After Vitrectomy. Vitrectomy Operation to remove a vitreous body

24.05.2020

Vitrectomy is a type surgical interventionwhich is used in the treatment of retinal diseases, fiscame body and macula degeneration. At the end of the operation, a clear solution is introduced into the eye area to fill the former volume and shape of the eye.

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During treatment with the help of vitrectomy from the vitreous body, scars, blood or pathological modified tissues causing traction (tension) of the retina are removed. Remote glassy body is replaced by a balanced brine and artificial polymers. Such artificial substances, expanding, press the penetrated retina from the inside to the walls of the eye. Thus, holding the retina in a normal position, the re-intraocular hemorrhages and the growth of newly formed pathological vessels prevent.

Indications

In what cases use vitrectomy?

Vitectomy is applied in the following cases:

retinal disinsertion
diabetic Retinopathy
macular hole
epietinal membranes
complications of cataract surgery, such as a lens dislocation or IOL offset
injuries
macula edema

Preparation for the operation

Before surgery:

Decision is made before the operation, whether the operation will be carried out under local or general anesthesia. Most patients vitratectomy are carried out under local anesthesia in combination with intravenous adhesion. This method of anesthesia creates ideal conditions for both the surgeon, and for the patient, which thus avoids possible complicationsassociated with general anesthesia. Hospitalization in the clinic is not required.

During the operation

What happens during the operation?

The duration of the procedure is 40-90 minutes. Vitrectomy can be combined with other types of surgical operations (for example, cataract or keratoplasty removal operations). During the operation, the doctor removes through the pockets of the fountain body fabric in the required volume, after which the required treatment is carried out: carries out the laser sections of the retina, seals the separation portions, restores the integrity of the mesh shell of the affected eye. Vitrectomy is a high-tech procedure that requires a surgeon experience, proper technical support and high-quality materials.

AT last years All over the world introduced new method Vitratectomy with minimal cuts that do not require seams.

After operation

After operation:

AT postoperative period The patient may experience a small discomfort. A bandage is superimposed on the operated eye. The doctor prescribes eye drops For the next 3-4 weeks. Patients with endotamponade retina gas is recommended not to rise to a large height and use ground transport to complete gas dissolution. Otherwise, there is a risk of increasing intraocular pressure.

Installing the drops begins after the operation and lasts for one month.

Patients after endotamponades of the retina gas:

it is forbidden to rise to a large height or fly by plane until the gas dissolution
head must be kept in a certain position within 10 days after surgery (your doctor will give detailed instructions)
in case of the need for general anesthesia before the gas is completely dissolved, first consult with your surgeon
for several weeks after the operation, your vision will not be full until the total absorption of the gas.

- It is forbidden to rub eyes within a month after surgery. It is necessary to avoid any intense physical activity as swimming or sports games.
- When my face, avoid the area of \u200b\u200bthe operated eye. If necessary, rinse your eyes, use the bandage moistened in cooled boiled water
- The pupil of the operated eye will be larger than the silence of the second eye for two weeks
- It may be necessary to adopt analgesics in the first postoperative days. Avoid aspirin. Recommended depon or lonarid
- In the first weeks after the operation you can annoy strong light. For this reason, it is recommended to use on the street sunglasses
- in case of a sudden impairment of vision, strong pain Or the appearance of "shadows", which stretches before the operated eye, as a curtain, you must immediately consult a doctor.

Vitrectomy, that's surgeryWhich is successfully used in hemorrhages in the vitreous body, the retinal detachment of the eye, severe injuries of the visual analyzer and diabetes mellitus.

All listed diseases were previously considered incurable and eventually led to loss of vision. Today modern medicine offers Vitrectomy as effective method Correction and treatment of eye diseases.

Vitrectomy is understood as an operation to remove from the eyes of a vitreous body. This structure occupies the largest volume. The body can be removed in part, i.e. Make a subtotal vitrectomy, and can be completely.

After Vitrectomy, an ophthalmologist receives full access to the retinal tissue. This allows the photocoagulation ("soldering") of the retina, moving from it a scar cloth, or restore the integrity of the shell.

When removing the vitreous body of the eye, gas or a special fluid is introduced instead.

This operation can be carried out under local or under general anesthesia.

The main reasons for the operation are:

Eye injuries, for example, due to the penetration of the foreign object;
Retinal detachment that occurred as a result of severe myopia sugar diabetes or from aging of the vitreous body. The retina can also be squeezed due to sulfur-shaped cell anemia or penetrating eye injuries;
Impregnating the blood of a vitreous body - hemophthalm;
Intraocular infection in severe;
- the diabetic pathology of the retina, complicating the detachment of the mesh shell of tracting type, hemophthalm, or electoral spots;
A serious staging of the vitreous body;
Large sizes of retinal rupture;
Hole in Makula (Yellow Stain) or a gap;
Dislocation of lens or intraocular lens replaced it (in case surgical treatment cataracts);
Removal of scar tissues in turbidity or multiple hemorrhages. Hemorrhage can provoke a fiber detachment, emergency measures will be required.

