Vitreous
surgery is performed in an operating room under local or general
anesthesia. The vitreous is removed and, therefore, this procedure
is called Vitrectomy. Dr. Campbell uses fiberoptic light to
illuminate the inside of the eye and other instrument inside
the eye, such as forceps, and scissors, to do the surgery.
The vitreous is replaced during the operation with either
clear fluid that is compatible with the eye, or with gas that
completely fills the eye. Over time, the fluid (or gas) is
absorbed by the eye and is replaced by the eye’s own
fluid; the eye does not replace the vitreous gel itself. The
lack of vitreous gel does not affect the functioning of the
eye.
The most common conditions requiring vitrectomy
are retinal detachment in an eye that has had cataract surgery,
vitreous hemorrhage with retinal detachment, proliferative
vitreoretinopathy, giant retinal tear, diabetic retinopathy
with vitreous hemorrhage and/or traction retinal detachment,
epiretinal membrane (macular pucker), intraocular infection;
endophthalmitis, trauma, intraocular foreign body, and macular
hole.
In a vitrectomy , instruments are passed through the sclera
into the vitreous cavity. A variety of instruments can be
used to remove the vitreous gel and any scar tissue that may
be growing on the surface of the retina. A laser probe can
be inserted into the eye so that laser treatment can be done
during surgery.
Vitrectomy can be combined with the placement of a scleral buckle. Usually, air, gas, or silicone oil is placed in the vitreous cavity. These materials hold the retina in place against the back wall of the eye while the laser scars are forming. After this surgery, it may be important for the patient to maintain a certain position of the head, which is often a face-down (prone) position. Eventually, the gas is absorbed and replaced by fluid produced by the eye. If silicone oil has been used, in some cases, it must be removed at a later time with another surgical procedure. Vitreous surgery usually lasts one to two hours but, with very severe and difficult problems, may take longer. Following surgery, the patient may experience some discomfort and a scratchy sensation in the eye due to the sutures placed at the end of surgery, but significant pain is unusual. If it occurs, Dr. Campbells office should be notified promptly.


