CLINICAL SERVICES - VITREO-RETINA
OUR CLINICAL SERVICES : WHAT WE DO
The Surgical VR team treats common conditions such as retinal tears and detachments, advanced diabetic eye disease, vitreous haemorrhage, giant retinal tears, macular holes, macular puckers, vitreomacular traction, myopic foveoschisis, trauma, proliferative vitreoretinopathy.
The various surgical procedures which are done include lasers, pneumoretinopexy, scleral buckling and vitrectomies. The vitreoretinal operating theaters are equipped with equipment to perform scleral buckling surgery, vitrectomies and lensectomies. We have wide-angle viewing systems such as the BIOM lens systems which are mounted on the Zeiss microscopes, ROLS system with the mini-quad lenses and the Topcon OFFISS microscope. Standard 20G as well as small incision sutureless 23 and 25G vitrectomies are frequently performed.
All vitreoretinal operations performed at the Singapore National Eye Centre is audited. Of particular note, the success rates of retinal detachment surgeries are analysed every year. There are 2 main methods of retinal detachment repair – scleral buckling (an external approach) and trans pars plana vitrectomy, TPPV (an internal approach). Over the past years, we have had anatomical success of 94.3 to 98.2% at 6 months follow up, with 88.4 to 91.6% success after only one operation. Our surgical results are comparable, if not better, with the international tertiary eye centres experiences.
The medical retina team manages the many conditions affecting the retina that do not require surgery. Instead these are often treated with other means including laser and injections. Age-related macular degeneration (AMD) including choroidal neovascularisation (CNV) and polypoidal choroidal vasculopathy (PCV), diabetic retinopathy, retinal vascular disease (including retinal vein occlusion and retinal artery occlusion) and central serous chorioretinopathy are some of the more common conditions in this category. Our medical retina service has extensive experience in managing these conditions.
Full-range of treatments for these conditions are available, including out-patient based anti-vascular endothelial growth factor intravitreal injections (including Lucentis, Macugen and Avastin), photodynamic therapy (PDT) with verteporfin (Visudyne), argon laser photocoagulation and steroid injections.
Our Laser Centre on the third storey of the Centre is equipped with five (5) retinal laser machines, including the PASCAL multi-spot laser.
In addition to treatment for the eye condition, medical retina conditions may often be manifestations of conditions affecting the rest of the body, such as hypertension, high cholesterol, heart problems and diabetes. Our doctors have a good understating of such diseases and will coordinate the necessary investigations and systemic follow-up.
The ophthalmic imaging department is run by four imaging specialists. We have a range of equipment to assess various vitreoretinal conditions. Our capabilities include retinal colour and autofluorescence photography, fluorescein and indocyanine green angiography (both static as well as on the Heidleberg Angiography system (HRA)), and spectral domain optical coherence tomography (SD-OCT) which includes high-resolution as well as 3D OCT (Zeiss Cirrus, Topcon 3D OCT & Heidleberg Spectralis).
3D OCT Image of a patient
with Vitreomacular Traction
2D OCT Image of a patient
with Macular Hole
Electrophysiology is the department which measures the functional aspect of the retina and optic nerve. These sophisticated tests can study in detail how well very specific aspects of vision are working, such as night vision (rod photoreceptor system), central vision (cone photoreceptor system) and optic nerve (ganglion cells). These tests are particularly valuable in diagnosing hereditary retinal diseases, monitoring certain types of medicine-related toxicity (e.g., hydroxychloroquine, ethambutol) and where visual loss cannot be explained by clinical examination findings. Our department is equipped with the specialised machines for performing full filed electroretinography (ERG), pattern electroretinography (PERG), multifocal electroretinography (mfERG), pattern and flash visual evoked potentials and multifocal visual evoked potentials (VEP). Furthermore, our lab is set up according to standards specified by the International Society for Clinical Electrophysiology of Vision (ISCEV). Our team of doctors have expertise in interpretation of tests and include members of ISCEV.
Please visit the following relevant links:
Outcome Results on Vitreo-Retina Procedure
Vitreo-Retina Clinical Staff
I Want an Eye Examination / an Appointment
SNEC Smartphone Apps for Patients
Read more on related Eye Conditions and Treatments:
Age-Related Macular Degeneration
Central Serous Chorioretinopathy
Epiretinal Membrane (Macular Pucker)
Floaters & Flashes
Retinal Vascular Disorders