vitrectomie

Vitrectomy, or vitrectomie, is a vitreous surgery that removes the gel-like vitreous body from the eye. It is performed through small incisions in the sclera, typically in the pars plana region, using microinstruments and illumination. The procedure can be done with different gauge systems and may be performed under local or general anesthesia. The vitreous may be removed in part or in whole, depending on the underlying condition, and sometimes membranes or traction on the retina are peeled during the same operation.

The procedure is used to treat a range of retinal and vitreoretinal diseases. Common indications include retinal detachment with vitreous traction, non-clearing vitreous hemorrhage, macular holes, epiretinal membranes, and proliferative diabetic retinopathy. It may also be employed for intraocular infections, trauma, or complicated cataract cases where vitreous removal is beneficial. After vitreous removal, the retina is examined, treated with laser or cryotherapy if needed, and the eye may be filled with gas or silicone oil to hold the retina in place during healing.

Tamponade agents such as air, expandable gases (e.g., SF6 or C3F8), or silicone oil may be used to stabilize the retina postoperatively. A fluid–air exchange is often performed, and depending on the situation, the eye may require a subsequent procedure to remove silicone oil.

Outcomes vary with the condition and extent of disease. Vitrectomy carries risks including endophthalmitis, retinal re-detachment, cataract progression in phakic eyes, glaucoma, bleeding, and hypotony. Postoperative care and adherence to positioning guidelines when gas or oil is used influence recovery and results.