vitrectomy – Dr Asif Khokhar https://engdrasif.trangolabs.com Senior Eye surgeon committed to professional excellence Tue, 19 Sep 2023 07:12:29 +0000 en-US hourly 1 https://wordpress.org/?v=6.5.3 https://engdrasif.trangolabs.com/wp-content/uploads/2023/09/cropped-LOGO2-1-32x32.png vitrectomy – Dr Asif Khokhar https://engdrasif.trangolabs.com 32 32 230074243 Retinal detachment https://engdrasif.trangolabs.com/retinal-detachment/ https://engdrasif.trangolabs.com/retinal-detachment/#respond Thu, 23 Sep 2021 15:50:47 +0000 https://www.drasifkhokhar.com/?p=3220

Retina is like a lamination on the inner surface of the eye. Small nerve fibers arise from throughout thr retina nad converge in the center at the point which is called optic disc. When we examine with different instruments, retina looks like the pictures below

The innermost layer seen in the picture is retina

Holes develop in the retina or sometimes some part of retina torns out. The holes and breaks appear as seen in following picture

When a part of retina tears out or a hole develops in some part, then fluid perculates and accumulates under the retina. That part of the retina bulges inwards as seen in the pictures

Detached retina and fluid appears as seen in this picture

When retina is detached, one method of reataching it is buckling. A silicon band is tied around the eye which presses from outside and compells the two layers of retina remain attached. The silicon band is seen as following after operation

The latest method for treatment of retinal detachment is vitrectomy operation. The fluid is drained out and the hole or break is welded by layer. This method is really a miracle. We should be thankfull to the reasearchers and Allah for this blessing to humanity. In the past This operation used to be very lenthy. Sometimes even 14 hours took one operation! bu now due to newer invenstions sometimes can be completed even less than a hour!

You can see how instruments work during vitrectomy operation

Laser is being applied during vitrectomy operation

I am performing vitrectomy operation by The Storz Company's Millinuim Vectrectomy Machine, Zeiss Company's Lumera Model Operation Microscope, and BIOM. This modern method requires neither general anesthesia nor stitching

I am performing vitrectomy operation by Oertli Company's Feros microsurgical system machine, Zeiss Company's Lumera Model Operation Microscope, BIOM. This modern method requires neither general anesthesia nor stitching.

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Laser treatment of retina https://engdrasif.trangolabs.com/laser-treatment-of-retina/ https://engdrasif.trangolabs.com/laser-treatment-of-retina/#respond Thu, 23 Sep 2021 07:01:55 +0000 https://www.drasifkhokhar.com/?p=3211

My dad has had diabetes for a long time. A few days ago, his vision suddenly deteriorated. When the doctor examined him, the doctor told that a blood vessels had ruptured. He has prescribed medicines. How does the vessel ruptures? Can the problem be treated with laser or surgery?

With the help of laser rays, the hole can be sealed-off, which stops the leakage and resoles the swelling. The laser is also applied to prevent the detachment of the retina. However, it is important not to delay the treatment by laser. Since most people start treatment too late, so the benefit is minimal.

Retina appearance when damaged by diabetese

In this retina has been severely damaged by diabetese

I am treating retina by laser

Retinal before laser treatment and after treatment

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Retinal Dteachment اردو https://engdrasif.trangolabs.com/retinal-dteachment/ https://engdrasif.trangolabs.com/retinal-dteachment/#respond Fri, 10 Jan 2020 09:31:12 +0000 https://www.drasifkhokhar.com/?p=1894

پردۂ بصارت آنکھ کے اندرونی سطح پر ایک لیمینیشن کی طرح موجود ہوتا ہے۔ اس کے اندر باریک اعصاب کا ایک جال ہوتا ہے جو ایک مرکزی جگہ پر آ کر مرکوز ہو جاتے ہیں۔ جہاں سارے اعصابی دھاگے اکٹھے ہو جاتے ہیں وہاں سے آپٹک نرو شروع ہو جاتی ہے۔ پردۂ بصارت کو مختلف آلات سے جب دیکھتے ہیں تو درج ذیل تصویر کی شکل میں نظر آتا ہے

درج ذیل تصویر میں نظر آنے والی اندرونی تہہ پردۂ بصادت ہے

پردۂ بصارت میں مختلف وجوھات کے نتیجے میں سوراخ ہو جاتے ہیں یا پردہ باقاعدہ پھٹ جاتا ہے۔ نیچے کی تصاویر میں مختلف مریضوں کی آنکھیں دکھائی گئی ہیں جن میں پردے میں ہونے والے سوراخ دکھائے گئے ہیں

