Vitreoretinal surgery

Vitreoretinal surgery
Vitreoretinal eye surgery includes a group of procedures performed deep inside the eye's interior with lasers or conventional surgical instruments.
As the name implies, this delicate surgery takes place where the gel-like vitreous and light-sensitive membrane (retina) are found.

The most common reasons for a vitrectomy include:

  • Diabetic vitreous hemorrhage.
  • Retinal detachment.
  • Epiretinal membrane.
  • Macular hole.
  • Proliferative vitreoretinopathy.
  • Endophthalmitis.
  • Intraocular foreign body removal.
  • Retrieval of lens nucleus following complicated cataract surgery.

WHAT ARE THE TREATMENT OPTIONS?

Retinal hole or breaks are treated with laser photocoagulation or cryopexy (a freeze treatment) as outdoor procedure. During laser treatment, dot like burns are placed around the hole to "weld" the retina. In Cryopexy the area around the hole is frozen and it helps reattach the retina. Retinal detachments are treated with surgery viz scleral buckling and complex vitreoretinal surgery involving use of Silicon oil or gases.

In scleral bucking, a silicon band, is placed anchored with stitches around the eyeball to gently push the wall of the eye against the detached retina.

In vitrectomy - The surgeon will make three tiny incisions in the eye to create openings for the various instruments that will be inserted to complete the vitrectomy.. The instruments that pass through these incisions include:

  • Light pipe, which serves as a microscopic, high-intensity flashlight for use within the eye.
  • Infusion port, used to replace fluid in the eye with a saline solution and to maintain proper eye pressure.
  • Vitrector, or cutting device, that removes the eye's vitreous gel in a slow, controlled fashion. It protects the delicate retina by reducing traction while the vitreous gel is removed.

 Vitrectomy instruments are placed inside the eye to take out the vitreous gel and it is replaced with silicon oil or gases to push the retina in place. Laser or cryopexy is done around the breaks to seal it.
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What To Expect After A Vitrectomy?

Because so many variables are involved, only the eye surgeon familiar with your condition can give you a realistic idea of what to expect following a vitrectomy.
 But the underlying reason for the procedure usually is a major factor in determining how fast you will recover as well as the ultimate outcome.
After a procedure, you likely will use antibiotic eye drops for about the first week and anti-inflammatory eye drop medications for several weeks.

Bleeding, infection, progression of cataract and retinal detachment are potential problems, but these complications are relatively unusual.
With modern vitreoretinal instrumentation, around 90 percent of cases with a retinal detachment can be successfully treated, Visual results are good if the retinal detachment is repaired before the macula (the centre region of the retina responsible for fine, detailed vision) detaches. Thus, it is important to contact your retina surgeon in time when you notice any flashes or floaters or a curtain in field of vision.
The procedure is a marvel of modern medicine for people with conditions that might be blinding otherwise.