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Innovative Surgical Solutions

Dr. Kent Small brings subspecialty fellowship training and innovative sight-restoring technology to the process of retinal surgery at Macula & Retina Institute. Dr. Small has performed thousands of successful surgeries, most of which can be performed on an outpatient basis at the following ambulatory surgery centers (Beverly Hills Surgical Speciality and Chevy Chase Surgery Center).  Dr. Small is on staff at the following hospitals: Glendale Memorial Hospital, Cedars-Sinai Hospital, Olympia Medical Center.

Dr. Small was one of the first retinal specialists in Los Angeles to use sutureless techniques for retinal surgeries; most of his procedures are now performed this way. Dr. Small's advanced treatments include vitrectomy, membrane peel, pneumatic retinopexy and scleral buckling. What’s more, Dr. Small performs many procedures at the Macula & Retina Institute using today’s state-of-the-art laser technology. He is one of only a handful of Los Angeles area retinal specialists who use the MicroPulse laser to treat macular edema from diabetes and vascular occlusions. The MicroPulse laser is the preferred method as it reduces the discomfort during the procedure. His other laser capabilities include:

  • Laser treatment for retinal tears & detachments
  • Photodynamic therapy
  • Laser photocoagulation

Pars Plana Vitrectomy Surgery

Vitrectomy is a type of eye surgery used to treat disorders of the retina (the light-sensing cells at the back of the eye) and vitreous (the clear gel-like substance inside the eye). It may be used to treat a severe eye injury, diabetic retinopathy, retinal detachments, macular pucker (wrinkling of the retina), and macular holes.

This surgery was invented and developed by Dr. Machemer who Dr. Small trained under at Duke University.

During a vitrectomy operation, performed at a surgical center, the surgeon makes tiny incisions in the sclera (the white part of the eye). Using a microscope to look inside the eye and microsurgical instruments, the surgeon removes the vitreous and repairs the retina through these tiny incisions. Repairs include removing scar tissue or a foreign object if present.

During the procedure, the retina may be treated with a laser to reduce future bleeding or to fix a tear in the retina. An air or gas bubble that slowly disappears on its own may be placed in the eye to help the retina remain in its proper position, or a special fluid that is later removed may be injected into the vitreous cavity.

Recovering from vitrectomy surgery may be uncomfortable, but the procedure often improves or stabilizes vision. Once the blood- or debris-clouded vitreous is removed and replaced with a clear medium (often a saltwater solution), light rays can once again focus on the retina. Vision after surgery depends on how damaged the retina was before surgery. 

Intravitreal Injections

In addition, Dr. Small can address these retinal conditions with intravitreal injections:

Wet Macular Degeneration 

Diabetic retinopathy

Diabetic and Cystoid Macular Edema

Retinal Vein Occlusion

Macular Holes

Pars Planitis

Chorioretinitis

Uveitis

Endophthalmitis 

Dr. Small is certified to use the following medications: Lucentis, Eylea, Ozurdex, Jetrea, Iluvien, Avastin, plus other steroidal and Anti-VEGF medications. 

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