223:– removal of layers of unhealthy tissue from the retina with minute instruments such as forceps (tiny grasping tools), picks (miniature hooks), and visco-dissection (separating layers of tissue with jets of fluid.) This layer of unhealthy tissue is called an epiretinal membrane and it can occur in anyone, but is more likely to occur in the elderly or in people who have had prior eye disease or eye surgery. If the patient has an epiretinal membrane and is also complaining of symptoms such as decreased visual acuity, then a membranectomy is performed in addition to the vitrectomy. Complications of this additional step are similar to complications of the standard vitrectomy procedure.
386:– may damage sight by either a non-proliferative or proliferative retinopathy. The proliferative type is characterized by formation of new unhealthy, freely bleeding blood vessels within the eye (called vitreal hemorrhage) and/or causing thick fibrous scar tissue to grow on the retina, detaching it. Often diabetic retinopathy is treated in early stages with a laser in the physician's office to prevent these problems. When bleeding or retinal detachment occur, vitrectomy is employed to clear the blood, membranectomy removes scar tissue, and injection of gas or silicone with scleral buckle may be needed to return sight. Diabetics should have an eye exam yearly.
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362:– a blinding condition where the lining of the eye peels loose and floats freely within the interior of the eye. Steps to reattach the retina may include vitrectomy to clear the inner jelly, scleral buckling to create a support for the reattached retina, membranectomy to remove scar tissue, injection of dense liquids to smooth the retina into place, photocoagulation to bond the retina back against the wall of the eye, and injection of a gas or silicone oil to secure the retina in place as it heals.
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280:– placement of a support positioned like a belt around the eyeball to maintain the retina in a proper, attached position. This is referred to as an "exoplant". Placement of the scleral buckle for patients who have had a retinal detachment has been shown to lead to reattachment approximately 80 to 90 percent of the time after one surgery. In cases of failure, most patients are treated with vitrectomy.
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199:. More recent advances have included smaller and more refined instruments for use in the eye, the injection of various medications at the time of surgery to manipulate a detached retina into its proper position and mark the location of tissue layers to allow their removal, and for long term protection against scar tissue formation. Several technologies and systems exist to treat vitrectomy.
637:
and it has been longer than 6 months, then a vitrectomy for that patient is unlikely to help. However, recent studies have shown that visual improvement might still be found in these patients. Given the high variability between outcomes for different patients with retinal detachments, it is very important to be examined by an ophthalmologist as soon as possible.
288:– In some cases, a lensectomy, or "cataract surgery", is done in conjunction with the vitrectomy. This extra procedure is performed when the lens of eye is cloudy (cataract), damaged during the vitrectomy, if there is attached to scar tissue, or if the pressure in the eye needs to be lowered (as in the case with some glaucomatous patients).
231:– injection of air into the eye to remove the intraocular fluid from the posterior segment of the globe while maintaining intraocular pressure to temporarily hold the retina in place or seal off holes in the retina. The air pressure is temporary as the posterior segment will soon re-fill with fluid.
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of the retina comes off too, outcomes might not be as good as they would if the macula was still attached. Also, the longer the time between the detachment and the reattachment, the worse the outcomes. Some ophthalmologists believe that if a patient has a retinal detachment that involves the macula
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is the most frequent complication. Many patients will develop a cataract within the first few years after surgery. Because there have been no published controlled trials evaluating the benefits and risks stemming from post vitrectomy cataract surgery, ophthalmologists have no clear evidence to rely
272:– In cases when there is a tear in the retina, or when there are unhealthy damaging blood vessels (which can be seen in patients with diabetic retinopathy), laser treatment can be used. In such cases, the laser is used to seal the hole or prevent growth of the unhealthy, damaging blood vessels.
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Problems such as return of the original condition, bleeding, or infection from the surgery may require additional treatment or can result in blindness. In the event that the patient would need to remain face down after surgery, a vitrectomy support system can be rented, to help aid during the
422:– deposits of various size, shape, consistency, refractive index, and motility within the eye's normally transparent vitreous humor which can obstruct vision. Here pars plana vitrectomy has been shown to relieve symptoms. Because of possible side effects it is used only in severe cases.
