Vitrectomy In India
About Vitrectomy ?
Vitrectomy is surgery to remove some or all of the vitreous humor from the eye. Anterior vitrectomy entails removing small portions of the vitreous humor from the front structures of the eye — often because these are tangled in an intraocular lens or other structures. Pars plana vitrectomy is a general term for a group of operations accomplished in the deeper part of the eye, all of which involve removing some or all of the vitreous humor — the eye's clear internal jelly.
Pars plana vitrectomy
The success of these first procedures led to the development of techniques and instruments to remove clouding and also to peel scar tissue off the light sensitive lining of the eye — the retina — membranectomy, to provide space for materials injected in the eye to reattach the retina such as gases or liquid silicone, and to increase the efficacy of other surgical steps such as scleral buckle.
Additional surgical steps
Membranectomy – removal of layers of unhealthy tissue from the retina with minute instruments such as forceps (tiny grasping tools), picks (miniature hooks), and visco-dissection (separating layers or tissue with jets of fluid.)
Fluid/air exchange – injection of air into the eye to remove the intraocular fluid from the posterior segment of the globe while maintaining intraocular pressure to temporarily hold the retina in place or seal off holes in the retina. The air pressure is temporary as the posterior segment will soon re-fill with fluid.
Silicone oil injection – filling of the eye with liquid silicone to hold the retina in place.Photocoagulation – laser treatment to seal off holes in the retina or to shrink unhealthy, damaging blood vessels which grow in some diseases such as diabetes.
Indications
Retinal detachment – a blinding condition where the lining of the eye peels loose and floats freely within the interior of the eye. Steps to reattach the retina may include vitrectomy to clear the inner jelly, scleral buckling to create a support for the reattached retina, membranectomy to remove scar tissue, injection of dense liquids to smooth the retina into place, photocoagulation to bond the retina back against the wall of the eye, and injection of a gas or silicone oil to secure the retina in place as it heals.
Vitrectomy
Complications
Along with the usual complications of surgery, such as infections, vitrectomy can result in retinal detachment. A more common complication is high intraocular pressure, bleeding in the eye, and cataract, which is the most frequent complication of vitrectomy surgery. Many patients will develop a cataract within the first few years after surgery.
Recovery
Patients use eye drops for several weeks or longer to allow the surface of the eye to heal. In some cases heavy lifting is avoided for a few weeks. A gas bubble may be placed inside the eye to keep the retina in place. If a gas bubble is used, sometimes a certain head positioning has to be maintained, such as face down or sleeping on the right or left side. It is very important to follow the physician’s specific instructions. The gas bubble will dissolve over time, but this takes several weeks.