Retinal Surgery and Vitrectomy
WHAT IS VITRECTOMY? PARS PLANA VITRECTOMY (PPV)
The eye is divided into two when describing diseases related to the eye: anterior and posterior part of the eye.
There are KORNEA and LENS at the front and VITREOUS and RETINA at the back.
Considering that the eye will be compared to the camera and the film, the front part's task is to ensure that the image reaches the back.
However, the part that performs the main visual function and transmits the messages to the brain is the back of the eye.
Vitrectomy, also known as Pars Plana Vitrectomy, is the name of the surgery performed with the help of special instruments on the "vitreous gel" on the back of the eye and "retina" with incisions smaller than 1 mm.
WHICH VITRECTOMY SURGERY IS APPLIED IN EYE-DISEASES
There are many reasons for vitrectomy. Vitrectomy is performed in many diseases that is related to the vitreous.
Some of the most important reasons;
- Diabetic retinopathy (Advanced pathologies seen in diabetics)
- Vitreous hemorrhage (intraocular bleeding)
- Macular pucker (Wrinkle at the visual center)
- Retinal detachment and tears (rupture of the nerve net layer of the eye)
- Macular hole (hole in the center of vision)
- Intraocular foreign object removal (foreign object as a result of eye injuries)
- After cataract surgery (lens residue complication in the eye)
- (Endophthalmitis) Intraocular infections after cataract and other eye operations)
HOW ARE VITREATOMY SURGERY done?
(It is called 20-scale, 23-scale and 25-scale vitrectomy according to the scale thickness of the instruments used during the vitrectomy surgery)
Since the diameter of the 20-scale vitrectomy is large, the holes in the sclera are large and stitching is required at the end of the surgery.
In seamless vitrectomy surgery developed in recent years, 23-scale (0.64 mm diameter) and 25-scale (0.5 mm diameter) microsurgical instruments are used.
Since the holes opened in the sclera are very small with this method, stitching is not required.
This surgery is called seamless vitrectomy.
In vitrectomy surgery, which can be performed under local or general anesthesia, the vitreous cavity of the eye and the retina are reached with 3 holes of 0.5 mm opened in the eye wall.
After the gel (vitreous) inside the eye is cleaned with a probe capable of making 1500-6000 incisions per minute, attempts are made to eliminate the problem in the retina.
AFTER VITRECTOMY SURGERY
During the surgical intervention, serum, gas or silicone oil is placed in the eye, depending on the type or severity of the disease in your eye, and sometimes patients may be asked to lie in a certain position for a while after surgery.
It is inconvenient for patients who have gas placed in the eye during vitrectomy to travel by plane until the gas is absorbed.
In patients with silicone oil in their eyes, it is usually necessary to remove the silicone oil after 3-6 months.
You can return home very shortly after vitrectomy surgery.
In the first days after surgery, discomfort, pain, redness and stinging sensation are common and expected conditions.
In order to protect your eyes from external factors, it is better to wander with an eye protection bandage for a few days or weeks after surgery.
With the seamless vitrectomy method developed in recent years, these problems have been considerably reduced.
Seamless vitrectomy method shortens the postoperative recovery period and operation time, reduces eye surface irritation and increases patient comfort.
Anatomical and vision improvement in the post-operative period is related to how much the sensitive structures of the eye were affected before the operation.
The results are very positive in intraocular bleeding where the retina is not affected.
Vision may reach better levels after the operation, especially in cases where the central retina is not affected.