Today, vitreous body diseases and retinal diseases can be treated without sutures and without any pain.
Detachment of retina due to a disease of the vitreous body may result in dying-off of visual cells and, if not diagnosed and treated as early as possible, even in blindness. Our surgeon Dr. H. Kaymak is internationally renowned in the field of minimal-invasive treatment of detached retina (retinal detachment surgery) as well as by means of sophisticated therapy concepts of vitreous body and retinal surgery.
What are the causes of retinal detachment?
Video: Floaters
Shrinking of the vitreous body is the most frequent cause of retinal detachment (also called retinal ablation). The vitreous body - which is located between lens and retina, and consists of 98% water, and initially almost completely fills the eye - loses fluid over time and correspondingly shrinks. This results in tension on the retina, which then may detach at certain locations. This happens with a lot of people, above all at an advanced age, and usually it is not dangerous. Typical symptoms include small dots or streaks that seem to be floating on a light background in the visual field (floaters).
Pathogenic retinal ablation may result in dying-off of visual cells.
Video: Retinal ablation
However, these signs could also represent early symptoms of a serious disease of the vitreous body. If the vitreous body increasingly shrinks due to a disease, then the tension on the retina also increases; this may cause fissures or holes in the retina. This is very dangerous, as this may enable eye fluid to enter behind the retina, correspondingly detaching the retina from the vital background. This will result in dying-off of visual cells. Myopic persons are more often affected than emmetropic persons. Prophylactic laser treatment of the preliminary stages of retinal holes may offer protection against retinal detachment.
The symptoms of a retinal hole are usually not accompanied by pain.
Video: Retinal hole
The symptoms indicating fissures or a hole in the retina include perception of shadows, fog-like, smoke-like or grime-like black or red objects, or a high increase of dots and streaks in the visual field. Furthermore, arch-shaped phosphenes or flashes that are not attributable to circulatory disorders or migraine attacks may indicate this disease. Usually, the symptoms are not accompanied by pain because the nerve fibres of the retina do not send pain information to the brain. Risk factors include family history (inheritance), high short-sightedness, previous cataract surgery, diabetes mellitus as well as head injuries and bruises in the eye area.
Early detected holes in the retina can be closed using a laser.
How is retinal detachment being treated?
Holes in the retina can be closed by laser treatment. Success depends on the stage of the disease and on the amount of fluid that entered the area behind the retina via the hole. During late stage or in case of additional complications, this will require surgical intervention for re-creation of retina (retinal detachment surgery). Here, the following is important: Early-as-possible performance of treatment grants a higher possibility of prevention of further detachment, avoidance of complications and best possible recovery of vision. When performing interventions at retina and vitreous body, Dr. H. Kaymak applies state-of-the-art techniques, e.g. the so-called 23-gauge technique, a method that enables surgery without sutures and pain and showing significantly lower complication rates, because the diameter of the instruments is smaller (0.64 mm) as compared to the conventional 20-gauge technique (0.8 mm). We developed the sophisticated technique and the correspondingly required instruments with the long-established Swiss company Oertli, and we belong to the first ophthalmologists in Germany who apply such technique.
Modern anti-VEGF medicaments inhibit vascular growth and stop the disease.
In case of retinal vascular occlusion, modern therapies may protect your vision.
The retina, which is located at the inner side of the posterior eye, is supplied with blood via arterioles (arterial end vessels); the blood flows back via veins. If blood clots occur at such location - i.e. a retinal artery or vein occlusion - then this will result in acute loss of vision. According to latest knowledge, retinal vein occlusion can be successfully treated by surgical insertion of new medicaments, e.g. Ozurdex®, into the vitreous body. Furthermore, combination therapies applying a growth inhibitor proved to be efficient; here, medicaments are injected into the vitreous body, thus inhibiting the Vascular Endothelial Growth Factor (VEGF), which is presumably responsible for vascular growth and progression of the disease. In some cases, vision can even be improved. Currently, the medicaments Lucentis®, Macugen® and Avastin® are available. We developed the sophisticated technique and the correspondingly required instruments with the long-established Swiss company Oertli, and we belong to the first ophthalmologists in Germany who apply such technique.