This procedure is performed in the office and requires a local anesthetic. Before the medicine is injected, the eye is cleaned with an antiseptic. There may be a spot of blood on the white part of the eye where the injection is given. This spot will usually resolve within two weeks. Many times, patients may experience some irritation or scratchy sensation and some blurry vision after the injection.
Improvements in vision may occur as quickly as a few weeks or may take several injections. Some patients will not experience any improvement in vision. This does not indicate that the medication is not working, instead it may be the disease beginning to stabilize.
Eylea injection, also known as aflibercept, is a medication that is used to treat the wet form of age-related macular degeneration, also known as AMD or ARMD. Age-related macular degeneration affects the macula, the part of the eye that provides sharp, central vision.
Eylea also slows the development of vascular endothelial growth factor, or VEGF, a protein that causes abnormal blood vessels to grow and leak, damaging the macula. By slowing the development of VEGF, Eylea aids in the prevention and reversal of vision loss experienced by those patients with macular degeneration. Unlike Avastin or Lucentis, Eylea binds with VEGF and has the potential to last longer than Avastin or Lucentis.
Approved by the Food and Drug Administration in 2011, Eylea was evaluated in two clinical trials with over 2,000 patients. Side effects that are most commonly reported for patients receiving Eylea include pain at the injection site, vitreous floaters, clouding of the lens of the eye, retinal detachment and an increase in intraocular pressure.
OZURDEX® is a tiny implant that slowly releases corticosteroid medication over time, without the need for monthly injections. It will dissolve naturally and will not need to be removed.
OZURDEX® (dexamethasone intravitreal implant) is a prescription medicine that is an implant injected into the eye (vitreous) and used:
•To treat adults with diabetic macular edema
•To treat adults with swelling of the macula (macular edema) following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO)
•To treat adults with noninfectious inflammation of the uvea (uveitis) affecting the back segment of the eye
Retinal laser photocoagulation is commonly used for treatment of focal vascular leakage in the retina (macular edema), proliferative retinopathy (diabetic retinopathy and vein occlusion) and retinal tears or limited retinal detachment. This is an in-office procedure. An anesthetic drop is applied to the eye and a coupling gel with a contact lens is placed over the eye. The laser procedure consists of bright light lasting for a few minutes. Some patients report pressure or mild pain during the procedure. Immediately after the procedure, vision will be discolored and blurred but will return in a few minutes. After the procedure, patients will most often experience the same level of vision as before the procedure. Patching of the treated eye is not necessary after laser procedures.
Pneumatic retinopexy is a procedure done in the office for repair of certain retinal detachments. It is an effective treatment for retinal detachments that are isolated in the upper portion of the retina and caused by tears localized to one area. The patient must be able to maintain strict head positioning for 1-2 weeks after the procedure. Before the procedure, the eye is cleaned with an antiseptic solution and a small amount of fluid is removed from the eye. A gas bubble is then injected directly into the eye and will remain for 3-8 weeks depending on the gas that is used.
The gas slowly dissipates on its own. During this time, the patient will be instructed about specific head positioning. During the next couple of days, the patient will then return for either laser photocoagulation or cryotherapy to treat the retinal tear. With the gas bubble in the eye, the patient will be restricted from flying in an airplane and should notify the anesthesiologist if any anesthesia will be needed for procedures.
PA scleral buckle is a surgical procedure that may be used to repair a retinal detachment. A retinal detachment occurs when the two layers of the retina become separated from each other and from the wall of the eye, causing shadows and vision loss. This condition requires prompt and thorough medical treatment to prevent permanent vision loss.
During this outpatient procedure, the patient is anesthetized with either a general or local anesthetic. The scleral buckle, which looks like a belt, is a thin strip of silicone that is secured around the eyeball under the conjunctiva, creating an indentation on the wall of the eye. This device is attached to the posterior portion of the eye, on the sclera, or white of the eye, and is not externally visible. The scleral buckle is usually left on the eye permanently but can be removed.
The scleral buckle will push in, or “buckle,” the sclera towards the middle of the eye, relieving the pull on the retina. This allows the fluid that has collected under the retina to drain and the retina to re-attach.
After the placement of the retinal buckle, patients may experience post-operative pain, swelling and redness for a few days. Prescription eye drops may be prescribed to treat these symptoms and prevent infection.
The scleral buckle procedure usually takes one to two hours to perform.
Vitrectomy is a surgical procedure that is performed in the hospital, as an outpatient. Some common reasons for vitrectomy surgery are for non-clearing vitreous hemorrhage, repair of retinal detachment, epiretinal membranes/ macular holes and retained lens fragments after cataract surgery.
Some common reasons for vitrectomy surgery are:
During Vitrectomy, anesthesia is used to help relax the patient and an injection around the eye is administered.
The surgical eye is cleaned and the patient’s face is covered to maintain sterility.
A microscope is placed over the eye. A bright light helps guide the surgeon see during surgery.
Multiple small incisions are made to remove the vitreous gel inside the eye. Laser or cryotherapy may be applied and the eye is usually filled with either gas or silicone oil at the end of the procedure.
The eye is then patched and shielded. This should not be removed until the next day in the office by the physician. Vision will be blurry after surgery, this is normal and to be expected.