vitrectomies

Vitrectomy is a vitreoretinal surgical procedure in which the vitreous gel filling the eye is removed to treat retinal and other intraocular disorders. The most common form, pars plana vitrectomy (PPV), is performed through small incisions in the sclera to access the vitreous cavity. After removal, the surgeon may address the retina directly, remove blood, or allow access for treatment.

The operation is usually done under local or general anesthesia. Small-gauge instruments create sclerotomies; the vitreous is dissected and aspirated. Depending on the disease, epiretinal membranes may be peeled, the retina may be reattached, and laser photocoagulation can seal retinal breaks. A tamponade medium such as a gas bubble or silicone oil is used to support healing.

Common indications include retinal detachment repair, macular hole closure, removal of epiretinal membranes, and treatment of vitreous hemorrhage from diabetic retinopathy or vein occlusion. It can also clear opaque vitreous in cases of inflammatory debris or trauma.

Risks include infection, bleeding, cataract progression in eyes with a natural lens, elevated intraocular pressure, and iatrogenic retinal breaks or detachments. Other potential issues are refractive changes and the need for additional surgery to remove silicone oil or to address cataract.

Recovery varies; vision improves over weeks to months. Gas tamponade may require limited head-positioning and avoidance of air travel until the gas resorbs; silicone oil often needs a second operation for removal. Outcomes depend on the underlying condition and extent of retinal damage.