3D Vitrectomy


Table of Contents

What is vitrectomy?

A vitrectomy is a surgical technique used to cure diseases that affect the transparency of the vitreous (which is the internal gel of the eye) or problems that affect the retina (which is the back of the eye).

During vitrectomy, the retina specialist removes all of the vitreous from the middle of your eye. This vitreous is replaced with either a salt water (saline) solution or a bubble made of gas or oil.

During healing after surgery, your eye replaces the saline solution or the bubble with the natural fluid the eye makes called aqueous humor.

Vitrectomy animation

When is vitrectomy recommended?

Your retina specialist may recommend a vitrectomy if you have one condition that affect the vitreous such as hemorrhages and problems that affect the retina. These are the main indications:

Subhyaloid hemorhage in Diabetic retinopathy. This complications are the first indication for surgery in Mexico and US Copyright Retina Center

How is a vitrectomy done?

Vitrectomy is usually done in an outpatient surgery center. surgery is performed under local anesthesia using a surgical microscope and may take between 30 minutes to 2 hours depending on the complexity of the case.

The surgeon usually places 3 access routes, each of which is a small microincision less than 1 mm in diameter. The first access route is used for the infusion system (liquid entry) to maintain a specific pressure inside of the eye. The second access route is used for a fiber optic light that illuminates the retina, and the third access route is for the vitrector to cut and remove the vitreous gel.

Vitrectomy video animation Copyright Retina Center
Vitrectomy as seen from the outside and inside

Sometimes a vitrectomy is combined with other surgeries, such as a cataract extraction with the implantation of an intraocular lens. This surgery is called phacovitrectomy.

What is phacovitrectomy?

Traditionally, in the United States, retinal surgeons do not perform combined phacoemulsification (cataract surgery) and vitrectomy, also known as phacovitrectomy a combined procedure that offers benefits for patients, surgeons, and the health care system.

Patients with visually significant cataracts undergoing vitrectomy are candidates for phacovitrectomy. Even patients with mild degrees of lenticular change are suitable for this procedure, as this will negate the need for cataract surgery at a later date and provide excellent posterior pole visualization for the surgeon.

Pars plana phacovitrectomy approach Copyright Retina Center

Advantages of phacovitrectomy

Benefits to the patient:

  • The patient avoids 2 trips to the operating room and has a faster overall postoperative recovery course compared with undergoing 2 separate procedures at different dates
  • The patient saves money by avoiding 2 procedures
  • The patient saves time, as he or she does not need to make appointments to see an anterior segment surgeon for the cataract procedure
  • Those without health insurance or who otherwise pay out of pocket greatly benefit from the combined procedure
  • Visual rehabilitation is faster

Benefits to the surgeon:

  • A better view of the retina is afforded for delicate maneuvers such as internal limiting membrane peeling and for detection of small retinal breaks
  • There are no scheduling mishaps causing the retina surgeon to have to wait for the cataract surgeon to begin the case
  • The patient is happy with the retina surgeon’s results, rather than allowing the cataract surgeon to become the hero when he or she does the cataract surgery at a later date
Constellation vision system
Our state-of-the-art medical equipment for vitrectomy Alcon Constellation Vision System
We use the best ophthalmic microscope on the market for our retina surgerys

What are the surgery risks?

The risk of complications with a vitrectomy is small, with about 1 in 200 patients developing a retinal detachment (which can be treated) and 1 in 2000 patients developing an infection after surgery.

Another possible risk after vitrectomy is getting a cataract in that eye. This is especially likely to happen in people over age 50 who have vitrectomy. If you already had cataract surgery with a lens implant, vitrectomy will not harm your implanted lens.

But remember, vitrectomy surgery often improves vision or keeps it from getting worse.

Here are some examples of Vitrectomies that we’ve performed

Retinal detachment
Vitrectomía por hemorragia vitrea secundaria a diabetes
Combined Phacovitrectomy due diabetic retinopathy complications
To remove floaters
Macular Hole
Epiretinal membrane
Vitrectomy to fix an intraocular lens

Don’t hesitate to visit our YouTube channel Dr. Aureliano Moreno RC Tijuana to see more videos like this one. Dr. Moreno has performed more than 5,000 successful retinal and cataract surgeries.

Additional information: American Society of Retina Specialists

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