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to hold the retina in place. In contrast to the pneumatic retinopexy, however, the silicone oil remains in the eye until it is later removed surgically. Oils have less surface tension and buoyancy than gases so the tension exerted by the oil is about 30 times less than that of the gas.
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The return of eyesight after vitrectomy depends on the underlying condition which prompted the need for surgery. It also depends on patient age and their visual acuity before surgery. For example, if the eye is healthy, but filled with blood, then vitrectomy can result in return of
239:– In some cases, gas can be used to help hold the retina in place. Gas, or more typically mixed gas and air, is injected through the sclera and into the posterior segment of the globe. This procedure is often referred to as pneumatic retinopexy. Typical gases used are
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A Cochrane review found vitrectomy for patients with idiopatic macular hole improved visual acuity by about 1.5 lines on an acuity chart. Macular hole closure was 76% in those treated with vitrectomy compared to 11% in those observed.
251:. The retinal tamponade acts to hold the retina in place or temporarily seal off holes in the retina. The mixed gases disappear spontaneously once they have accomplished their purpose and the posterior segment re-fills with fluid.
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Each anesthesia technique has its advantages and disadvantages, and the selection of anesthesia will depend on various factors including the surgeon's and patient's choice, disease and additional surgical steps required.
534:) has to be maintained, such as face down or sleeping on the right or left side. The gas bubble will dissolve over time, but this takes several weeks. Flying should be avoided while the gas bubble is still present.
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Lastly, although vitrectomy surgery is often done to correct retinal detachments, a subsequent retinal detachment is a possible complication as well. Rates of retinal detachment have been reported to be less than 5%.
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Even before the modern era, some surgeons performed crude vitrectomies. For instance, Dutch surgeon Anton Nuck (1650–1692) claimed to have removed vitreous by suction in a young man with an inflamed eye. In Boston,
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found that in one study, cataract surgery was needed within two years for about half of the eyes operated on for idiopathic macular hole, and retinal detachment was found in about one in 20 eyes.
442:, swelling in the back of the eye. In most cases, the retinal edema can be managed with over-the-counter medication. In severe cases, this swelling can be treated with intra-ocular injections.
449:(inflammation of the fluids in the eye) or suprachoroidal hemorrhage (bleeding above the choroidal layer of the eye). Rates of these complications have been reported to be less than 0.5%.
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The success of these first procedures led to the development of techniques and instruments to remove clouding and also to peel scar tissue off the light sensitive lining of the eye—the
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is a general term for a group of operations accomplished in the deeper part of the eye, all of which involve removing some or all of the vitreous humor—the eye's clear internal jelly.
188:, to provide space for materials injected in the eye to reattach the retina such as gases or liquid silicone, and to increase the efficacy of other surgical steps such as
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with contributions from Thomas M. Aaberg Sr in late 1969 and early 1970. The original purpose of vitrectomy was to remove clouded vitreous humor—usually containing blood.
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entails removing small portions of the vitreous humor from the front structures of the eye—often because these are tangled in an intraocular lens or other structures.
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394:– the normal shrinking of the vitreous humor with aging can occasionally tear the central retina causing a macular hole with a blind spot blocking sight.
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Patients use eye drops for several weeks, or longer, to allow the surface of the eye to heal. In some cases, heavy lifting is avoided for a few weeks.
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Benson WE, Brown GC, Tasman W, McNamara JA (December 1988). "Complications of vitrectomy for non-clearing vitreous hemorrhage in diabetic patients".
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632:, some very important considerations are how long the retina has been detached, and what part of the retina was detached. For example, if the
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eyesight. With more serious problems, such as a retina which has detached several times, final sight may be only sufficient to safely walk (
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A gas bubble may be placed inside the eye, to keep the retina in place. If a gas bubble is used, sometimes a certain head positioning (
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247:. The gases are mixed with air to neutralize their expansive properties to provide for a longer acting (than air alone) retinal
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The development of new instruments and surgical strategies through the 1970s and 1980s was spearheaded by surgeon and engineer
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Parravano, Mariacristina; Giansanti, Fabrizio; Eandi, Chiara M; Yap, Yew C; Rizzo, Stanislao; Virgili, Gianni (2015-05-12).
