Hole in retina repair12/10/2023 ![]() Cataract: this means that the natural lens in eye has gone cloudy. ![]() ![]() If the hole fails to close, then the vision may be a little worse than prior to the surgery. Failure of the macular hole to close: In most circumstances, it is possible to repeat the surgery.Six specific complications of macular hole surgery, which you must be aware of, are outlined below: In a small minority, the vision may end up worse than before the surgery, and there is even a tiny chance of total loss of sight. Please remember that if you are not able to posture then there is still a good chance that the hole will close successfully.Īs with any procedure there may be risks involved and you should discuss these fully with the consultant involved prior to your operation, however it is unlikely that you will suffer harmful effects from a macular hole surgery. Your surgical team will advise on aids that can make face down posturing easier to manage e.g. A short break of 10-15 minutes can be taken every hour to allow eating, trips to the bathroom etc. You should try to remain in this position for usually 50 minutes in each hour for the duration advised. This could be done sitting at a table, or lying flat on your stomach on a bed or sofa. You will be asked to position in a face down posturing position at home, your head should be positioned so that the tip of your nose points straight down to the ground. The day after surgery, you are able to mobilise freely keeping your head upright at home or outdoors.” “For smaller and medium-size macular holes, you only need to posture for one day and one night after surgery. There is evidence that posturing improves the success rate for larger holes (usually 5-7 days after the Surgery). Whether you are required to posture, and for how long, will depend on the size of the macular hole, and also the preferences of your surgeon. The aim of face down posturing is to keep the gas bubble in contact with the hole as much as possible to encourage it to close. Please discuss this with your surgeon Mr Muqit, and he will discuss the natural history of small macular holes with you, together with both conservative and treatment options. Vitrectomy surgery is far superior to this drug, but some patients with small macular holes may wish to avoid an eye operation so “intravitreal ocriplasmin” may be their choice of treatment. The jelly then softens and peels away from the surface of the macula, and in the process, the macular hole can close. The drug loosens the “jelly” within the eye known as the vitreous. It is important to understand that return to completely normal vision is not possible.įor patients with small macular holes with “ vitreomacular traction“, an injection of a therapeutic drug called Ocriplasmin may be successful in closing the macular hole without the patient requiring a surgical operation. In a minority of patients the hole does not close despite surgery and the central vision can continue to deteriorate however, a second operation can still be successful in closing the hole. Even if this degree of improvement does not occur, the vision is at least stabilised and many patients find that they have less distortion. Of these, more than 70% will be able to see two or three lines more down a standard vision chart, compared to before the surgery. If the hole has been present for less than a year, the surgery will be successful in closing the hole in about 90% of cases. As cataract is inevitable, you may be offered combined vitrectomy surgery with cataract extraction and lens implantation (‘phacoemulsification”) at the same time as the macular hole repair. A macular hole can often be repaired by an operation called a Vitrectomy, peel and gas.
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