Vitrectomy is a surgical procedure performed to remove the vitreous humor, the gel-like substance filling the eye, to treat various retinal conditions. This procedure allows access to the retina for repairs and is commonly used for conditions that threaten vision.
Indications for Vitrectomy
Vitrectomy is used to treat a variety of retinal and vitreous disorders, including:
Retinal detachment, especially with vitreous traction
Vitreous hemorrhage from diabetic retinopathy or retinal vein occlusion
Macular hole, a small break in the central retina
Epiretinal membrane (macular pucker), a layer of scar tissue on the retina
Endophthalmitis, a severe eye infection
Complications from previous eye surgeries
Removal of intraocular foreign bodies
Procedure Overview
The procedure is typically performed under local anesthesia with sedation, though general anesthesia may be used in complex cases.
Incision Placement: Three tiny incisions are made in the sclera (white part of the eye) to insert microsurgical instruments.
Vitreous Removal: The vitreous gel is cut and aspirated using a vitrectomy probe.
Retinal Repair: If necessary, additional procedures such as membrane peeling, laser treatment, or cryotherapy may be performed.
Tamponade Placement: The vitreous cavity may be filled with saline, gas (SF6 or C3F8), or silicone oil to stabilize the retina.
Closure: Small-gauge vitrectomy incisions are often self-sealing, but larger incisions may require sutures.
Postoperative Care
Positioning: If a gas or oil bubble is used, face-down positioning may be required for days to weeks.
Medications: Antibiotic and anti-inflammatory eye drops are prescribed.
Vision Recovery: Improvement varies depending on the underlying condition; some cases may only prevent further vision loss rather than restore sight.
Restrictions: Patients with a gas bubble must avoid high altitudes and airplane travel until the bubble dissolves.
Potential Risks and Complications
Cataract progression (common in older patients)
Retinal detachment or recurrent detachment
Infection (endophthalmitis)
Increased intraocular pressure (glaucoma)
Incomplete visual recovery
Vitrectomy is a highly specialized procedure tailored to each patient’s condition. A retina specialist will determine if surgery is necessary based on disease severity and potential visual benefits.
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