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699:"A Family of Early English Oculists (1600–1751), With a Reappraisal of John Thomas Woolhouse (1664-1733/1734)"
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recovery time. This particular equipment may be used for as little as five days to as long as three weeks. A
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867:"Comparison of modern high-speed vitrectomy systems and the advantages of using dual-bladed probes"
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Petersen J. (1987). "The physical and surgical aspects of silicone oil in the vitreous cavity".
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259:– Similar to an air/gas exchange, or pneumatic retinopexy, the eye can also be filled with
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Machemer R (August 1995). "The development of pars plana vitrectomy: a personal account".
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Other common complications include high intraocular pressure, bleeding in the eye, and
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Additional surgical steps involved as part of modern vitrectomy surgeries may include:
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Wang CC, Charles S (1984). "Microsurgical instrumentation for vitrectomy: Part II".
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Leffler CT, Schwartz SG, Wainsztein RD, Pflugrath A, Peterson E (2017).
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There are a few complications that can result from vitrectomy surgery.
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with a laser can shrink unhealthy blood vessels or seal retinal holes.
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A wristband that provides a warning regarding risks post vitrectomy
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Roth M, Trittibach P, Koerner F, Sarra G (September 2005). "".
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Showing eyes shortly after vitrectomy and removal of bandages
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Graefe's
Archive for Clinical and Experimental Ophthalmology
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Oravecz R, Uthoff D, Schrage N, Dutescu RM (January 2021).
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748:"Ophthalmology in North America: Early Stories (1491–1801)"
653:, an American actor, screenwriter and playwright, released
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1161:"Vitrectomy surgery of diabetic retinopathy complications"
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upon when counseling patients about cataract surgery.
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Conditions which can benefit from vitrectomy include:
410:), or blocked blood vessels. Once blood is removed,
402:– bleeding in the eye from injuries, retinal tears,
956:Surgical Technology for the Surgical Technologist
445:More severe complications after a vitrectomy are
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1096:Do DV, Gichuhi S, Vedula SS, Hawkins BS (2018).
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958:(2 ed.). Delmar Learning. 2004. pp.
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596:Learn how and when to remove this message
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342:Learn how and when to remove this message
1942:Optical coherence tomography angiography
1231:"Vitrectomy for idiopathic macular hole"
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1741:Pre-Descemet's endothelial keratoplasty
1235:Cochrane Database of Systematic Reviews
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1872:Botulinum toxin therapy of strabismus
1865:Minimally invasive strabismus surgery
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1098:"Surgery for postvitrectomy cataract"
663:and his decision to undergo surgery.
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489:adding citations to reliable sources
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324:adding citations to reliable sources
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1695:Minimally invasive glaucoma surgery
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1518:Intrastromal corneal ring segment
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374:) distorting vision. Also called
1159:Constantin, Brănişteanu (2016).
985:Graefes Arch Clin Exp Ophthalmol
844:10.1097/00004669-198401000-00015
697:Leffler CT, Schwartz SG (2017).
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131:Single port 19-gauge vitrectomy
1974:Bagolini Striated Glasses Test
1769:Corneal collagen cross-linking
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33:Three port 23-gauge vitrectomy
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1932:Indocyanine green angiography
1927:Heidelberg Retinal Tomography
1759:Anterior chamber paracentesis
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173:Vitrectomy was originated by
1937:Optical coherence tomography
1816:Phototherapeutic keratectomy
1690:Excimer laser trabeculostomy
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1565:Photorefractive keratectomy
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1964:A-scan ultrasound biometry
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678:List of surgeries by type
203:Additional surgical steps
123:Anesthesia for vitrectomy
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404:subarachnoid hemorrhages
1917:Fluorescein angiography
1764:Boston keratoprosthesis
1726:Corneal transplantation
1498:Conductive keratoplasty
1796:Intravitreal injection
1660:Laser photocoagulation
1605:Glued intraocular lens
1289:(September 16, 1996).