جب پردے میں سوراخ بن جاتا ہے یا پردہ کسی جگہ سے جب پھٹ جاتا ہے تو وہاں سے پانی کی شکل کا مواد پردے کے نیچے چلا جاتا ہے جس سے اکھڑ کر ابھرنا شروع ہو جاتا ہے۔ درج ذیل کی تصاویر میں پردے کے مختیل حصّے اکھڑے ہوئے اور ابھرے ہوئے نظر آ رہے ہیں

الٹراساؤنڈ کی مدد سے جب معائنہ کرتے ہیں تو اکھڑا ہوا پردہ کیسے نظر آتا ہے وہ نیچے کی تصویر میں دکھایا گیا ہے

پردۂ بصارت جب اپنی جگہ سے اُکھڑ جاتا ہے تو اپریشن کر کے اُسے دوبارہ جوڑا جا سکتا ہے۔ اِس کیلئے مختلف طریقے اِستعمال کئے جاتے ہیں۔ ایک طریقہ تو یہ ہے کہ آنکھ کے گرد ایک سیلیکون کی پٹی مستقل طور پر باندھ دی جائے جو آنکھ کو باہر سے دبا کر رکھتی ہے جس سے دونوں پرتیں آپس میں جُڑ جاتی ہیں اور پھر مسلسل پریشر سے مسلسل جُڑی رہتی ہیں دوبارہ نہیں اُکھڑتیں۔ جیسا کہ ذیل کی تصویر میں نظر آ رہا ہے:

پردۂ بصارت جب اپنی جگہ سے اُکھڑ جاتا ہے تو اپریشن کر کے اُسے دوبارہ جوڑا جا سکتا ہے۔ اِس کیلئے مختلف طریقے اِستعمال کئے جاتے ہیں۔ ایک طریقہ تو یہ ہے کہ آنکھ کے گرد ایک سیلیکون کی پٹی مستقل طور پر باندھ دی جائے جو آنکھ کو باہر سے دبا کر رکھتی ہے جس سے دونوں پرتیں آپس میں جُڑ جاتی ہیں اور پھر مسلسل پریشر سے مسلسل جُڑی رہتی ہیں دوبارہ نہیں اُکھڑتیں۔ جیسا کہ ذیل کی تصویر میں نظر آ رہا ہے:

دوسرا انتہائی جدید اوزارا اور مشینیں استعمال کرکے خرابی کے سبب کو دار کرنے کے بعد محلول کو نکال کر سوراخ یا پھٹنے کی جگہ کو لیزر کے زریعے ویلڈ کردینے کا طریقہ ہے۔ اِس طریقے کا نام ویٹریکٹومی Vitrectomy اپریشن ہے۔

اپریشن کا یہ طریقہ آج کے دور کی دریافتوں میں سے ایک ایسی دریافت ہے جس پر ا للہ تعالی کا بھی شکرگذار ہونا چاہئے اور اُن محقیقن کا بھی جن کی محنتوں کے نتیجے میں یہ نعمت انسان کے علم میں آئی اور مسلسل ترقی کر رہی ہے۔ یہ طریقۂ علاج ایک عظیم نعمت ہے ۔ کسی زمانے میں اِس اپریشن پر دس دس گھنٹے صرف ہو جایا کرتے تھے لیکن اب وہی کام بعض اوقات صرف ایک گھنٹے میں اُس سے بہتر معیار کے ساتھ ہو جاتا ہے۔ پھر کسی قسم کے ٹانکے بھی نہیں لگانے پڑتے اور نہ ہی مریض کو بیہوش کرنا پڑتا علاوہ ازیں بینائی بھی صرف چند دنوں میں بحال ہو جاتی ہے۔ ذیل کی تصاویر میں اس اپریشن کے مناظر دکھائے گئے ہیں:

ویٹریکٹومی آپریشن کے دوران اوزار کیسے استعمال ہوتے ہیں آپ اس تصویر میں دیکھ سکتے ہیں

دوران آپریشن ریٹینا کو لیزر لگائی جا رہی ہے

میں ویٹریکٹومی آپریشن کر رہا ہوں Storz کمپنی کی Millinuimوٹریکٹومی مشین، Zeiss کمپنی کی Lumera ماڈل اپریشن مائیکروسکوپ اور BIOM استعمال کرتے ہوئے۔ اس جدید طریقے میں نہ ٹیکا لگانے کی ضرورت ہوتی ہے اور نہ ٹانکے لگانے کی۔

میں ویٹریکٹومی آپریشن کر رہا ہوں Oertli کمپنی کی Feroz microsurgical system مشین، Zeiss کمپنی کی Lumera ماڈل اپریشن مائیکروسکوپ اور BIOM استعمال کرکے استعمال کرتے ہوئے۔ اس جدید طریقے میں نہ ٹیکا لگانے کی ضرورت ہوتی ہے اور نہ ٹانکے لگانے کی۔

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How is retinal defects are treated? https://engdrasif.trangolabs.com/how-is-retinal-defects-are-treated/ https://engdrasif.trangolabs.com/how-is-retinal-defects-are-treated/#respond Tue, 07 Jan 2020 05:50:57 +0000 https://www.drasifkhokhar.com/?p=1647

Does the operation of retina is successful? People are warning us. We are also afraid that the operation of the retina will not be beneficial and the vision will be completely lost. It is heard all over that the retinal disease is incurable?

