Vitrektomia

Vitrectomy, known in Romanian as vitrektomia, is a surgical procedure that removes the vitreous gel from the eye. The vitreous occupies the posterior chamber and helps maintain globe shape; removing it provides access to the retina to treat diseases that cause traction, bleeding, or opacity within the vitreous.

Most vitrectomies are pars plana vitrectomy (PPV), performed through small scleral incisions. Modern operations use microincisional systems with 23-, 25-, or 27-gauge instruments. After anesthesia, the vitreous is detached and removed with a vitreous cutter; the retina is examined and potentially treated with laser photocoagulation or membrane peeling. Depending on the condition, air, a gas such as sulfur hexafluoride (SF6) or perfluoropropane (C3F8), or silicone oil may be introduced as tamponade to hold the retina in place. Fluid–air exchanges may be performed. In many cases, cataract extraction is combined with vitrectomy (phacovitrectomy).

Indications include rhegmatogenous retinal detachment, macular hole, epiretinal membrane, vitreous hemorrhage from diabetic retinopathy, and ocular trauma. Outcomes depend on the disease treated and the extent of retinal damage; many patients experience improved or stabilized vision after successful repair, particularly for macular holes and detachments.

Risks include infection (endophthalmitis), bleeding, cataract progression in phakic eyes, retinal tears or detachment, increased intraocular pressure, and inflammation. Recovery involves prescribed eye drops, activity restrictions, and, when gas tamponade is used, positioning instructions for several days to weeks. The procedure has evolved since its development in the 1970s, with smaller-gauge instrumentation and broader indications.