Understanding Surgical Ophthalmology
Ophthalmology is the study of the structure and function of the eye. Surgical ophthalmology describes the surgical treatments to help patients who have such eye conditions and diseases as cataracts, glaucoma, cancer, vision errors, cornea diseases and strabismus, in which the eyes are not aligned with each other.
Surgical ophthalmologists also have special expertise in surgically treating diseases of the eyelid and eye socket, vitreo-retinal diseases and neuro-ophthalmological disorders.
WellStar Health System, through its Surgical Services programs at four of its hospitals, offers a comprehensive range of inpatient and outpatient ophthalmic services that covers any issues with the eyes.
WellStar Cobb Hospital, WellStar Douglas Hospital, WellStar Kennestone Hospital and WellStar Windy Hill Hospital partner with skilled surgeons using the most advanced equipment and techniques in modern surgical facilities. These surgeons perform more than 42,000 surgeries each year. For information, call 770-956-STAR (7827).
Because of the fragility of the eye, extreme care is essential before, during and after the surgical procedure.
Anesthesia is required for all eye surgeries, although local anesthesia is most commonly used. Regional anesthetic nerve blocks such as a retrobulbar or peripulbar also may be used around the eye muscle cone to immobilize the extraocular muscles to eliminate the sensation of pain. Children typically undergo general anesthesia.
Recovery and rest is also of the utmost importance in order for the eye to recover fully from any surgical procedure.
Cataract surgery is the most common surgical procedure involving the eye. A cataract is the cloudiness of the eye’s lens due to aging, disease or trauma and typically blocks light, preventing it from forming a clear image on the retina. Most cataract surgeries involve the removal of the cataract.
For the most common surgical procedure for cataracts — phacoemulsification — the surgeon uses an operating microscope and precision tools to make a tiny incision in the surface of the eye in or around the cornea. A thin ultrasound probe is inserted into the eye to create vibrations to dissolve or phacoemulsify the clouded lens. The fragmented pieces are then suctioned out.
Once the cataract is removed, an artificial lens is inserted into the eye to replace the spot the cataract once occupied.
Glaucoma describes a group of diseases affecting the optic nerve that results in vision loss and often comes with a considerable rise in intraocular pressure. All glaucoma surgeries are designed to reduce this internal eye pressure either with laser treatment or an incision in the eye.
Surgeons typically recommend laser surgery as a first surgical treatment unless the eye pressure is extremely high or the optic nerve is damaged. During this procedure, a tiny but powerful beam of light is used to make several small scars in the eye’s drainage system to increase the flow of fluid outside of the eye.
For filtering microsurgery, the surgeon creates a tiny drainage hole with a precision tool. For a procedure called canaloplasty, the surgeon makes a tiny incision to gain access to a canal in the eye and then threads a microcatheter through the canal to enlarge the drainage channel. By opening the canal, the pressure in the eye can be reduced.
Refractive surgery describes any surgical procedure designed to improve the refractive state of the eye and decrease or eliminate the need for corrective lenses. The procedures may involve the reshaping of the cornea surface with the use of lasers or precision surgical tools.
Corneal transplantation describes a procedure where a damaged or diseased cornea is replaced with donated corneal tissue. During the most common type of transplant — penetrating keratoplasty — the surgeon cuts through the damaged or diseased cornea to remove a button-sized disc of tissue. The donor cornea is cut to fit and placed in the opening. The surgeon uses an exceptionally fine thread to stitch the new cornea in place. The stitches will be removed at a later visit. Partial tissue transplants may often be recommended procedures in lieu of transplanting an entire SpotBodyGreen cornea.
Vitreo-retinal surgery is completed to treat disorders related to the retina, vitreous and macula. Such conditions include retinal detachment, macular degeneration, diabetic retinopathy and uveitis.
Eye Muscle Surgery:
Eye muscle surgery, or extraocular muscle surgery, stands as the third most common eye surgery behind treatments for cataracts and glaucoma. This surgery most commonly treats strabismus, a condition in which the eyes are not properly aligned together, and may involve loosening or weakening the muscles or tightening and strengthening the muscles
Oculoplastic surgery describes any surgical procedure that deals with the reconstruction of the eye and related structures such as the eyelids, tear ducts and the eye socket.