Featured Speaker

Dr. Michael Kapusta

MD, FRCSC Ophthalmologist Montreal, QC

Dr. Michael Kapusta, MD, FRSCS, Ophthalmologist, talks about advanced (proliferative) diabetic retinopathy and pars plana vitrectomy as a treatment option.

BIO: Diabetes Now

Dr. Michael Kapusta is a manuscript reviewer for the Journal of Ophthalmic Practice (Montreal), the Canadian Journal of Ophthalmology (Ottawa) and Comprehensive Ophthalmology Update (Boston), as well as authoring or co-authoring many peer-reviewed articles. He has also delivered numerous lectures at international conferences and symposiums

Dr. Michael Kapusta completed his medical degree and his residency in ophthalmology at McGill University. He then completed a two-year subspecialty program in retinal diseases and vitreoretinal surgery at the prestigious Doheny Eye Institute of the University of Southern California. He is a member of numerous well recognized associations, including the Association des médecins ophthalmologists du Québec, the Canadian Ophthalmological Society and the American Academy of Ophthalmology.

Back in Montreal, Dr. Kapusta was appointed Head of the Ophthalmology Department of the Jewish General Hospital, where he set up the retina surgery unit and a subspecialty program at McGill University. Since this program’s creation, Dr. Kapusta has trained and supervised 14 ophthalmologists from various countries to become retina surgery specialists.

Dr. Kapusta has for the past three years sat on the Board of Directors of the Association des médecins ophtalmologistes du Québec. He also serves as Director of the Retina Surgery Unit of McGill University. He has delivered numerous lectures across Canada and abroad within the framework of international meetings on the retina and its diseases.

Dr. Kapusta joined the Eye Institute of the Laurentians in January 2012. He enjoys an active and happy family life with his spouse, a pediatric emergency physician, and their four young children.

( Dr. Michael Kapusta, Ophthalmologist, Montreal, QC ) is in good standing with the College of Physicians and Surgeons. Now Health Network

What is Advanced (Proliferative) Diabetic Retinopathy and Pars Plana Vitrectomy?

Diabetic patients may experience two forms of retinopathy. One is called background, the other proliferative. Background retinopathy has changes in the retina that include swelling of the retina, or diabetic macular edema.

Proliferative diabetic retinopathy may have growth of blood vessels, which can bleed in the eye, or pull on the retina and detach the retina. Diabetic retinopathy that’s called proliferative, where there’s bleeding or pulling on the retina, may require the consultation with a vitreoretinal surgeon.

Advanced diabetic retinopathy or proliferative diabetic retinopathy can be associated with hemorrhage and traction on the retina. If these situations cannot be controlled with injections of drugs such as anti-VEGF medication or laser photocoagulation, they may require an intervention called pars plana vitrectomy.

Your ophthalmologist or retina specialist may send you for an opinion of a vitreoretinal surgeon to determine whether your disease state has reached a point that you would benefit from pars plana vitrectomy to maintain or stabilize your vision in diabetic retinopathy.

Pars plana vitrectomy is typically performed under a local – but sometimes under general anesthesia. The surgeon will enter the eye with a cutting device to remove the blood, and sometimes with a cutting device or scissors, to remove traction that is pulling on your retina.

The recovery from diabetic vitrectomy is longer than vitrectomies for other conditions. Diabetics are operated on because there’s blood or traction in their eye. Even after the operation, there may be recurrent bleeding, which can last days to weeks, and the need for restricted head position.

One should not expect a rapid improvement of vision after diabetic vitrectomy. The goal of this operation is to improve the prognosis in the long run, and to stabilize diabetic retinopathy. It is not usually an immediate recovery of central or peripheral vision.

The improvements in the technology for pars plana vitrectomy in patients who have diabetic retinopathy have offered better outcomes. That said, the ultimate improvement of vision will rely and depend upon the underlying state of the diabetic retinopathy. So that is if a patient has significant poor circulation, the vitrectomy will improve part of their vision but not everything.

Your doctor will be the best person to determine how much vision improvement can be gained by pars plana vitrectomy in your case. By following the suggestions of your surgeon, and maintaining particular head position in the aftermath of pars plana vitrectomy, you can improve the chances of improving your vision after a diabetic vitrectomy.

If you have had bleeding in your eye, or your doctor has noted progressive growth of blood vessels and traction, you may be best served by having the opinion of a vitreoretinal surgeon to determine whether or not your condition has reached the point of requiring pars plana vitrectomy.

Presenter: Dr. Michael Kapusta, Ophthalmologist, Montreal, QC

Local Practitioners: Ophthalmologist

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