vitrectomy

Indications

• macular hole
• macular pucker

Procedure

• vitreous gel is removed to prevent it from pulling on the retina
• it is replaced with a bubble containing a mixture of air & gas
• the bubble acts as an internal, temporary bandage that holds the edge of the macular hole in place as it heals
• vitrectomy is performed under local anesthesia & often on an out-patient basis
• following surgery, patients must remain in a face-down position, normally for a day or two but sometimes for as long as two-to-three weeks
• this position allows the bubble to press against the macula & be gradually reabsorbed by the eye, sealing the hole
• as the bubble is reabsorbed, the vitreous cavity refills with natural eye fluids
• maintaining a face-down position is crucial

Complications

• increase risk of cataract development (most common)
• infection
• retinal detachment (either during surgery or afterward)

Management

Post-op:

• for a few months after surgery, patients are not permitted to travel by air
  • changes in air pressure may cause the bubble in the eye to expand, increasing pressure inside the eye
• vision recovery can continue for as long as 3 months after surgery

Prognosis:

• on average, about 1/2 of the vision lost from a macular pucker is restored
• In most cases, vision distortion is significantly reduced

More general terms

• eye surgery; opthalmologic surgery; ocular surgery
• surgical resection (excision)

More specific terms

• pars plana vitrectomy (PPV)
• vitrectomy with photocoagulation
• vitrectomy with removal of subretinal membrane