The ‘eyes’ have it: Retinal surgery sees major advances

Does the mere thought of someone making an incision into one of your eyeballs instantly make you uncomfortably squeamish?

Dr. Robert Reinauer of Vero Beach’s New Visions Eye Center says you’re far from alone. “Everybody,” he admits, “feels that way.”

Nonetheless, people suffering from retinal detachments, macular holes or macular puckers face a simple choice: Seek help or lose their sight.

The Mayo Clinic puts it bluntly. “Retinal detachment,” says the Rochester, Minn., institution, “is an emergency situation . . . you should always seek immediate medical attention.”

The retina is the light-sensitive layer of tissue in the eye. It sends signals through the optic nerve to the brain. When the retina detaches or is lifted or pulled away from its normal position, it’s a serious problem.

Symptoms of a detached retina, according to the National Eye Institute at the National Institutes of Health, “include a sudden or gradual increase in either the number of floaters, which are little ‘cobwebs’ or specks that float about in your field of vision and/or light flashes in the eye.”

Another symptom is the appearance of a “curtain over the field of vision.”

Aging often causes the retina to thin. That thinning according to the Mayo Clinic, can lead to pressure on and the eventual collapse or tearing of the retina.

In rudimentary laymen’s terms, fluid inside the vitreous (the jelly-like substance in the eye) finds its way through that tear and collects underneath the retina, peeling it away from the underlying tissues. Those tissues contain layers of tiny blood vessels and if that blood supply is lost, the entire vision process simply stops working.

Forever.

“The more birthdays you have,” explains Reinauer, “the more likely you are to have this (detached retina).”

Suddenly the thought of having an incision made in your eye to deal with a detached retina may not seem so outlandish.

In fact, when Reinauer starts talking about the latest “micro-surgical” techniques he uses to treat retinal detachments, macular holes, diabetic vitreous hemorrhages and other conditions, the procedures sound (almost) inviting.

“The first thing we do,” explains Reinauer, “is make sure the patient is relaxed. Then I do one injection. It’s called a retrobulbar injection and then they don’t feel anything,” for the rest of the procedure.

During that procedure, known as a vitrectomy, Reinauer makes a tiny incision in the white of the eye which, he says, “is less than a millimeter,” or about 1/25th of an inch. An inert gas is then injected to help re-position and re-attach the retina in its proper position. Better still, Reinauer continues, in most cases he doesn’t even need to use sutures.

Best of all, this 37-year-old specialist says, “Patients can pretty much go back to their normal activities day one or day two.”

Perhaps surprisingly, those “normal activities” can include driving.

Reinauer claims many of his surgical patients “can drive the next day because they always have the other eye . . . I have patients that drive themselves to the post-op appointments and drive home and the next day drive to their yoga classes.”

That’s a borderline shocking revelation because in previous incarnations of this type of surgery, patients needed to be positioned face-down for as long as six weeks after the operation and were often admitted to hospitals for recovery. Now it’s an outpatient procedure at New Visions.

“I’ve had many patients,” Reinauer recalls, “who’ve told me they had a surgeon five years ago – or even yesterday – tell them if they had this surgery they would have to be face down (for weeks).’ I tell them that with the techniques I use, we don’t need to do face down.”

Precision is the key, and yet, interestingly, there are no robotics involved.

Reinauer flatly states, “It’s too delicate to let a robot do. I think the big thing is that it’s so small and so delicate and you have such a small area you’re working in, you really can’t trust a robot to make the moves that we do.”

As if steady hands, an encyclopedic knowledge of the most current surgical techniques along with six years of post-graduate training and a residency at Detroit’s famed Kresge Eye Institute weren’t enough, Reinauer also boasts an especially rare trait for any specialist. Availability.

“I’m always available,” the soft-spoken Reinauer says. “I’ve seen patients on Friday nights; I’ve seen patients on Sunday mornings. I saw one gentleman on Christmas Eve and operated on him Christmas Day. For me it was the best Christmas gift ever. That guy has his vision now so I’m happy with that. It’s a blessing.”

Dr. Robert Reinauer is with New Vision Eye Center at 1055 37th Place in Vero. The phone is 772-257-8700.

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