vitrectomy

Indications: 1) macular hole 2) macular pucker Procedure: 1) vitreous gel is removed to prevent it from pulling on the retina 2) it is replaced with a bubble containing a mixture of air & gas 3) the bubble acts as an internal, temporary bandage that holds the edge of the macular hole in place as it heals 4) vitrectomy is performed under local anesthesia & often on an out-patient basis 5) 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 6) this position allows the bubble to press against the macula & be gradually reabsorbed by the eye, sealing the hole 7) as the bubble is reabsorbed, the vitreous cavity refills with natural eye fluids 8) maintaining a face-down position is crucial Complications: 1) increase risk of cataract development (most common) 2) infection 3) retinal detachment (either during surgery or afterward) Management: Post-op: 1) 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 2) vision recovery can continue for as long as 3 months after surgery Prognosis: 1) on average, about 1/2 of the vision lost from a macular pucker is restored 2) In most cases, vision distortion is significantly reduced

Specific

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

General

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

References

National Eye Institute: Macular Hole http://www.nei.nih.gov/health/macularhole/index.asp