Conducting an operation

To produce operational treatmentThe patient is hospitalized for several days. After a preliminary careful examination, it is prescribed a date of operation.

Before the operation, about 18:00, the patient must take food for the last time. After that, before the operation, it is impossible, nor drink. Operational intervention lasts about 2 hours.

Vitrectomy eyes can be carried out after instilcing anesthetic agent, or under general anesthesia. The solution depends on the state of the patient, the presence of other diseases and the total number of intended procedures.

The surgical operation itself is performed on the patient, which is located in the pose lying on the back. After combined or local anesthesia, a special eyelid is inserted into the eye, it will fix the eyes during the procedures performed by the surgeon.

After that, there are 3 small outbreaks in the eye, where the tools are injected, which give the surgeon to manipulate on the retina and the vitreous body.

The surgeon uses the following toolkit during operation:

Vitreot - a special cylinder with a knife,
Lighting device
Cannula for regular feeding in the eyeball of a sterile saline solution. The substance supports an apple eye in a normal tone.

The vitreous body must completely suck the vacuum. From the body after that they are removed: scars, pathological tissues, blood. Next, the doctor conducts manipulation on the retina.

The vitreous body, which was removed, replaced:

A mixture of air or sterile air with a gas, if the target is to shift the retina, as well as keep it in a normal position (in the event of a break of the yellow spot area. The mixture is solved on 3 weeks. After this time, its intraocular fluid appears;
Fluoroorganic liquid, i.e. Water, which is saturated with fluorine or silicone oil. Liquid by weight is heavier than water. Silicone oil is much heavier than water, it presses the retina for 3-4 months, after which the doctor removes it.

Microfervasive Vitrectomy

A variety of surgical intervention is the extraction of a whole vitreous body or its part. The operation is carried out in three microscopic punzes with a size of 0.3-0, 5 mm. An even smaller tools are introduced into the punctures.

It is characteristic that the frequency of the work of the Vitreotoma with microinvasive vitrectomy is higher, and is not 2500 per minute, but twice as much. In addition, another type of illuminators is used - self-locking multipoints.

Features of the operation are as follows:

Low traumatic level;
Reducing the risk of bleeding, which is important when excessive springs of vessels in fiber;
Operation is performed in amublastic conditions, without hospitalization;
Reduced postoperative rehabilitation.

Microsvasive vitrectomy is not performed in all ophthalmic centers.

Vitrectomy reviews directly depend on the qualifications of the doctor and the presence of a special tool.

Features of the postoperative period

After standard vitrectomy, the patient for 1-3 days should be abide medical institution, under the strict control of doctors.

Patient's vision is restored after a while after the operation. The degree of recovery and duration depends on the following factors:

The presence of severe pathologies of the mesh shell;
Penalty of optical eyes for the light beam;
condition spectator nerve.

If the vitreous body was replaced by brine, then some time the blood elements will be fluent in the eye. Patient reviews indicate that a few weeks can be maintained.

If the vitreous body was replaced with a gas mixture, then black wrench will appear, which will leave for seven days.

With late treatment, when the retina has already acquired irreversible changes, rehabilitation activities are held for a long time.

After the vitrectomy for 3-6 months is prohibited:

Lift gravity weighing more than two kilograms;
Read more than 30 minutes;
Bend over the fire of the gas stove or stand over open fire;
Play sports where tilts are present;
Testing any intense physical exertion.

Please note, after surgery, you do not need to comply with a special diet.

The following complications may arise:

Eye pressure hanging, which is as dangerous for people suffering from glaucoma;
Retinal detachment;
Hemorrhage in the vitreous body;
Formation of an infectious intraocular process;
Leakage of lens;
Cataract;
Swelling of the areas under the cornea - the outer shell of the eye;
The emergence of the mass of new vessels in the iris, which can provoke glaucoma.

The better the preparation for operation and preoperative research will be carried out, the greater the likelihood of avoiding complications.

Vitrectomy is the most common operation if you need to remove the vitreous body of the eye, especially when. Often, the operation is the only condition for the rescue of the human view. Currently, Vitrectomy is performed on modern equipment in good medical conditions.

More than half of the volume. Vitractomy It assumes the full or partial removal.

It is carried out under anesthesia and has the following testimony:

severe infection inside the eye;
organ;
turbidity of the vitreous body;
dislocation.

