hole is only a partial thickness defect in the macula.

What is the treatment option for Lamellar hole?

Lamellar holes typically do not require surgical treatment. However, if a lamellar hole worsens and develops into a full-thickness macular hole, a surgical procedure called a vitrectomy may be performed to repair it. This involves removing the vitreous gel and inserting a gas bubble inside the cavity. Call on
022 26287107 / 9004496621 for Macular Hole Treatment in Mumbai.

Follow up appointments after the procedure

After your surgery, you will have follow-up appointments with your doctor to ensure your eye is healing properly and to address any concerns you may have. The first appointment is typically scheduled two weeks after the operation.

When to seek medical advice after the procedure?

In case of severe pain, worsening vision, or redness in the eye, seek immediate medical attention.

Visit at Dr. Vaidya Eye Hospital for the best and most advanced Macular Hole Treatment in Mumbai. Dr. Harshit Vaidya is one of the best retina and eye surgeon in Andheri. Get an appointment today!