Guide to Macular Degeneration Surgery

November 29th, 2020

If you’ve been diagnosed with age-related macular degeneration, you might not be aware that managing the disease may, at some point, involve surgery. While this chronic eye condition is usually treated with macular degeneration supplements, vitamins or medications, in rare cases, macular degeneration surgery may be necessary. Keep reading to learn more about macular degeneration laser surgery and what to expect before and after your procedure.

What Is Age-Related Macular Degeneration?

Macular degeneration affects the portion of the eye (the macula) that helps us focus on things like faces or television screens. The macula is a thin layer of tissue toward the back of the eye that sends images we see to the brain via the optic nerve. Occasionally the macula will deteriorate and stop working, causing central vision loss, also known as age-related macular degeneration (AMD). In terms of the types of age-related macular degeneration, there are two: wet AMD and dry AMD.

  • Dry AMD is when small deposits of drusen (cell debris) appear between the retina’s layers. When it accumulates, drusen can split the macular layers and cause them to become dry and thin. This can result in mild to significant vision loss. Dry AMD makes up about 90 percent of AMD cases and can sometimes progress to wet AMD.
  • Wet AMD is when new, abnormal blood vessels grow behind the retina and begin to leak. As blood and other fluids seep into the retina, the macula will bulge and stop working. Most AMD-related vision loss is the result of wet AMD. This type makes up about 10 percent of AMD cases.

How Long Does It Take to Lose Vision with Macular Degeneration?

In general, it takes about 10 years to go from diagnosis to legal blindness, but cases can vary. There are typically three phases of AMD: early, intermediate and late. There are no real vision issues in the early stages, though your doctor may advise you to make some lifestyle changes to prevent the disorder from progressing. It is during the intermediate stage when you might begin to experience issues with your central vision. Your doctor may ask you to start taking a daily vitamin for macular degeneration to slow the progression. During the late stage, you may have difficulty seeing things clearly. Based on your case, your doctor might advise you to work with an occupational therapist.

People with AMD often ask, “When is surgery required for macular degeneration?” Macular degeneration surgery may be used to treat some kinds of late-stage, wet AMD.

What Is Macular Degeneration Surgery?

Laser surgery for macular degeneration is a medical treatment used to seal the leaking blood vessels caused by wet AMD. This surgery can help to slow down the loss of the central vision.

There are two types of wet AMD surgeries: laser photocoagulation and photodynamic therapy.

  • Laser photocoagulation is a procedure that uses a thermal (hot) laser on the bleeding vessel in the back of the eye to burn and then seal it. While this can cause a small blind spot in your vision, most people learn to ignore it. This procedure is used in very rare cases.
  • Another type of wet macular degeneration surgery is called photodynamic therapy (PDT). Also used to close off leaky blood vessels, this procedure utilizes an infrared (cold) laser to activate an intravenous medication. This type of surgery also comes with a small risk of cell loss in the treated area. While also rare, this procedure is slightly more common than laser photocoagulation.

Note that for those with dry AMD, there is a macular degeneration surgery available for certain cases of geographic atrophy. With dry macular degeneration surgery, the doctor will remove the eye’s natural lens and implant an FDA-approved, pea-sized telescope behind the eye’s iris. This will enable the patient to use their central vision in the affected eye to better see close-up images. Side effects after surgery may include decreased peripheral vision, double vision, infection and/or swelling of the cornea.

What Are the Risks Associated with Laser Surgery for Macular Degeneration?

As we’ve mentioned, there are some risks associated with wet macular degeneration surgery. Your healthcare provider should thoroughly explain to you the procedure and any risks that may be involved. Possible risks include:

  • Return of blood vessels following treatment
  • Permanent blind spot
  • Loss of vision

Every medical procedure or treatment comes with risks. Be sure to talk with your doctor about any questions or concerns you may have.

How to Prepare for Macular Degeneration Laser Surgery

To prepare for your macular degeneration laser surgery, you’ll want to plan ahead and heed any instructions your doctor gives you.

  • Plan for a ride home from a friend or family member following your procedure. If you’ll need at-home care afterward, be sure to arrange that prior to your surgery.
  • Be sure to tell your doctor about any and all medications and supplements you take on a regular basis. Some you may not be able to take on the day of your procedure.
  • On the day of your surgery, avoid wearing eye makeup, cologne or perfume.
  • Ask any and all questions before the procedure, so you fully understand what your doctor is going to do, as well as the risks associated with the surgery.

What to Expect When Undergoing Eye Surgery for Macular Degeneration

During your eye surgery for macular degeneration, your doctor will start by dilating your pupil with eye drops. Then, they will put in drops to numb your eye and may even give you a shot around or behind the eye to numb it even more. At this point in a laser photocoagulation procedure, the doctor will aim a thermal laser at the blood vessels to seal them so they no longer leak fluid behind the retina. If you’re getting a PDT procedure done, the doctor will instead inject a medicine that reacts to light into your bloodstream. Once this medicine reaches the retina, an infrared laser will be used to activate the medicine and close the leaking blood vessels. This procedure might need to be repeated three or more months later.

What to Expect Following Macular Degeneration Surgery

Following your procedure, you’ll be permitted to go home. You’ll want to have someone drive you home and assist you, as your vision may be poor for a few hours following the surgery. If you had infrared (cold) laser treatment, your doctor might advise that you avoid sunlight for a few days as your skin may be sensitive to the sunlight. If you received a shot, you may need to wear a patch over your eye for a few hours. Be sure to ask your doctor about your recovery period, what activities you should avoid, aftercare instructions and symptoms to watch out for. It’s also important to schedule a post-surgery checkup.

How to Prevent Macular Degeneration

AMD often occurs after the age of 60. It’s also more common in women and Caucasians. It’s important for at-risk patients to get regular eye exams and macular degeneration tests. In addition to regular eye exams, there are some ways to slow and possibly even prevent AMD. The following are just a few healthy habits you can start doing now to help prevent macular degeneration.

  • Know and understand your family health history
  • Quit smoking
  • Eat your leafy greens
  • Wear sunglasses or protective eyewear to protect against harmful exposure to UV and blue light
  • Maintain a healthy weight and blood pressure
  • Check your vision daily using an Amsler grid
  • Take macular degeneration supplements

Slow the Progression of Your AMD with the Help of Focus Labs

At Focus Labs, our top priority is providing safe and innovative products that help support eye health and improve quality of life. While our macular degeneration supplements cannot treat or cure AMD, they can help to decrease your risk of getting more severe forms of AMD and slow the progression of the disease. Have questions about macular degeneration or need additional information regarding our line of eye care products? Reach out — our team of experts is here to help.

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