During the operation, the doctor makes three small outbreaks in the eye, which introduces tools. Then the vitreous body is sucked off with vacuum and remove the blood with the scars. The transparent mass is replaced with silicone oil, sterile air with gas or fluororganic liquid.

There are 2 types of surgery:

Total.
Subtotal (content eyeball Not completely deleted).

The last look is divided into another two subspecies. Vitrectomy happens:

Rear. Performed with the pathology of the rear segment.
Front. In this case, the vitreous body penetrates the front chamber of the eye as a result of crust problems, injuries, or.

A variety of surgical intervention is microfervasive Vitrectomy . It is carried out using tools little sizethat insert into microproballs.

Such an operation has many advantages, including:

a short period of rehabilitation;
low traumatic level;
reduced risk of bleeding;
optional hospitalization.

The success of the procedure depends on the qualification of the surgeon and the availability of special tools.

Video:

Price

Pay for the operation will have a lot. This manipulation is carried out only in large eye centers that have all the necessary equipment. In Russia, there are no such clinics.

Perform vitrectomy only experienced vitreoretinal surgeons.

The cost of the operation begins from 20 thousand rubles And it comes to up to 100 thousand rubles .

It depends on several parameters:

type of surgical intervention;
complexity category;
type of anesthesia;
surgeon qualifications;
region.

So, front vitrectomy 1 category difficulties will cost approximately 20 thousand rubles, and the same operation, but already 2 categories difficulties - 25 thousand rubles. Surgical intervention with complicated states higher category costs about 100 thousand rubles.

In each case, the price will differ. Only a doctor and anesthesiologist may completely determine it after survey.

Postoperative period

Usually after surgery, the patient stays in the hospital for no more than 3 days.

After the procedure, the doctor jars the eye with a bandage to protect against dirt. It must be removed the next morning and gently process the eyelids sterile tampon, which is pre-wetted in an aqueous solution of the antibacterial drug.

The recovery rate depends on several factors:

the presence of severe diseases;
state card nerves;
the possibility of perceiving objects.

In case of replacing the vitreous body on saline Browse eyes remains for several weeks. If there is a gas mixture, a black film appears, which takes place in a week.

After the operation for six months, it is prohibited:

read more than half an hour;
raise objects more than 2 kg;
stand, leaning over fire;
engage in active sports;
ride driving;
rub eyes or put pressure on it;
look at UV rays;
skip the appointed reception doctor;
ignore doctor's recommendations.

Special diet after winctomy is not required. During the washing, it is necessary to avoid soaps and water into the eyes. The head is better to wash, tilting back. In case of water from entering the healing organ of view, it should be rinsed aqueous solution 0.02% Furatcin.

After the operation, some complications may arise:

detachment of the inner shell;
infection inside the eye;
cataract;
edema of the outer shell of the eye;
glaucoma;
blood getting into the vitreous body;
macular;
raising.

You can avoid negative consequences, if you carefully prepare for the operation and to spend high-quality before the vitrectomy.

In any case, late treatment causes irreversible consequencesand the rehabilitation period is delayed.

Vitrectomy - This is an operational intervention, providing for a complete or partial removal of the vitreous body. This treatment method is shown at breaks or total retinal detachment, diabetic retinopathy, exceeding the acoustic density of the vitreous body 19 dB, traumatic damage or foreign body Eye apple. For the operation, 3 micro is carried out and the special irrigation system is powered. After removing the vitreous body, silicone tamponade is required with the removal of PFOS. Complete Witrectomy overlapping X-shaped Varquilova seam. Spectatical functions after the intervention conducted are gradually restored within 2-3 months.

Vitrectomy is a routine operation in the field of microsurgery of the eye. The tactics of surgical intervention was developed in 1972 by the German ophthalmologist R. Mahemer after the invention of the first vitreotoma. The closed method of operational impact was introduced into clinical practice in 1977. Subsequently, experts created a modification of vitrectomy by the type of "Open Sky". This method of treating the pathology of the retina and the vitreous body is used in the case of low efficiency or presence of contraindications to conservative therapy and modern methods Correction of pathologies of the organ of vision. Vitrectomy is an indispensable technique in the urgent surgery of the eye.

The operation to remove the vitreous body requires the presence of ophthalmic equipment (vitreot, irrigation system) and a specially prepared command of ophthalmoshurgeons. The advantages of Vitrectomy are its economy, wide spectrum Indications and high efficiency. Operational intervention is carried out simultaneously, the re-conducting is not required, which is an advantage compared to laser vitreolysis. However, due to the fact that Vitrectomy is an invasive method of treatment, the risk of intra- and postoperative complications When using this technique is much higher.

