Microincision phacoemulsification cataract surgery is usually performed under topical anaesthesia, but an anaesthetist is always present during surgery. Cataract surgery procedures are performed at the Wellington Hospital as well as Holly House and Spire London East Hospital. Please click on this link for post-operative instructions and general advice after phacoemulsification cataract surgery.
Vitreoretinal surgery is performed at the Wellington Hospital. Most cases are performed as a day case, in particular if surgery is performed in the morning, however an overnight stay is possible, in particular if a patient does not live locally. Surgery is usually performed under local anaesthesia with mild sedation if the latter considered necessary. Mr. Zambarakji works with a skilled and caring team of Nurses and Consultant Anaesthetist who will attend to your needs and ensure you have a satisfying experience. Some patients will be asked to posture after vitrectomy surgery. Please click on the link for post-operative instructions and general advice following vitrectomy surgery. We recommend hiring a posturing device for two weeks following surgery if your consultant has recommended post operative face down posturing. Please click on the link to facedownsupporthire.com. Alternatively, a selection of smaller face down pillows can be purchased from amazon.co.uk.
For patients undergoing any form of ophthalmic surgery as a day case, please click on the link for general advice about driving, clothing, medications etc.
Intravitreal therapy is administered for the treatment of macular degeneration, diabetic retinopathy and retinal vascular venous occlusions. There are different ways of delivering drugs to the retina, a summary can be found in a short article I have written for the winter 2014 edition of the Holly House Hospital GP newsletter, this can be accessed on page 8 of the GP newsletter. More recently, a new treatment for symptomatic vitreomacular attachment (VMA) and small macular holes has been developed; this is based on the administration of a vitreolytic enzyme called Ocriplasmin (Jetrea) by an intravitreal injection. Various intravitreal medications can be delivered depending on the condition being treated. These include anti-VEGF agents including Ranibizumab (Lucentis), Bevacizumab (Avastin), as well as Aflibercept (Eylea). Other intravitreal agents include 2 steroid implants: the dexamethasone implant (Ozurdex) with a lasting efficacy of 4 months and the longer acting Fluocinolone implant (Iluvien) with a lasting efficacy of 36 months. Please click on this link for brief details about intravitreal anti-VEGF treatments for age related macular degeneration (Lucentis, Avastin and Eylea). Information about intravitreal therapy for diabetic macular oedema can be obtained by clicking on the diabetic macular oedema link. Patients who have received an intravitreal injection should be aware of the possible risks of intravitreal therapy. Dos and don’ts after intravitreal injections can be accessed here.