Vitrectomy Procedures

Vitrectomy is a form of eye surgery that is designed to remove a part or the whole vitreous humor (the clear jelly-like substance inside the eye). There are several procedures associated with vitrectomy. Pars plana vitrectomy is the general surgical operation associated with the removal of part or all of the vitreous humor. Certain other procedures often accompany or form a part of the vitrectomy surgery.

Pars Plana Vitrectomy

• The pars plana vitrectomy refers to the general surgery designed to remove the clouded vitreous. Occasionally, blood or other agents, making it difficult to see, cloud this clear inner jelly inside the eye. The pars plana vitrectomy removes this clouded area. Because of the success of the original pars plana vitrectomy, vitrectomy procedures have expanded to include other related procedures. Additional vitrectomy procedures include the removal of eye scar tissue and the removal of the clear jelly to allow medications to be injected into the eye.

Membranectomy

• A membranectomy is often performed as part of vitrectomy procedures. This involves separating the layers of the eye using fluid, in a process called "viscodissection," to use tiny forceps or picks to remove scar or other unhealthy tissue from the retina. This procedure is often performed as a part of or in addition to a standard vitrectomy.

Fluid-Air Exchange

• Fluid-air exchange is also often incorporated into vitrectomy procedures. This involves the use of an air injection to remove intraocular fluid from the eye. Intraocular pressure is simultaneously used to allow the eye to keep its shape and the retina to remain in place. When the air pressure ceases, the intraocular fluid will once again come back in and fill the eye up.

Air-Gas Exchange

• Air-gas exchange is an alternative to the use of fluid air exchange during a vitrectomy procedure. In an air-gas exchange, gas (or a mixture of air and gas) is inserted into the eye's posterior segment. These gases (usually sulfur perfluoropropane or hexafluoride) help the air to expand and remain in the eye longer while the retina is helped into place by a tamponade. The tamponade helps to seal holes in the retina or keep the retina in place while the vitreous humor is being removed. Once the air-gas mixture leaves the eye, the intraocular fluid once again fills the eye back up.

Recovery

• Typically, the recovery period after a vitrectomy procedure takes a few weeks. During this time, eye drops are used and the patient is advised to refrain from strenuous work and heavy lifting. Occasionally, gas bubbles are inserted into the eye to help the retina to remain in place and, if this is the case, the patient may have to maintain a certain head position during the recovery period.