The problem of retinal impairments is very important in Pakistan. The main reason for this is that there are very few places for its treatment, and there are very few doctors trained to treat it. As a result, people develop a frustrated and carefless attitude towards treatment of retinal disorders, so the disease goes on progressing to final stages of the disease. When the treatment is approached till that time the disease may has become incurable. In fact, the delay in initiating treatment makes the cure uncertain. However, there are some disorders that cannot be cured, although even in many of such cases it is possible to at least reduce the amount of disability.

With the emergence of innovative methods of treatment, about 90% of patients can now be treated successfully, but many of them have to undergo a second or third operation. It is extremely difficult to predict about the prognosis in those who have come late for treatment.

How is retinal disorder treated? Will retina become OK with intravitreal injections?

In fact, treatment can only be done if the cause of the illness is treatable. In many patients it is not possible to cure the cause of the disease. Many patients do not start treatment on time, they start very late so the condition becomes untreatable.

There are many different ways to treat the diseases of the retina. The key methods are mentioned below:

  1. Various types of medicines that are used orally or in the form of drops.
  2. Some medicines are given in the form of injections. These injections are given into the vitreous. The injected medicines reach internal layers. Some injections are given under the superficial membranes of the eye called conjunctiva and Tenon’s capsule.
  3. Laser are very important and useful method of retinal treatment.
  4. Some operations are performed:
    1. To weld the retinal holes.
    2. To clear the opaque vitreous.
    3. To inject silicon oil.
    4. To tie silicone bands around the eye and stitched to the eye, so that the retina may not detach again.
  5. The most important operation is vitrectomy operation. In this operation the membranes are peeled away, and blood is cleared, and laser is applied where necessary.

?Does retina heals with laser? Can retina be re-attached with laser

Laser is used to seal the hole. When the leakage stops, the swelling resolves. The laser is also applied to prevent the tearing of the retina. This prevents te detachment of retina.

Laser application can prevent the detachment but can’t reattach a detached retina!

I am performing laser procedure on the retina to seal a retinal break so that detachment can be prevented

Diabetic retina after application of laser

How is vitrectomy performed? Why this operation so much costly?

Vitrectomy operation is performed to for many puposes. Very important is to reattach the retina is by welding the holes or breaks with laser after removing the subretinal fluid. This is done by using highly sophisticated tools and machines.

This method of operation is one of the most precious discoveries of today. We should be thankful to Allah, and also to those researchers whose hard work has resulted in the blessing for human being. The technology is constantly evolving. This treatment is a great blessing. At one time, the operation-time used to be many hours, but now the same thing is sometimes done with better quality in less than one hour. No stitches are required; no anesthesia is needed, the retinal function is restored within a few days.

Major problem with this operation is that this is very costly. The reason is the heavy costs of machines, very costly disposable parts of the machines, due to heavy investments operation theater charges are very high, and last but not least that the maintenance of the machines is very much demanding and the models of the machines are frequently improving compelling to upgrade!

This is silicon band which we fix with the eye on outer surface. It presses the eye from outside so that the retina may not detach

You can see how a torn piece reathaches. inner view is also shown

You can see how instruments work during vitrectomy operation

It has been shown that clotted blood is being extracted by inserting various tools inside the eye.

Take a closer look at how tools are being used in a real operation:

In the first phase of operation, laser is being applied to the edges of the break in retina after cleaning the vitreous.

Laser is being applied during vitrectomy operation

I am performing vitrectomy operation by Alcone's Constellation Vectrectomy Machine, Zeiss Company's Lumera Model Operation Microscope, and BIOM. This modern method requires neither general anesthesia nor stitching.

I am performing vitrectomy operation by The Storz Company's Millinuim Vectrectomy Machine, Zeiss Company's Lumera Model Operation Microscope, and BIOM. This modern method requires neither general anesthesia nor stitching.

I am performing vitrectomy operation by Oertli Company's Feros microsurgical system machine, Zeiss Company's Lumera Model Operation Microscope, BIOM. This modern method requires neither general anesthesia nor stitching.

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