Medical & Surgical Ophthalmology

Vitrectomy

What is vitrectomy?

Vitrectomy is a surgical procedure, through ocular microsurgery, in which the vitreous body is extracted (transparent gel that fills the eyeball and approximately occupies 80%), in order to work on the retina or the vitreous gel is extracted because vitreous haemorrhage has occurred and prevents correct vision. Sometimes it is replaced by air, gas or silicone oil to block the retina while it does its retinal repair process. It is a technique that with the current techniques of microsurgery with incisions of Small caliber (23g or 25g) offers many advantages for the patient as it is less aggressive, shortens surgery and presents less inflammation during the postoperative period and therefore a faster recovery.

In which cases is it done

Vitrectomy is performed mainly for retinal pathologies such as: macula diseases: macular hole or epiretinal membrane, retinal detachment; retinal complications of diabetes mellitus such as vitreous haemorrhages principally; eye trauma; pathologies related to high myopia (nearsighted); uveitis or ocular inflammation and complications of cataract surgery. At the hospital universitari general de catalunya, Dr. Laura sararols, head of the omiq ophthalmology service, is responsible for these surgeries.

Vitrectomy is an outpatient procedure, which lasts between half an hour to two hours and is performed under local anesthesia, under sedation. Through 3 microincisions of the size of a needle (23/25g) the interior of the eyeball is accessed, the vitreous is cut and aspirated and later the macular epiretinal membrane can be stained with a blue dye to remove it with endocular forceps, it can be injected liquid perfluorocarbon, sulfur hexafluoride (gas) or silicone oil, as determined by the ophthalmologist, to repair the damaged retina. It is frequently combined with cataract surgery if necessary.

  • Retinal detachment
  • Diseases of the macula: macular hole, epiretinal membrane… diabetic retinopathy
  • Eye trauma
  • Intraocular haemorrhages
  • Pathologies related to high myopia (nearsighted)
  • Uveitis or ocular inflammation
  • Complications of cataract surgery

Previous exams

Before surgery, it is necessary to carry out a complete ophthalmological examination, which may include a retinography, an angiography (agf), an ocular ultrasound or an optical coherence tomography oct. The oct is the princeps test of macular exploration, it is a fast and painless technique for diagnosis, control and follow-up, which allows us to study histological sections of the macula “in vivo”.

The intervention

Vitrectomy is an outpatient procedure, which is performed under local anaesthesia and under sedation. Using microincisions, the vitreous is cut and extracted and later liquid perfluorocarbon, sulphur hexafluoride (gas) or silicone oil can be injected, as considered by the ophthalmologist, in order to repair the damaged retina.

An occlusive patch should normally be worn for one day. It is common for the patient to notice a sensation of a foreign body, red eye or other discomfort after the operation, which will disappear over time.

The first week it is not recommended to make sudden movements with the head or intense physical exercise. It is very important if you have been injected with gas, that you do not take any plane. The improvement in vision will be progressive.

Risks

As in all surgery, there are some risks associated with it, such as postoperative bleeding, retinal detachment, cataract or infection.

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