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The Dedicated Ophthalmology Referral Practice |
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Post-operative |
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Post-operative retinal detachment is a serious sight-threatening complication of cataract surgery. Although it has a relatively low incidence, it can result in the affected patient becoming totally blind again, having had a period of good vision after the operation.
Naturally, this is particularly disappointing for all involved. Fortunately, there is now available the possibility of laser "spot welding" the retina in affected cases if caught in time. The particular wavelength of diode laser light is absorbed mainly by dark pigment.
Bursts of laser power can be used toproduce a line of spot adhesions, retina to underlying choroid, along the edge of a partial detachment to prevent progression to total detachment. An exciting approach, providing this group of high-risk patients can be identified, will be to carry out trans scleral retinal spot welding (retinopexy) under a general anaesthetic one month before the planned cataract surgery. The trans scleral route is possible as the white scleral tissue is non-pigmented so the laser power passes through as far as the retinal pigment epithelium. Spot temperatures of 2,000ūC are reached for a few milliseconds! These patients will then come to surgery with a much lower risk of post-operative total detachment. |
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An indirect ophthalmoscope is used to focus laser power through the pupil onto the retina to produce "spot welds". Laser absorbing protective goggles are worn by the nurse. |
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1. Technology and Microsurgery |
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