Vitreoretinal Eye Surgery

Before talking about the surgery an explanation of vitreoretinal eye surgery and the parts of the eye affected is important.

Vitreoretinal eye surgery is the surgery that alleviates problems such as retinal detachment and intraocular infection (an infection inside the eye). These problems affect the retina and vitreous within the eye.

What is the retina?

The retina is a thin layer of neural cells that is an outgrowth of the developing brain, along with the optic nerve it is found at the back of the eye.

The retina is part of the central nervous system and its primary responsibility is to produce the images we “see” through retinal receptors, rods and cones that show patterned excitation depending on the image received. This information is sent to the different parts of the brain that form a representation of what we understand we are seeing.

What is the Vitreous?

Vitreous, known as vitreous humor, is a clear liquid very much the same in texture as the white of an egg. The vitreous is found in the eye between the lens and the retina and has a dual function, first the vitreous must not impede the light travelling into the eye so the best possible vision is achieved while secondarily, providing cushioned support to the eye.

Vitrectomy eye surgery

The vitrectomy surgery was the brainchild of Robert Machemer in 1970 and is the surgical operation to remove vitreous humor from the eye. Since its creation the surgery has expanded further and now has extra surgical steps involved so it is effective in treating retinal problems as well as vitreous problems.

The vitrectomy surgery is generally completed under a local anaesthetic and involves three incisions being made in the pars plana of the eye (are located between the iris and retina). A light rod, infusion port and vitrectomy cutting device are placed into the inner eye through the incisions made.

The vitrectomy-cutting device has a microscopic cutter that cuts through and removes the vitreous fluid in a slow, controlled manner.

The infusion port is used to replace lost fluids in the eye so no pressure is lost within the eye during and post surgery.

For those with retinal detachment two additional steps are added.

The first step is scleral buckling which places a support belt around the inner wall of the eye so the retina is kept in its correct, attached position within the eye.

The second step is membranectomy, which involves removing unhealthy layers of retina tissue. This is achieved by using the three holes already created for the first part of the vitrectomy procedure but uses different instruments; the instruments used are forceps, picks, and visco-disection.

The visco-section uses jets of fluid to separate layers of tissue which the forceps and picks can grasp and hook before the vitrectomy cutting device can cut away the unhealthy retinal tissue.

Rates of recovery

This varies greatly on how much damage you have to the eye and how successful the operation is, the only person who will be able to advise on the forecast rate of recovery should you be embarking on vitrectomy surgery would be the surgeon themselves.

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