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Conditions Requiring A Vitrectomy; How The Procedure Works

Vitrectomies have a very high success rate. Bleeding, infection, progression of cataract and retinal detachment are potential problems, but these complications are relatively unusual. For most patients who undergo a vitrectomy, sight is restored or significantly improved.

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The procedure is a marvel of modern medicine for people with conditions that might be blinding otherwise. Epiretinal membrane ERM , also known as macular pucker and cellophane retinopathy, involves growth of a membrane similar to scar tissue across the macula. This type of growth interferes with central vision by shrinking or contracting, which distorts the central retina.

If you have this condition, you likely will see straight objects appearing wavy and crooked. Also, you could experience reduced central vision, depending on the condition's severity. Epiretinal membranes may be associated with other eye conditions, but the cause of most ERMs is unknown. Some disorders occasionally associated with ERMs include previous retinal detachments and related surgery, inflammatory conditions uveitis , retinal tears, branch retinal vein occlusion BRVO and central retinal vein occlusion CRVO.

Your surgeon will help you decide if an epiretinal membrane peeling procedure is appropriate for you. But the decision will depend on the extent of preoperative vision loss and distortions. The ERM peeling procedure begins with a vitrectomy. The vitreoretinal surgeon then uses an extremely fine forceps , under high magnification, to grasp and gently peel away the membrane from the retina.

Diamond-dusted instruments may be used also to help remove the membrane.

Precision is key, because this procedure may very well be the most delicate operation that's performed on the human eye. Usually a few tiny sutures are used to close the incisions in the eye; generally these don't require removal later.

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  5. After the ERM stripping, vision should improve gradually, though it may take up to three to six months for the best visual results. Studies show that about 80 to 90 percent of patients will experience visual improvement after the surgery. But due to potential permanent retinal damage following the ERM, some patients' vision will not improve. Potential complications of epiretinal membrane peeling include infection, bleeding, retinal detachment and cataract progression. Recurrence of the ERM takes place in about 10 percent of patients following the initial surgery.

    Proliferative vitreoretinopathy PVR is the most common complication following a rhegmatogenous retinal detachment associated with a retinal hole or break. A confirmed diagnosis of PVR may mean that you need surgery. PVR is the growth of cellular membranes within the vitreous cavity and on the front and back surfaces of the retina. These membranes are essentially scar tissues that exert traction on the retina, possibly causing recurrences of retinal detachment even after an initially successful reattachment procedure.

    PVR may be associated with spontaneous reopening of otherwise successfully treated retinal breaks and may even cause new retinal breaks to develop. Because of the contracting membranes, PVR also may be associated with severe distortion and "stiffness" of the retina. This can produce disappointing vision, despite the very best management of the condition.

    Micro-incision Vitrectomy Surgery – Past, Present and Future

    Following the vitrectomy, the surgeon usually instills special gases or fluids into the eye to help flatten the retina and keep it reattached to the outer wall of the eye. If gases are instilled in the eye, stabilizing the head following surgery may be necessary for days or even weeks to help keep the retina attached. If silicone fluid is placed in the eye to help maintain the retina in the attached position, it must eventually be removed from the eye in most cases.

    Additionally, a scleral buckling procedure may be needed. Material such as plastic is sewn onto the outside white of the eye sclera to exert continuous pressure. This pressure reaches the interior, where the retinal tear may be pushed into place to relieve traction and help repair the damaged area.

    Or if your eye condition has caused bleeding into your vitreous. Ask your eye doctor about the benefits and risks of all of your treatment options. Most people do well with vitrectomy. But complications do sometimes happen. Your risks may depend on your age, your health conditions, and the specifics of your eye problem. Some risks of the procedure include:. There is also a risk that the surgery will not successfully fix your original problem. If this is the case, you might need a repeat surgery.

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    Ask your eye doctor what you need to do to get ready for vitrectomy surgery. Ask if you need to stop taking any medicines before the procedure. Follow any directions you are given for not eating or drinking before your surgery. Your eye doctor may want to use special tools to shine a light in your eye and examine your retina.

    Complications I Experienced Following Vitrectomy Surgery for My Pseudohole

    You will need to have your eyes dilated for your eye exam. You also might have an ultrasound of your eye, which helps your eye doctor view the retina. Talk with your eye doctor about what to expect during your surgery. The details of the surgery may differ a bit. A doctor specially trained in eye surgery will do your surgery. In general, you can expect the following:. You may be awake during the surgery. You will be given a medicine to help you relax. In other cases, you may have general anesthesia to put you to sleep.

    If this is the case, you will sleep deeply during the surgery. Your eye doctor will do other repairs to your eye as needed. For example, he or she might use a laser to fix a tear in your retina. In some cases, your eye doctor may inject a gas bubble into your eye to help keep your retina in place.

    Vitrectomy for idiopathic macular hole | Cochrane

    Your eye doctor may replace the vitreous with some other sort of fluid, such as silicone oil or saline. Your eye doctor may close your surgical cuts incisions with stitches.

    Surgical Demonstration: The Basics of Vitrectomy Surgery

    But stitches are often not needed. Ask your eye doctor about what you should expect after your surgery. In most cases, you will be able to go home the same day. Plan to have someone drive you home after the procedure. You may need to take eye drops with antibiotics to help prevent infection. Your eye may be a little sore after the procedure. But you should be able to take over-the-counter pain relievers. You may need to wear an eye patch for a day or so. If you had a gas bubble placed in your eye during your vitrectomy, you will need to follow specific directions about positioning after the surgery.

    To avoid complications, you will also need to not do any air travel until the bubble is gone. Ask your eye doctor when it will be safe for you to fly again. You will need close follow-up with your eye doctor to see if the procedure was effective. You may have a scheduled appointment the day after the procedure. Be sure to tell your eye doctor right away if you have decreasing vision or increasing pain or swelling around your eye.

    If silicone oil is injected into your eye during surgery, over time you may need another surgery to remove it from your eye.

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