Vitreo Retinal Surgery:
Vitreoretinal surgery refers to any operation to treat eye problems involving the retina, macula, and vitreous fluid. These include retinal detachment, macular hole, epiretinal membrane and complications related to diabetic retinopathy. Various vitreoretinal
surgical and laser approaches can restore, preserve and enhance vision for many eye conditions such as certain types of age-related macular degeneration, diabetic retinopathy, diabetic vitreous hemorrhage, macular hole, a detached retina, epiretinal membrane and CMV retinitis. Vitreoretinal eye surgery includes a group of procedures performed deep inside the eye's interior with lasers or conventional surgical instruments. As the name implies, this delicate surgery takes place where the gel-like vitreous and light-sensitive membrane (retina) are found. Various vitreoretinal surgical and laser approaches can restore, preserve and enhance vision for many eye conditions such as certain types of age-related macular degeneration, diabetic retinopathy, diabetic vitreous hemorrhage, macular hole, a detached retina, epiretinal membrane and CMV retinitis.
General ophthalmologists, other ophthalmologist sub-specialists and optometrists usually refer patients in need of vitreoretinal management to a specialist. This type of specialist trains first as a general ophthalmologist and subsequently specializes in the medical and surgical management of vitreoretinal disorders. A vitreoretinal specialist performs nearly all of the surgical procedures listed here, although general ophthalmologists and other ophthalmologist sub-specialists commonly handle procedures involving lasers. Procedures mentioned here are the more common of many surgical approaches to specific conditions requiring vitreoretinal surgery.
A vitrectomy procedure removes the vitreous humor or gel-like substance in the eye. This approach can address vision problems caused when foreign matter invades this usually pristine area of the eye's interior. One example of foreign matter is blood, from conditions such as diabetic vitreous hemorrhage. Light rays passing through the eye cause the foreign matter to cast shadows on the retina, resulting in distorted or greatly reduced vision.
Vitreo Retinal Surgery is a sub-specialty of ophthalmic surgery, and is required to treat the following conditions:
1. Retinal detachment
Retinal detachment refers to a condition where the retina (the inner lining of the back of the eye) peels off the inside wall of the eye (akin to wallpaper peeling off a wall). Without vitreo retinal surgery, the retina will not reattach and blindness will
invariably result. Accordingly, retinal detachments need to be assessed and repaired by a vitreo retinal surgeon.
2. Epiretinal membrane
An epiretinal membrane (ERM) refers to an irregular surface involving the centre of the retina (the macula), and results in distorted vision. Epiretinal membranes are treated by peeling the offending membrane from the surface of the macula, using a vitreo
retinal surgical technique.
3. Macular Hole
Macular Hole refers to a defect at the centre of the retina, and can be treated in a small proportion of cases with an injection, but in most cases the macular hole requires vitreo retinal surgery to repair the defect.
4. Vitreous Haemorrhage
The most common cause of vitreous haemorrhage, which refers to bleeding into the back of the eye, is diabetic eye disease, and if the blood does not clear in a reasonable time, vitreo retinal surgery will be required so that the retina can be fully
assessed and also to restore vision to the patient.
Vitreo Retinal Surgery is very specialised, and patients with eye conditions requiring virtual retinal surgery are managed at the Institute of Eye Surgery.
A vitrectomy can restore vision in diabetic retinopathy by removing the natural vitreous that has become clouded by leaking blood vessels and replacing it with clear fluid. Once the surgeon removes the vitreous humor and clears the area, he or she
usually injects a saline liquid to replace the vitreous humor that ordinarily fills up the inner chambers of the eye. However, a vitrectomy is considered inappropriate and extreme for addressing most ordinary spots and floaters that occur with vitreous
detachments affecting almost everyone to some degree as they grow older.
The most common reasons for a vitrectomy include:
1. Diabetic vitreous hemorrhage
2. Retinal detachment
3. Epiretinal membrane
4. Macular hole
5. Proliferative vitreoretinopathy
7. Intraocular foreign body removal
8. Retrieval of lens nucleus following complicated cataract surgery
Usually vitrectomies require general anesthesia. However, local anesthesia is used in certain situations, especially when general anesthesia would be inappropriate, such as for people with breathing problems. Your surgeon will make three tiny
incisions in the eye to create openings for the various instruments that will be inserted to complete the vitrectomy.