Vitrektomian

Vitrektomian refers to vitrectomy, a surgical procedure in which the vitreous humor—the gel-like substance inside the eye—is removed. The operation is performed to treat disorders affecting the vitreous or retina and to provide access for retinal repair, membrane peeling, or injection of therapeutic agents.

Indications include rhegmatogenous retinal detachment, macular hole, epiretinal membrane, nonclearing vitreous hemorrhage (often from diabetic retinopathy), diabetic macular edema, endophthalmitis, ocular trauma, and certain intraocular foreign bodies or infections.

Procedure overview: Most modern vitrectomies are performed through small scleral incisions in the pars plana region using microincision transconjunctival techniques. A three-port or single-port setup with 23-, 25-, or 27-gauge instruments is common. The vitreous is removed with a vitrector while balanced salt solution is infused to maintain intraocular pressure. Depending on the condition, surgeons may peel the epiretinal membrane or internal limiting membrane, apply laser photocoagulation, and then insert a tamponade agent such as gas, silicone oil, or air to hold the retina in place. Cataract extraction can be combined (phacovitrectomy) when the natural lens is removed during the same session.

Outcomes and recovery: Vision may improve over weeks to months, depending on the underlying disease and retinal integrity. Possible complications include cataract progression in phakic eyes, retinal detachment, endophthalmitis, intraocular bleeding, elevated intraocular pressure, corneal edema, and silicone oil–related issues. Postoperative positioning and monitoring are required for certain tamponades.

History: The procedure was developed in the 1970s and has evolved with microincisional techniques to reduce trauma and recovery time.