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All you should know about Vitrectomy & Vitreoretinal surgery of the eye

By: Hassaan Javaid: A group of surgical procedures performed deep within the eye’s interior either with lasers or through conventional instruments are included in Vitreoretinal eye surgery. As the name suggests, the procedure is delicate and executed at the area where gel-like vitreous and light-sensitive membrane (retina) are located. 


The different Vitreoretinal and laser surgeries are aimed towards restoration, preservation and enhancement of various eye anomalies namely age-related macular degeneration, macular hole, diabetic retinopathy, CMV retinitis, detached retina, diabetic vitreous hemorrhage and epi-retinal membrane.

A brief on surgical specialists

Ophthalmologists, sub-specialists and optometrists mostly refer patients to specialists who require vitrectomy surgery and Vitreoretinal management. These specialists acquire initial training of general ophthalmologist with specialisation in surgical management of Vitreoretinal anomalies. A Vitreoretinal surgeon is trained in performing almost all surgical procedures related to the eye.

About the procedure

Removal of vitreous humour or gel-like substance in the eye is the primary reason to undergo the procedure. The approach addresses vision related problems caused by invasion of the foreign body in pristine region of the eye’s interior. A finest example of foreign body here is release of blood in the eye following conditions such as diabetic vitreous hemorrhage.

Light rays which passes through the eye collides with the foreign object and casts a shadow on the retina thus resulting in distorted or significantly compromised vision. Post-surgery, the removal of vitreous humour clears the affected region after which a saline liquid is injected as a replacement to the natural vitreous humour, filling up interior eye chambers.

In common, vitrectomy surgery requires administration of general or local anaesthesia in certain conditions; only after detailed examination of the patient’s health and medical history for particular diseases. The surgeon would make three tiny slits in the eye which will create openings for surgical instruments to penetrate conveniently thereby performing the surgery.
The cuts are made in the pars plana area of the eye which lies rear to the iris and in front of the retina. Surgical instruments that will eventually pass through the incisions include:


  • Light pipe which complements to a minuscular, high-intensity flashlight


  • Infusion port which replaces the eye fluid against the saline solution as well as maintaining appropriate eye pressure


  • A vitrector or a special cutting tool which will remove the vitreous gel in a neat, gentle and controlled fashion; made especially for surgeons. The cutting tool is fashioned in a way which protects the delicate retina by lowering rigidness as the vitreous humour is being extracted.

Post vitrectomy

Due to involvement of many different variables, only an expert surgeon would tell you about the post-surgical expectations and possible conditions. The underlying reason for undergoing the surgery matters most when it comes to recovery along with the ultimate outcome. The patient is likely to be prescribed with antibiotic eye drops following first week post-surgery. Anti-inflammatory eye medication may be prescribed for several weeks onwards depending on overall recovery.

Conclusion

Patients who’ve had their Vitreoretinal surgery shows significant improvement and restoration of vision however, the procedure isn’t for everyone and suggested only after doctor’s consent.
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