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2014:Slit-lamp examination
1979:Color perception test
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920:"Epiretinal Membrane"
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1855:Harada–Ito procedure
1528:Laser blended vision
758:: 1179172117721902.
709:: 1179172117732042.
574:improve this article
485:improve this article
383:Diabetic retinopathy
320:improve this article
2039:Plaque radiotherapy
1912:Electroretinography
1630:Phacoemulsification
645:Cultural references
399:Vitreous hemorrhage
376:epiretinal membrane
245:sulfur hexafluoride
141:general anaesthesia
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113:John Collins Warren
96:Anterior vitrectomy
1922:Fundus photography
1907:Electrooculography
1892:Corneal topography
1860:Strabismus surgery
1071:Ophthalmic Surgery
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1437:
1435:
1434:
1429:
1424:
1419:
1414:
1413:
1412:
1405:Blepharoplasty
1401:
1399:
1390:
1384:
1383:
1381:
1380:
1375:
1374:
1373:
1363:
1357:
1354:
1353:
1348:involving the
1341:
1340:
1333:
1326:
1318:
1310:
1309:
1278:
1218:
1192:
1151:
1088:
1061:
1018:
975:
968:
936:
908:
857:
822:
787:
738:
688:
687:
685:
682:
681:
680:
675:
668:
665:
661:macular pucker
656:Gray's Anatomy
646:
643:
604:
603:
562:
560:
553:
547:
544:
515:
514:
473:
471:
464:
458:
455:
427:
424:
367:Macular pucker
350:
349:
308:
306:
299:
293:
290:
204:
201:
190:scleral buckle
170:
164:
124:
121:
86:vitreous humor
77:
76:
69:
66:
65:
58:
52:
51:
42:
36:
35:
32:
24:
23:
15:
9:
6:
4:
3:
2:
2098:
2087:
2084:
2082:
2079:
2078:
2076:
2061:
2058:
2056:
2053:
2052:
2050:
2046:
2040:
2037:
2036:
2034:
2032:
2026:
2020:
2017:
2015:
2012:
2010:
2007:
2005:
2002:
2000:
1997:
1995:
1992:
1990:
1987:
1985:
1982:
1980:
1977:
1975:
1972:
1970:
1967:
1965:
1962:
1961:
1959:
1957:
1951:
1943:
1940:
1939:
1938:
1935:
1933:
1930:
1928:
1925:
1923:
1920:
1918:
1915:
1913:
1910:
1908:
1905:
1903:
1900:
1898:
1895:
1893:
1890:
1889:
1887:
1885:
1879:
1873:
1870:
1866:
1863:
1862:
1861:
1858:
1856:
1853:
1852:
1850:
1848:
1842:
1832:
1829:
1827:
1824:
1822:
1819:
1817:
1814:
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1809:
1807:
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1799:
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1777:
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1775:
1772:
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1742:
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1729:
1728:
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1712:
1706:
1703:
1701:
1698:
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1686:
1683:
1682:
1680:
1678:
1672:
1666:
1663:
1661:
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1636:
1633:
1632:
1631:
1628:
1626:
1623:
1621:
1618:
1616:
1613:
1611:
1608:
1606:
1603:
1601:
1598:
1596:
1595:Capsulorhexis
1593:
1592:
1590:
1588:
1582:
1576:
1573:
1571:
1568:
1566:
1563:
1561:
1558:
1556:
1553:
1549:
1546:
1545:
1544:
1541:
1539:
1536:
1534:
1531:
1529:
1526:
1524:
1521:
1519:
1516:
1514:
1511:
1509:
1506:
1504:
1503:Corneal inlay
1501:
1499:
1496:
1494:
1491:
1489:
1488:Alpins method
1486:
1485:
1483:
1481:
1475:
1472:
1470:
1466:
1456:
1453:
1451:
1448:
1447:
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1433:
1430:
1428:
1425:
1423:
1420:
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1411:
1408:
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1403:
1402:
1400:
1398:
1394:
1391:
1389:
1385:
1379:
1376:
1372:
1371:Oculoplastics
1369:
1368:
1367:
1364:
1362:
1359:
1358:
1355:
1351:
1347:
1339:
1334:
1332:
1327:
1325:
1320:
1319:
1316:
1298:
1297:
1292:
1288:
1287:Todd McCarthy
1282:
1274:
1270:
1265:
1260:
1256:
1252:
1248:
1244:
1240:
1236:
1232:
1225:
1223:
1206:
1202:
1196:
1188:
1184:
1179:
1174:
1170:
1166:
1162:
1155:
1147:
1141:
1133:
1129:
1124:
1119:
1115:
1111:
1107:
1103:
1099:
1092:
1084:
1080:
1077:(12): 862–4.
