21 Apr Optometry Student's First Retinal Surgery
Optometry students frequently rotate through our office. One of our visiting students had the chance to watch me in the operating room. I asked her to write about the experience…
My name is Maggie, and I’m a fourth year student at the SUNY College of Optometry in NYC. I had the opportunity to observe retinal surgeries with Dr Wong in the OR, and it was an amazing experience!
The first surgery was scheduled at 7:30am (I know, I wasn’t too excited) for a vitrectomy to repair a retinal detachment. The patient had developed a retinal detachment secondary to a retinal hole. Sub-retinal fluid can accumulate under the hole and cause the retina to detach, which then needs to be treated. The urgency of treatment depends on the location of the detachment and the condition of the macula (the central part of vision). If the macula is still attached, ie “macula-on retinal detachment”, the patient needs to be treated as soon as possible, which was the case in patient# 1.
The patient was already prepped for surgery (with pre-operative antibiotics, anesthesia etc). Retinal surgeries usually do not require general anesthesia; the patient was given retrobulbar anesthesia, which is local “blocking” of an area supplied by a specific nerve. I was very excited to be in the OR; I have observed a few surgeries before but this was my first ocular surgery! I got to sit right behind Dr Wong and see the entire thing. Dr Wong had warned me about the graphic nature of ocular surgery, but it wasn’t bad at all! There wasn’t any blood or fluid gushing out, as one would imagine. It was a relatively clean, blood-less surgery! The incision was made 5mm lateral to the limbus (where the color part of your eye meets the white part). This was like “port of entry” to get into the retina. Before performing the laser, Dr Wong performed a “vitrectomy”. Vitreous is the jelly part of the eye, between the lens and the retina. It sort of keeps the eye intact, keeps the retina attached to the choroid. However, it can also block the surgeon’s view and interfere with laser treatment, which is why it is necessary to remove it.
After the vitrectomy, Dr Wong sealed up the retinal hole with the laser and repaired the retinal detachment. The surgery went well, and the patient was discharged after being given post-op anti-biotics/anti-inflammatory.
The second patient was scheduled for a membranectomy secondary to epi-retinal membrane (ERM). An ERM is a membrane that forms over the macula. ERM can distort vision and cause traction on the macula, which is when treatment is indicated. The pre-op process is similar to the one described above; vitrectomy is also necessary in this case. After the vitrectomy, Dr Wong physically peeled off the membrane with forceps! This is a very delicate procedure since the membrane is over the macula; and a little slip up can affect the central vision! You could actually see the membrane coming off-of the macula! Again, the patient was discharged after the appropriate post-op treatment.
Both the patients are scheduled to see Dr Wong for follow up visits.
Being in the OR was an awesome experience, and I can’t wait to go back!