Vitrectomy: what is it and when is it performed?

24/10/2024

Vitrectomy: what is it and when is it performed?

The vitreous humour, or vitreous gel, is a gelatinous substance that fills the space between the retina and the lens, helping to maintain the consistency and transparency of the eyeball. Pars plana vitrectomy is a surgical procedure in which this gel is removed to treat various eye conditions, such as retinal detachment or macular holes.

Procedure

During vitrectomy, a small incision is made in the eye to access the vitreous gel. A specialized instrument called a vitrector is then used to cut and aspirate the gel. After removing the vitreous humour, a saline solution, gas, or silicone oil is injected to maintain the eye's structure. The procedure is performed under local or general anaesthesia, depending on the specific case and patient preference. Once the surgery is completed, a bandage is placed over the eye for several hours.

This technique offers varied results based on the specific condition treated and the individual characteristics of each patient. Generally, vitrectomy helps to address the underlying pathology and minimize its long-term effects.

When is it indicated?

Vitrectomy may be recommended for various eye conditions:

• Macular hole: Performed to promote anatomical closure.
• Retinal detachment: Vitrectomy is often the preferred surgery to reposition the retina in its normal location.
• Vitreous haemorrhage: Necessary when bleeding in the vitreous cavity is secondary to conditions such as diabetic retinopathy or retinal tears, among other indications.
• Epiretinal membranes: These are layers of fibrous tissue that form on the retina's surface, distorting vision. Vitrectomy helps to remove these membranes and restore macular anatomy.
• Diabetic retinopathy: A common complication of diabetes mellitus that affects retinal function. Vitrectomy is performed in advanced cases involving intraocular haemorrhage, tractional processes, and/or retinal detachment.
• Uveitis: Inflammation within the eye affecting one or more parts of the uvea. Vitrectomy is performed in cases of persistent vitreous opacity, intraocular haemorrhage, or retinal detachment. It can also be performed for diagnostic purposes.

Dr. Santiago Abengoechea, ophthalmologist at Barraquer Ophthalmology Centre