1076:
1072:
1065:
1057:
1053:
1049:
1045:
1041:
1037:
1034:(9): 728–32.
1033:
1029:
1022:
1014:
1010:
1006:
1002:
998:
994:
990:
986:
979:
971:
965:
961:
957:
953:
947:
945:
943:
941:
925:
921:
915:
913:
904:
900:
895:
890:
885:
880:
876:
872:
868:
861:
853:
849:
845:
841:
837:
833:
826:
818:
814:
810:
806:
803:(8): 453–68.
802:
798:
791:
783:
779:
774:
769:
765:
761:
757:
753:
749:
742:
734:
730:
725:
720:
716:
712:
708:
704:
700:
693:
689:
679:
676:
674:
671:
670:
664:
662:
658:
657:
652:
651:Spalding Gray
642:
638:
635:
631:
626:
624:
620:
610:
600:
597:
589:
579:
575:
569:
568:
563:This section
561:
557:
552:
551:
543:
541:
535:
533:
528:
521:
511:
508:
500:
490:
486:
480:
479:
474:This section
472:
468:
463:
462:
454:
450:
448:
443:
441:
440:retinal edema
436:
433:
426:Complications
423:
421:
420:
415:
413:
409:
405:
401:
400:
395:
393:
392:
391:Macular holes
387:
385:
384:
379:
377:
373:
369:
368:
363:
361:
360:
355:
346:
343:
335:
325:
321:
315:
314:
309:This section
307:
303:
298:
297:
289:
287:
286:
281:
279:
278:
273:
271:
270:
265:
262:
258:
257:
252:
250:
246:
242:
238:
237:
232:
230:
229:
224:
222:
221:
220:Membranectomy
216:
209:
200:
198:
197:Steve Charles
193:
191:
187:
186:membranectomy
183:
178:
176:
168:
163:
159:
157:
154:
150:
146:
142:
138:
129:
120:
118:
114:
108:
106:
104:
99:
97:
93:
91:
87:
83:
73:
67:
63:
59:
57:
53:
50:
46:
43:
41:
37:
30:
25:
20:
1830:
1786:Evisceration
1655:Ignipuncture
1455:Punctoplasty
1432:Tarsorrhaphy
1300:. Retrieved
1294:
1281:
1238:
1234:
1209:. Retrieved
1207:. 2018-08-07
1204:
1195:
1168:
1164:
1154:
1140:cite journal
1105:
1101:
1091:
1074:
1070:
1064:
1031:
1027:
1021:
991:(6): 452–6.
988:
984:
978:
955:
927:. Retrieved
923:
874:
870:
860:
838:(1): 63–71.
835:
831:
825:
800:
796:
790:
755:
751:
741:
706:
702:
692:
654:
648:
639:
627:
615:
592:
583:
572:Please help
567:verification
564:
536:
531:
529:
526:
503:
494:
483:Please help
478:verification
475:
451:
444:
437:
429:
417:
416:
397:
396:
389:
388:
381:
380:
365:
364:
357:
356:
353:
338:
329:
318:Please help
313:verification
310:
283:
282:
275:
274:
267:
266:
254:
253:
234:
233:
226:
225:
218:
217:
214:
194:
179:
172:
166:
160:
158:irrigation.
