Minimally Invasive Maculopathy surgery

Maculopathy surgery procedures

Maculopathy laser treatment is used to cure exudative maculopathy. Minimally invasive maculopathy surgery. Laser therapy uses a concentrated ray of light to destroy neoformed vessels typical of exudative maculopathy, from which liquid comes out. This treatment is performed as outpatient, using eye drops as anaesthetic.

If neovessels are clearly visible with Fluorangiography (standard form), they can be closed with laser, but only if they are not in the central part of the macula (extrafoveal) and if they’re treated early on. Maculopathy laser therapy is useful to close anastomosis (feeder vessel), that is responsible for RAP (retinal angiomatous proliferation).

Today, new kind of lasers for maculopathy are available: these are definitely safer and more effective if compared to the old ones. Among these, we highlight the new yellow laser for curing maculopathy.
Dr. Badalà uses this maculopathy treatment in Milan. The cure for exudative maculopathy has completely changed after the introduction of the Bevacizumab.

Bevacizumab and Ranibizumab are active substance used for treating exudative maculopathy with great success. These medications can stop the disease’s development and, in some cases, even improve vision, They are injected inside the eye so that they can stop neovessels growth: this is typical of exudative maculopathy. Injection is performed as an outpatient treatment in a few minutes; anyway, this process is performed in the operatory room in order to guarantee sterility.

More than one injections is needed in a timespan of 1 to 3 months, until vision quality settles.
The current therapeutic orientation consists in perform a cycle of 3 injections (loading phase) and then intervene again only in case of loss of vision or new liquid presence when performing OCT and angiography exams. Maculopathy therapy with Bevacizumab and Ranibizumab should be followed with extreme caution by heart patients. There is also a risk linked to intravitreal injection that is infection (endophthalmitis, about 1.5%).

Photodynamic maculopathy therapy has been the first exudative maculopathy treatment to be proven effective. It is used to treat exudative maculopathy. A substance that makes the patient photosensitive is injected endovenously; this accumulates in the vessels (verteporfin). Then a non-thermal laser is applied.

It is necessary not to be exposed to light for the next 3 days after treatment. This laser is suggested especially for maculopathies of patients with myopia, and/or combined with antiangiogenic therapy (Bevacizumab, Ranibizumab).

There is a huge research for maculopathy. Even stem cells have been tried for maculopathy, with no success yet. Researchers are studying INTEGRINE antagonists, and, through nanotechnologic platforms, cellular systems able to release intraocular medications (microimplants).

Slow release medications are currently at study, in order to avoid repeating injections inside the eye every month.

For treating exudative maculopathy linked with retinal venous thrombosis there’s a great solution: a cortison implant that stays inside the eye for 3 months (Desametasone).

It seems to be useful also for treating diabetic maculopathy. all these therapies can be combined among each other. For dry senile maculopathy, cure is based upon slowing down an additional retinal degeneration with specific precautions and nutritive helpers (scientific data suggest a diminished retinal deterioration).

• Use sunglasses able to cut wavelenghts that are less than 500nm, that is a part of the visible blue and all ultraviolet radiations (A and B).
• Avoid situations that could promote retinal bleeding, like smoking, rubbing the eyes and anticoagulants or ematic fluidizers (if truly necessary, use the minimum dosage).
• Vitamin supplements: vitamin C, vitamin E, selenium, zinc.
• Foods with antioxidants, carotenoids and polyunsaturated fat acids like cabbage, carrots, all green vegetables.

Not to take in case of:

• Kidney stones (high vitamin C dosage can precipitate stones)
• Diabetes (vitamin E and selenium can increase infections and vitamin C in high dosage could interfere with glycemia dosage)
• Gout, arteriosclerosis (vitamin C can interfere with concentrations of uric acid and cholesterol dosages)
• Scheduled test to look for blood in urine or feces (could result in a false positive)
• Coagulation anomalies (vitamin E could alter vitamin K, increasing anticoagulants effects)
• Anemia

For both senile exudative maculopathy and dry maculopathy, when retinal degeneration is evolved, it is still possible to do something. Today, there are several helpers like video enlargers and prismatic glasses, that, by greatly enlarging images or deviating light rays to the healthy retina portion, can improve vision.
There are also special maculopathy glasses with an orange filter that improve contrast sensitivity.

We’d like to highlight also the possibility of implanting inside the eye a system of lenses that by greatly enlarging images, can improve vision (IOL Vip – OriLens). A specialized maculopathy center will suggest you the best solution for you case.