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Silicone oil for retinal detachment

Vitrectomy is the most common operation done for retinal detachment. I usually inject a gas bubble like SF6 into the eye at the end of the operation. This gas bubble helps prevent the retina from coming off again and stays in the eye for 2 weeks. It will dissolve by itself naturally. When you have a gas bubble in the eye, you cannot fly in an airplane as the bubble can expand at high altitude and cause permanent damage to your eyesight.

You can travel by air with silicone oil in your eye

Recently, I had a few patients that had retinal detachment who needed to travel by airplane soon after surgery for work purposes. For these cases, instead of injecting gas into the eye, I injected a substance called silicone oil. Unlike gas, oil will not expand in the eye at high altitude. The main disadvantage of silicone oil in your eye is that you will require a second operation in 3 months time to remove the oil. Retinal specialists do not recommend leaving the oil in your eye permanently as your eye can develop glaucoma and cataract. With oil in the eye, you can usually have some vision immediately  after the operation. With gas in the eye, your vision will be very blurred until the gas bubble dissolves.

What is silicone oil?

It is a highly purified medical grade substance that floats and can stay in the eye for a long time without damaging the retina or other structures in the eye. There are several types available with different viscosities. There used to be many complications associated with silicone oil use in the past but this was due to impurities in the oil. With more modern silicone oils now, these complications are less. Among the complications are glaucoma, cataract, and, inflammation in the eye. All these can usually be treated by removal of the oil. There is a small risk of the retina redetaching after the oil is removed.

I am now on the way home from Shanghai after a regional eye meeting on cataract surgery. It will be nice to be back in Malaysia to see my friends and family. Have a great week ahead, my dear readers.

Cataract Surgery

What is a cataract?

A cataract is clouding of the lens in your eye. This is usually due to old age but can also occur due to trauma, diabetes, or due to medications.

Cataract surgery is done when the lens in your eye has become cloudy making it difficult for you to see well enough to carry out your usual daily activities. If the cataract is not removed, your vision may stay the same, but it will probably gradually get worse. Waiting for a longer period of time may make the operation more difficult. If you are considering surgery, please let the doctor know if you are taking the following medications: Flomax (Tamsulosin), Doxazosin, Asprin, or any blood thinning drugs like Warfarin, Plavix or Ticlid (Dipyradimole). These medications may need to be stopped before surgery.

You can listen to Dr Fong talking about cataract surgery.

Phacoemulsification surgery

The purpose of the operation is to replace the cataract with a plastic lens (implant) inside your eye. This usually done under local anesthesia. With a local anaesthetic you will be awake during the operation. You will not be able to see what is happening, but you will be aware of a bright light...

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