153:intracameral
135:Options for
134:
109:
102:
101:
100:
95:
94:
81:
80:
2081:Eye surgery
2009:Retinoscopy
1969:Amsler grid
1956:examination
1845:Extraocular
1774:Enucleation
1600:Capsulotomy
1366:Eye surgery
1211:22 November
1171:(1): 31–6.
673:Eye surgery
625:) or less.
292:Indications
2075:Categories
1994:Gonioscopy
1989:Funduscopy
1831:Vitrectomy
1826:Sclerotomy
1801:Iridectomy
1478:Refractive
1346:procedures
1344:Tests and
929:3 December
684:References
497:April 2021
332:April 2021
285:Lensectomy
169:vitrectomy
167:Pars plana
137:anesthesia
105:vitrectomy
103:Pars plana
82:Vitrectomy
22:Vitrectomy
2029:Radiation
1821:Pterygium
1779:Conformer
1513:Epi-LASIK
1255:1465-1858
1056:260205524
649:In 1996,
586:June 2018
532:posturing
249:tamponade
156:lidocaine
88:from the
2055:Couching
1806:Peritomy
1675:Glaucoma
1585:Cataract
1273:25965055
1187:27220230
1132:29364503
1048:16175483
903:33468260
877:(1): 8.
852:10265855
782:28804247
733:28989288
667:See also
457:Recovery
432:Cataract
117:glaucoma
40:ICD-9-CM
2048:History
2031:therapy
1884:imaging
1882:Medical
1847:muscles
1677:surgery
1648:surgery
1646:Retinal
1635:Prechop
1587:surgery
1480:surgery
1397:Eyelids
1302:June 4,
1296:Variety
1264:6669239
1178:5712917
1123:4257703
1083:3231410
1013:9857386
1005:3678857
960:580–581
894:7814550
817:8537019
773:5533269
724:5624362
628:With a
546:Outcome
62:D014821
1388:Adnexa
1271:
1261:
1253:
1185:
1175:
1130:
1120:
1081:
1054:
1046:
1011:
1003:
966:
901:
891:
850:
815:
780:
770:
731:
721:
634:macula
372:macula
182:retina
1752:Other
1575:SMILE
1543:LASIK
1469:Globe
1052:S2CID
1009:S2CID
619:20/20
70:[
49:14.74
45:14.73
1350:eyes
1304:2018
1269:PMID
1251:ISSN
1239:2015
1213:2019
1183:PMID
1146:link
1128:PMID
1079:PMID
1044:PMID
1001:PMID
964:ISBN
952:"16"
931:2019
899:PMID
848:PMID
813:PMID
778:PMID
729:PMID
406:(as
151:and
56:MeSH
1954:Eye
1259:PMC
1243:doi
1205:AAO
1173:PMC
1118:PMC
1110:doi
1036:doi
1032:222
993:doi
989:225
889:PMC
879:doi
840:doi
805:doi
801:233
768:PMC
760:doi
719:PMC
711:doi
576:by
487:by
322:by
243:or
90:eye
2077::
1293:.
1267:.
1257:.
1249:.
1237:.
1233:.
1221:^
1203:.
1181:.
1169:60
1167:.
1163:.
1142:}}
1138:{{
1126:.
1116:.
1104:.
1100:.
1075:19
1073:.
1050:.
1042:.
1030:.
1007:.
999:.
987:.
962:.
954:.
939:^
922:.
911:^
897:.
887:.
873:.
869:.
846:.
834:.
811:.
799:.
776:.
766:.
754:.
750:.
727:.
717:.
705:.
701:.
192:.
147:,
143:,
119:.
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1330:t
1323:v
1306:.
1275:.
1245::
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1148:)
1134:.
1112::
1106:1
1085:.
1058:.
1038::
1015:.
995::
972:.
933:.
905:.
881::
875:7
854:.
842::
836:9
819:.
807::
784:.
762::
756:9
735:.
713::
707:9
599:)
593:(
588:)
584:(
570:.
510:)
504:(
499:)
495:(
481:.
345:)
339:(
334:)
330:(
316:.
184:—
74:]
47:-
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