![]() ![]() Lensectomy is the removal of the eye’s crystalline lens during a vitrectomy procedure. Scleral buckling is sometimes combined with a vitrectomy procedure to add additional support to the re-attached retina It is a helpful technique when the cornea or lens are cloudy and do not allow a clear view through the operating microscope. Most of these vitreoretinal tools have a diameter of less than 1mm, making them some of the most precise and finely crafted instruments in the world today.Įndoscopy allows the surgeon to view the inside of the eye on a television monitor while treating intraocular structures. Literally hundreds of vitrectomy instruments are available to assist in different surgical maneuvers. ![]() Microsurgical instruments such as forceps, scissors and picks may be used to manipulate intraocular structures such as in the removal of scar tissue and foreign bodies. Endophotocoagulation is frequently used to treat proliferative diabetic retinopthy as well. This modality is often used to treat retina tears in the setting of retinal detachment. Like gas, silicone oil can promote cataracts, cause glaucoma, and may damage the cornea.Įndophotocoagulation is the use of laser to treat intraocular structures. Positioning is less critical with silicone oil, therefore, it may be used in patients unable to position postoperatively (i.e. Unlike gas, patients are still able to see through clear silicone oil. This technique is advantageous when long term support (“tamponade”) of the retina is required, for instance in the repair of very complicated retinal detachments. Silicone remains in the eye until it is removed (often necessitating a second surgery at a later date). ![]() Silicone oil is sometimes used instead of gas to keep the retina attached postoperatively. It is unsafe to fly in a plane while gas remains in the eye. Possible complications of intraocular gas include progression of cataracts and elevated eye pressure (glaucoma). Vision in a gas filled eye is usually rather poor until at least 50% of the gas is absorbed. It is frequently necessary to maintain a certain head position following surgery when gas is used. Gas injection is also used to close macular holes. Gas is useful for flattening a detached retina and keeping it attached while healing occurs. They are eventually replaced by the eyes own natural fluid. Intraocular gases (usuallyeither perfluropropane (C3F8) or sulfur hexafluoride (SF6)) when mixed with sterile air have the property of remaining in the eye for extended periods of time (up to two months). Retained lens material or dislocated lens implants following cataract surgeryĭuring vitrectomy surgery, the retinal surgeon may use a variety of special techniques to achieve the desired results, including: Intraocular infections (endophthalmitis)ħ. Complicated, tractional or recurrent or retinal detachmentĥ. Proliferative diabetic retinopathy (including vitreous hemorrhage)Ĥ. Pars plana vitrectomy is used to treat many different retinal disorders including those listed below (more information on some of these topics can be found elsewhere in our patient information section):ġ. Entering the eye through this location avoids damage to the retina and the crystalline lens. This is why the procedure is often referred to as a trans pars plana vitrectomy (TPPV). It can often be done as an ambulatory procedure.Īlthough vitrectomy procedures are sometimes performed through incisions made near the front of the eye, most vitreoretinal surgeons enter the globe through a part of the eye known as the pars plana. ![]() The procedure is performed in an operating room under local or (occasionally) general anesthesia. The surgeon uses a specialized operating microscope and contact lenses, which allow a clear view of the vitreous cavity and retina at various magnifications. A high intensity fiberoptic light source is used to illuminate the inside of the eye while the surgeon works. The vitreous is removed with a miniature handheld cutting device and replaced with a special saline solution similar to the liquid being removed from the eye. The initial step in this procedure is usually the removal of the vitreous gel through very small (~1.4mm) incisions in the eye wall, hence the name “vitrectomy”. Vitrectomy is a microsurgical procedure in which specialized instruments and techniques are used to repair retinal disorders, many of which were previously considered inoperable. ![]()
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