Macular hole
What does vitrectomysurgery involve?
Macular hole surgery is a form of keyhole surgery performed under a microscope.
Three small incisions (one millimetre in size) are made in the white of the eye and very fine instruments are inserted.
First, the vitreous jelly is removed (vitrectomy) and then a very delicate layer (theinner limiting membrane) is carefully peeled off the surface of the retina around the hole, to release the forces that keep the hole open.
The eye is then filled with a temporary gas bubble, which presses the hole flat onto the back of the eye to help it seal.
The bubble of gas will block the vision while it's present, but it slowly disappears over a period of about four to eight weeks.
Macular hole surgery usually takes 45-90 minutes and can be done while you're awake (under local anaesthetic ) or asleep (under general anaesthetic ).Most patients opt for a local anaesthetic, which involves a numbing injection around the eye, so no pain is felt during the operation.
You may be able to go home the same day,but most patientsneedto stay in hospital overnight.
Medically Reviewed by a doctor on 21 Dez 2018
Introduction
A macular hole is a small gap that opens up at the centre of the retina in the macula. It causes blurred and distorted vision, and can be treated with surgery.
Why does it happen?
We don't know why macular holes develop. The vast majority of cases happen spontaneously (without an obvious cause). They most often affect people aged 60-80, and are twice as common in women as men.
What should I do?
If you have blurred or distorted vision, or there's a black spot in the centre of your vision, see your GP or optician as soon as possible. You'll probably be referred to an ophthalmologist (a special
What is the treatment and how successful is it?
Vitrectomy surgery A macular hole can often be repaired using an operation called a vitrectomy, withinner limiting membrane (ILM) peel and gas. If you've had the hole for less than a year, there's a
What does vitrectomysurgery involve?
Macular hole surgery is a form of keyhole surgery performed under a microscope. Three small incisions (one millimetre in size) are made in the white of the eye and very fine instruments are inserted.
macular-hole-expect-operation
Temporary poor vision With the gas in place, the vision in your eye will be very poor a bit like having your eye open under water. Your balance will be affected and you'll have trouble judging dista
Do I need to position myself face down after the operation?
Once at home, you may have to spend several hours during the day with your head held still and in a specific position, called posturing. The aim of lying or sitting face down is to keep the gas bubbl
Am I able to travel after macular hole surgery?
You must not fly or travel to high altitude on land while the gas bubble is still in your eye (up to 12 weeks after surgery). If you ignore this, the bubble will expand at altitude, causing very high
What if I need another operation shortly after my treatment?
Ifyou need a general anaesthetic while the gas is still in your eye, it's vital you tell the anaesthetist, so they can avoid certain anaesthetic agents that can cause expansion of the bubble.
Can I drive after the operation?
No the gas bubble will still be present in your eye for six to eight weeks after your surgery, so during this time you can't drive a vehicle of any sort. None of these exclusions apply once the gas h
How much time will I need off work?
Most people will need at least two weeks off work, although this will depend to an extent on the type of work you do and the speed of recovery. Discuss thiswith your surgeon.
What are the possible complications of macular hole surgery?
It's unlikely that you'll suffer harmful effects from a macular hole operation. However, you should be aware of these six possible complications: Failure of the hole to close. This happens in 1-2
How successful is macular hole surgery?
The most important factor in predicting whether the hole closes as a result of surgery is the length of time the hole has been present. If you've had a holefor less than six months, there's about a90
Can I develop a macular hole in my other eye?
After carefully examining your other eye, your surgeon should be able to tell youthe risk of developing a macular hole in this eye. In some people this is extremely unlikely, in othersthere's a1 in 1
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