The vitreous is a normally clear, gel-like substance that fills the center of the eye. It makes up approximately 2/3 of the eye's volume, giving it form and shape before birth. Certain problems affecting the back of the eye may require a vitrectomy or surgical removal of the vitreous. After a vitrectomy, the vitreous is replaced as the eye secretes aqueous and nutritive fluids.
A vitrectomy may be performed to clear blood and debris from the eye, to remove scar tissue, or to alleviate traction on the retina. Blood , Inflammatory cells, debris, and scar tissue obscure light as it passes through the eye to the retina, resulting in blurred vision. The vitreous is also removed if it is pulling or tugging the retina from its normal position.
Some of the most common eye conditions that require vitrectomy include:
• Complications from diabetic retinopathy such as retinal detachment or bleeding
• Macular hole
• Retinal detachment
• Epiretinal membrane
• Vitreous blood
• Injury or inflection
• Certain problems related to previous eye surgery
The retinal surgeon performs the procedure through a microscope and special lenses designed to provide a clear image of the back of the eye.
Several tiny incisions just a few millimeters in length are made on the sclera.
The retinal surgeon inserts microsaurgical instruments through the incisions such as:
• Fiber optic light source to illuminate inside the eye
• Infusion line to maintain the eye's shape during surgery
• Instruments to cut and remove the vitreous
Vitrectomy is oftenperformed in conjuction with other procedures such as retinal detachment repair, macular hole surgery and macular membrane peel.
The length of the surgery depends on whether additional procedures are required and the overall health of the eye.
The retinal surgeon may use techniques along with vitrectomy to treat the retina.
The surgeon will determine if any of these are appropriate for the patient's eye:
• Sealing blood vessels: Laser is sometimes used to stop tiny retinal vessels from bleeding inside the eye
• Gas bubble: A small gas bubble may be placed inside the eye to help seal a macular hole
• Silicone oil: After retinal detachment surgery, the eye may be filled with silicone oil to keep the retina in position