A vitrectomy is a surgical technique in which the vitreous gel inside the eyeball is removed.
This procedure is necessary for microsurgeries of the retina and/or vitreous, because if it is not removed the movement of the surgical instruments could alter the structure of the vitreous chamber and damage the retina.
What is the purpose of vitrectomy?
Thanks to vitrectomy, Ophthalmology specialists can better access the retina and act in clinical situations in which the vitreous is the protagonist.
What it consists of
First of all, a local or general anesthesia is administered to the patient. The duration of the procedure depends on the pathology and can last from less than an hour to three hours.
In vitrectomy, surgeons insert micro-instruments inside the eye in order to precisely treat the ocular systems. In this way, the image is magnified to the point where structures that are impossible to see at first glance can be differentiated. For this purpose, a surgical microscope is combined with wide-field lenses and magnifiers, as well as optical image inversion systems, since with the lenses used the image is perceived inversely.
Illumination is also essential, for which cold halogen or xenon light sources are currently used.
It is a complex surgery in which the surgeon uses both hands and feet to operate the vitrectomy equipment and the surgical microscope. The vitrectome can work with various parameters of intraocular pressure, number of cuts per minute and suction power… The surgeon will program it according to the needs of the surgery.
Vitrectomy in 8 steps
1. Fractionate the gel in fragments as small as possible.
2. Aspiration of the gel.
3. Removal of diseased tissues with micropincers.
4. Cutting of tractions with microscissors when the micropincers are not sufficient and can damage the retina.
5. Application of laser treatments with probes.
6. Application of endocautery to avoid bleeding.
7. Aspiration.
8. Replacement: the eye is filled with a substance that will depend on the treated disease, which will reabsorb the eye. If it does not, another surgery will be necessary to remove it.