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Conditions a vitrectomy can help | Technique | Additional special techniques

A vitrectomy is surgery which is used to correct a number of conditions that involve the vitreous (the clear jelly-like substance that fills the inside of the eye). The fluid is removed and replaced.

Conditions a vitrectomy can help

A vitrectomy may be used in the treatment of the following:

• Complications of diabetic eye disease such as bleeding or retinal detachment.
• Clouding of the vitreous jelly from leaking blood vessels, inflammatory debris, or infection.
• Retinal detachment with stiffness and scarring of the retina.
• Treatment after a foreign body has entered or passed through the eye.
• Vitreous changes after cataract surgery.

Technique

When performing a vitrectomy, the surgeon uses a sophisticated miniature aspiration and cutting device. The cutting tip is 1.0 mm in diameter. The surgeon makes three small incisions in the wall of the eye. One is for aspirating vitreous, one is for infusing a balanced salt solution similar to the vitreous, and one is for the fiberoptic light used to see inside the eye. The surgeon uses a special operating microscope as well as a special contact lens to provide a clear view of the interior of the eye. The combination of the intraocular light source, the contact lens, and the operating microscope gives a greatly magnified view of the retina and vitreous. This enables the surgeon to remove the abnormal vitreous and tiny strands of scar tissue.

Additional special techniques

Some special techniques may be used in conjunction with a vitrectomy. In endophotocoagulation, a fiberoptic light source delivers a focused laser beam to the eye's interior. It is used to seal retinal tears, treat abnormal blood vessels, and stop bleeding.

Endodiathermy uses a miniature cautery device to cauterize abnormal blood vessels.

The air/gas injection technique fills the inside of the eye with inert gases or air. It is used with retinal detachment or when retinal tears are present. It seals retinal holes and holds the reattached retina in place. The air or gas is slowly absorbed and replaced by normal eye fluids. Patients may have to sleep on their side or face down in the immediate post-op period. They cannot fly in an airplane while gas bubbles are present.

In a small number of patients with retinal scarring, the eye is filled with clear, inert silicon oil. It helps hold the retina in place after repair and is usually removed four to six months after surgery.