In Which Cases Is Epiretinal Membrane Surgery Suggested?

Epiretinal membranes are thin transparent fibrous layers of tissues formed on the internal layer of retina. These membranes generally occur in people who are above 50 years. In most cases patients do not need treatment. In few cases when the severity increases, epiretinal membrane surgery is suggested. As there is no other treatment than surgery, the membrane is peeled off from the retina after performing vitrectomy on patient’s eye. 

The other cases when vitrectomy is performed on a patient’s eye are for macular hole treatment. A macular hole is a small break in the macula(responsible for sharp and central vision like reading and driving, is the central part of retina). Macular holes are generally related to people who are over 60 years. The location and size of the hole on the retina decide the effect on person’s vision. When a stage 3 hole develops, detailed vision can be lost and if left untreated can lead to retinal detachment and sight threatening condition. 

Eyes’ most interior part is filled with vitreous, which is a gel like substance that helps to maintain the round shape of an eye. As a person ages, vitreous shrinks slowly and pulls away from retinal surface. If vitreous is firmly attached to retina when it pulls away, it can tear retina and cause a macular hole. The natural fluid that replaces vitreous seeps through the hole onto macula and cause blurring and vision distortion. These holes can also occur in cases like high myopia, injury to eyes, retinal detachment and macular pucker (very rarely).

2 Major Steps Of Retinal Membrane Surgery

An epiretinal membrane is a condition in which a very thin layer of scar tissue is formed over retina. Macula, the part of the eye affected by this membrane, is responsible for a person’s sharpest vision. A person with this problem would experience blurring and distortion of vision. If these two symptoms are severe and are disrupting day to day activities, then ophthalmologist would suggest a retinal membrane surgery.  Since there is no medication (like drops) for this problem, removal of membrane surgically is the only way out.

Epiretinal removal involves vitrectomy eye surgery followed by membrane peeling. Three holes are made in the effected eye; the jelly like substance that fills the center of eye called vitreous humor is removed with the help of instruments (vitrectomy). The vitreous fluid is replaced by natural fluid produced by eye, thus not causing any permanent damage to the eye. The membrane is peeled off retina with the help of fine forceps (membrane peeling). A small air bubble is left inside the eye at the end of surgery, which helps in healing process. This bubble is expected to disappear within a week. The three holes, made at the beginning of the surgery, heal and close by themselves. No stitches are required for this procedure which generally takes less than an hour to perform. This procedure is done under local anesthesia, but you are required to remain still during the whole process. After a surgery, a shield is placed on your eye and can be removed after a day.

When Does An Ophthalmologist Perform A Vitrectomy Procedure?

Eyes are one of the most important parts of our body. People are developing many problems relating to eyes because of excessive exposure to the blue screen. Dry, itchy and swollen eyes, problem in retina are few of the non serious problems faced in young age.  One of the problems faced with old age is the macular degeneration also known as Age related Macular Degeneration (AMD). There are two types of AMD, dry and wet. Macular degeneration injections are the only available treatment for wet AMD. At times a hole is developed in the Macula which can be treated by vitrectomy procedure.

In wet AMD, fragile vessels that grow behind macula, start leaking blood which distorts vision. This condition is treated with injections which block the growth of the vessel, there by blocking the flow of liquid. These injections are given directly into eyes every month. The short term side effects are slight redness or bleeding. These injections have been around for more than 10 years, no long term side effects have been observed till now.

During vitrectomy procedure the expert removes the vitreous gel from the eye cavity to have better access to the retina. The removal of this gel helps in other complications like removal of scar tissue, laser removal of retinal detachment, treatment of macular holes. Some other problems which this procedure helps in treating are damaged blood vessels in retina, wrinkles in retina, and infections inside eye. In some cases the vitreous liquid fills with blood or hardens. This liquid has to be removed and filled with saline water to save vision. This procedure could anywhere take one hour to several hours depending upon the condition being treated. Vitrectomy could also be a beginning of a series of procedures. Once the surgery is completed a gas bubble or silicone gel is inserted into the vitreous gel to hold the retina in place.