Vitrectomy - Causes, symptoms and treatment. MF.
Vitrectomy is a surgical operation of partial or complete removal of the vitreous. The operation is performed in a hospital with special equipment by an ophthalmologist who has a large clinical and practical experience.
Indications:
1. Hemophthalm.
2. Retinal detachment.
3. Injuries and surgical operations with significant loss of vitreous body.
4. Foreign body inside the vitreous.
5. Gaps in the retina of large sizes.
6. Severe proliferative retinopathy.
7. Significant opacity of the vitreous humor.
Contraindications:
1. Significant corneal opacity.
2. Allergic reactions.
3. Severe disorders of the blood coagulation system.
Progress of operation
The operation is performed at the doctor's discretion either under local anesthesia or under anesthesia. The patient lies on the operating table with his head in the direction of the surgeon. With the help of the eyelid extensions, eyelids are divorced and fixed in this position for the duration of the entire operation.
The doctor on the sclera makes several incisions through which the instruments are inserted into the eye: vitreotome and a lighting device, as well as an infusion cannula.
With the help of these devices, the vitreous body is separated and sucked, and then this cavity is filled with silicone oil or a special gas-air mixture. Filling the inner space of the eyeball, the oil or mixture, as it were, presses the retina to the underlying layers and keeps it in this position. During the operation, the patient does not feel anything;preliminary anesthesia is performed.
The operation lasts an average of about 1.5 hours, but the duration can reach 3 hours. The duration of the operation depends on the severity of the pathological process. In addition, it is not always possible to perform an operation immediately, so sometimes you have to perform it in several stages.
After operation
After operation for several days it is necessary to stay in a hospital under the supervision of a doctor. After the operation for a certain period of time( the doctor will tell you), weight lifting, torso of the trunk, intensive visual load are forbidden.
Complications of vitrectomy
As with any other operation, vitrectomy also has inherent risks of complications, both during and after a while. Thus, during the operation, the occurrence of rupture of the retina, its detachment, the occurrence of bleeding may occur, as well as damage to the lens. After a while after surgery, there is a risk of rebleeding, cataract development, increased intraocular pressure, inflammation, corneal changes, retinal detachment.
As a rule, vision is not restored immediately after the operation, but this is only if there is no serious pathology of the retina or optic nerve, when vision can not be restored.
Modern medicine already allows you to perform a vitrectomy operation on an outpatient basis, i.e.without hospitalization in a hospital( microinvasive vitrectomy).Every year the diameter of the working tools decreases, at present the operations are carried out through 3 microscopic punctures of only 0.3-0.5 mm. Improvement of options in vitreoretinal devices, increase in the frequency of cutting the knife from 2500 to 5000 beats per minute, allow to reduce the operation time, reduce the traumatic nature of the operation to make it as effective as possible. The use of multipoint self-locking lighting sources frees the hands of the surgeon for additional tools that facilitate the work of the surgeon and help reduce the time of the operation. And the use of special optical wide-angle systems provides maximum visibility of all parts of the retina, making the operation more accurate and qualitative. In the morning the patient comes to a medical institution, the doctor performs the operation and 2-3 hours after the operation and in the absence of complications the patient can leave this medical institution. But the patient must be observed at the ophthalmologist and strictly observe all the recommendations of the doctor. When pain occurs in the operated eye or redness, you should immediately consult a doctor. But, unfortunately, such modern equipment is not available in many clinics.
Doctor ophthalmologist Odinochko Е.А.