Is macular hole surgery a medical emegency?

Written by: Mr Hadi Zambarakji
Edited by: Conor Lynch

Top Doctors recently had the pleasure to speak with distinguished London-based consultant ophthalmologist, Mr Hadi Zambarakji, who, here in our latest article, details what exactly the macular is and why it is so essential, whilst also describing how macular hole surgery is typically performed.

What is the macular, and why is it so important?

The macula is the part of the retina which gives central vision, colour vision, and detailed central vision. Therefore, any pathology affecting the macula will result in deteriorating vision, distorted vision, and in some cases, retinal detachment, which leads to very poor vision.


What does macular surgery entail and what does it treat?

Vitrectomy (removal of the vitreous) is the first step. This is followed by a macular procedure which usually involves peeling of the offending membrane on the surface of the macula (in case of an epiretinal membrane or macular hole) or injection of sub-retinal TPA (tissue plasminogen activator) for the management of a sub-macular haemorrhage


Is macular surgery an emergency?

No, it is not an emergency, but, for macular holes, I personally prefer to operate within four weeks.


What is the success rate of macular hole surgery?

Macular hole closure for small macular holes is very high (97 per cent). The larger macular holes and those of a very long-standing duration have lower success rates (80 to 95 per cent).


How long does it take to recover from macular surgery?

With small incision surgery, recovery is fairly quick, and the visual recovery is fairly rapid, unless gas is used as a tamponade agent at the time of surgery, in which case you would need to wait for the gas to reabsorb.


Mr Hadi Zambarakji is a well-regarded and highly experienced consultant ophthalmologist. Consult with him today via his Top Doctors profile

By Mr Hadi Zambarakji

Mr Hadi Zambarakji is a highly-skilled consultant ophthalmic surgeon with a subspecialist interest in vitreoretinal and cataract surgery. He assists private patients at four highly regarded clinics across London and Essex. His private practice secretary is Miss Molly Mapp and he is assisted in clinic by Miss Rajinder Bharaj, Specialist Optometrist.

Mr. Zambarakji and his team are committed to providing a first class quality service and to ensuring that you are totally satisfied with the level of care they provide. With over 15 years' experience as a consultant, as well as a broad range of specialist skill, Mr Zambarakji provides a range of expertise in the fields of vitreoretinal and cataract surgery as well as medical retina. This includes but is not limited to, retinal detachment, macular holes, epiretinal membranes, vitreomacular traction, and advanced diabetic eye disease, as well as macular degeneration, retinal vein occlusion, and diabetic retinopathy.

Regarding cataract services, this includes premium lens implants (toric and multifocal/extended range) for greater independence from glasses. He was an early adopter of local anaesthesia for vitreoretinal surgery and performs most surgeries under local anaesthesia with sedation as day case.

Mr Zambarakji dedicates his career to patient care, but he also commits his time to medical research, which he has presented at national and international conferences. He has taken an active role in research throughout his training and continues to do so as a consultant. His research interests include imaging in retinal disorders, vitreomacular diseases and macular hole, diabetic macular oedema, investigational treatments for diabetic retinopathy and macular degeneration, complications of high myopia, and angiogenesis. A complete list of his research publications can be seen on PubMed.

He has taken up a number of additional roles including college tutor and regional advisor for The Royal College of Ophthalmologists, clinical governance lead for ophthalmology at Barts Heath, and examiner for the Royal College of Ophthalmologists. What's more, he is heavily involved in education and training and runs a busy vitreoretinal fellowship program at Whipps Cross University Hospital, Barts Health for future retina specialists.

You can view Mr Zambarakji's reviews on IWantGreatCare here.

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