Removal of vitreous was once thought of a dangerous procedure and not done as a routine. With understanding the disease and advent of modern vitreoretinal instruments and technique, it is done in a wide variety of patients with predictable results.
In this procedure diseased vitreous is removed, and it is replaced by ringer lactate solution.
Vitrectomy is helpful in following conditions:
Due to injury, eale's disease, diabetic retinopathy or vascular occlusion are managed by simple vitrectomy with good results. Laser photocoagulation may be done as a supplemental treatment at the end of surgery.
Diabetic Retinopathy with advanced fibrovascular proliferation or traction on macula or detachment can be managed reasonably well with highly skilled bimanual vitrectomy techniques combined with endolaser and gas or silicon oil.
Complicated Retinal Detachment or Giant Retinal Tear can be treated well by vitrectomy, removal of scar tissue around retina, endolaser, silicon oil temponade and scleral buckling. Perfluorocarbon liquid (PFCL) may be used during surgery to reattach retina.
Macular Hole & Macular Pucker are managed very well by vitrectomy operation with good anatomical result. The vision improvement is modest in successful surgeries.
Complications following Phakoemulsification surgeries for cataract are managed very well with predictable result by vitrectomy procedure.
Endophthalmitis due to very virulent organisms or unresponsive to medical treatment can be treated by vitrectomy in a good no. of patients.
Silicone oil removal is done after 3 to 6 months if the retina is attached and stable to prevent long term complications.
Cataract may need removal.
Retinal Detachment can sometimes occur following vitrectomy and may need another surgery.
Per say it is not a painful procedure and the recovery is good. However if any gas is injected in the eye at the end of surgery, patient may have to maintain a particular position for a couple of days to a week. Also flying is not permitted for 2 months usually if gas is ejected during surgery.