Optic nerve atrophy (ONA) is an irreversible progressive condition leading to significant visual acuity decline, visual field narrowing, and sometimes blindness. Timely treatment is crucial to halt further deterioration of visual function and potentially achieve some improvement. While most patients receive conservative therapy, including neuroprotection, antioxidants, antihypoxants, and anti-inflammatory medications, in rare cases optic nerve atrophy surgery may be necessary. Given the delicate nature of optic nerve tissue and its limited capacity for regeneration, surgical intervention requires exceptional precision and expertise from highly specialized ophthalmology teams using advanced microsurgical techniques. Let’s explore the surgical interventions available for this condition.
Glaucoma-Related Surgical Interventions
Glaucoma represents the most common cause of optic nerve atrophy. This group of diseases is characterized by chronic elevation of intraocular pressure. While eye drops can help control pressure, long-term reduction requires laser procedures and surgical techniques aimed at restoring aqueous humor outflow. The choice of surgical intervention depends on the type, cause, and mechanism of glaucoma development.
Modern ophthalmology centers offer various surgical approaches for glaucoma treatment, from non-penetrating deep sclerectomy to drainage tube implantation. Advanced techniques such as transscleral micropulse cyclocoagulation and selective laser trabeculoplasty provide innovative solutions for pressure management and nerve preservation.
Non-Glaucomatous ONA Surgery
In both ophthalmology and neurology, ONA typically refers to non-glaucomatous nerve atrophy. While surgery is rarely employed in treating this condition, with conservative therapy being the primary approach, advanced medical centers now offer autologous stem cell transplants to enhance regeneration and partial nerve restoration.
Surgical treatment, while limited, focuses on preventing further progression since direct nerve repair is currently impossible. Modern surgical approaches can be categorized into several distinct methodologies:
1. Extrascleral operations:
These procedures primarily facilitate conservative treatment rather than serving as standalone interventions. During surgery, specialists place a catheter in the sub-Tenon’s space of the eye to deliver medications or stem cells. This technique creates optimal conditions for subsequent treatment and recovery.
2. Vascular Reconstruction:
These sophisticated surgical techniques aim to redistribute blood flow to improve nerve nourishment. The most common procedure involves external carotid artery branch ligation. This results in the formation of multiple arterial connections around the optic nerve disc, expansion of arterial anastomoses, and enhancement of collateral blood supply pathways.
3. Decompression Interventions:
These surgical procedures focus on reducing pressure on the optic nerve, potentially slowing or halting atrophy progression. Surgeons may perform selective incisions in the scleral and bone canals. This can lead to partial restoration of visual acuity by eliminating axoplasmatic transport blockade.
4. Revascularization Procedures:
Currently, this is the most frequently utilized surgical approach; revascularization encompasses operations aimed at improving blood supply to the peripheral portion of the nerve. The procedure involves implanting autologous tissues or allografts into the suprachoroidal space, enhancing local circulation and supporting nerve function.
Consult an ophthalmologist abroad through Booking Health to undergo diagnostics and determine if surgery suits your condition. Foreign medical centers successfully perform even the most complex operations while also offering effective conservative treatment methods, stem cell therapy, gene therapy, and other innovations for ONA treatment.
For clinic selection and appointment scheduling, use the Booking Health service. Here you can learn about prices, book convenient dates, and receive travel organization services. Service costs through Booking Health are lower than direct clinic contact due to the absence of additional foreign patient fees.
Source: Cosmo Politian