Indications and contraindications

Vitrectomy is shown in the central and gigantic breaks of the inner shell of the eyeball. The technique is used in damage to the retina, accompanied by signs of traction on the periphery. With a total detachment, the removal of a vitreous body is an alternative method of treatment in patients with contraindications to episcileral sealing. In patients with diabetic retinopathy at the stage of exudation or proliferation, not accompanied by hemophthalm or preset fibrosis, the subtotal vitrectomy is carried out. The testimony to resection of the vitreous body is the excess of its acoustic density of 19 dB according to the results of the quantity ultrasonic echolocation.

Operational intervention is performed when the inner shell of the eyeball from the toothed line, the secondary detachment on the background infectious diseases and traumatic damage. Vitrectomy is carried out according to individual indications in patients with penetrating injuries of the organ of vision. In the event that the hemophthalma led contusion 2-3 degrees of gravity, this treatment method can be applied no earlier than 7-10 days after injury. With a diagnosed foreign body with signs of propellers located in the thickness of the vitreous body or on the eye day, the vitrectomy is shown within healthy tissues.

Partial or subtotal variety operational intervention Permanently performed with double penetrating injuries. In addition, this surgical tactic is used in post-traumatic changes in the eyeboard and a vitreous body in patients with high-density clouds or fibrosis. Vitrectomy has limitations to use in patients with turbidity of the horny shell of the eye. Contraindication to surgical intervention are coagulopathy in the decompensation stage. Surgical tactics of treatment is recommended only when the tolerant intraocular pressure values \u200b\u200bare reached. Vitrectomy is contraindicated in patients with malignant neoplasms Intorbital localization.

Preparation for Vitrectomy

At the preoperative preparation stage, a visometry is carried out. With the preserved transparency of the optical media, the eyes in order to estimate the state of the retina and the optic nerve disk is shown ophthalmoscopy. When clouding a vitreous body or hemophthalm, it is necessary to carry out optical coherent tomography of the eye. An alternative option in this case is ultrasound procedure in a and in mode. Eye biomicroscopy is used to study the front pole of the eyeball. At the stage of preparation for vitrectomy, quantitative ultrasound echolocation is performed in order to measure the acoustic density of the vitreous body. All over preparations for vitrectomy, intraocular pressure is measured by contactless toneometry. When identifying signs of ophthalmogypertensis, hypotensive therapy is shown.

Methodology

For Vitrectomy, the ophthalmic surgery produces three incision with 4 mm wide in the flat part area. The first micro is necessary to implement the irrigation system. The remaining holes are used for manipulations during operational intervention, accompanied by the introduction of the lighting device and tips of the toolkit. At a distance of 4 mm from the place of articulation of the cornea and the sclera dissectably conjunctiva, gradually exposing the scleer. At the same time, surface vessels coagulate in physical way. The use of empty cannula during the vitrectomy does not require the superimposition of the seam, since they are equipped with a special fixing groove. In other cases, the device is fixed by one nodal seam.

When hemorrhages in the vitreous body, operational intervention is carried out, starting from the front. For this, the front border membrane is separated from the lens with its subsequent removal. With the preserved transparency of the vitreous body and other optical environments, the vitrectomy is performed from the rear sections. The rear hyaloid membrane should be separated in the area of \u200b\u200bthe disk of the optic nerve and introduce a perfluororganic compound in the department of separation (PFOS). This substance is used to remove the vitreous body without the risk of retinal traumatization. Next, to perform the vitrectomy, the rear membrane is gradually separated from the central part to the peripheral. The naked plot is gradually filled with PFOS.

To remove the bulk of the vitreous body used by Vitreot. The introduction of PFOS during operational intervention provides the adjacent of the retina to the chorioide in the physiological position. In the vitrectomy, the subretinal liquid is removed through special microcepses in the peripheral retinal departments. With a decrease in the volume of the vitreal cavity, it is expanded by excretion and dissection of fibrous seewers. After restoring the normal volume into the vitroal cavity to the level of retinal rupture, PFOS is introduced. If the vitrectomy is complicated due to the formation of dense vitreoretinal battles, partial retinotomy is shown. The retinal break zones are recommended to coagulate a laser way. The next stage of surgical intervention is silicone tamponade of the vitreous body with the removal of PFOS. In conclusion, an X-shaped VKryklin seam is imposed, a subconjunctival injection of glucocorticosteroids and antibacterial agents is carried out.

After Vitrectomy

After the operation, instillations of disinfectants and non-steroidal anti-inflammatory drugs are shown. Antibacterial therapy It is assigned a short course on average for 5-7 days. Over the course of the week, intraocular pressure is measured by contactless way. On the first day after surgery, a visometrium is carried out. To evaluate the results of the vitrectomy, a ultrasound study is shown in a or or in-mode or optical coherent tomography. Hemostatics or fibrinolities are prescribed according to individual indications.

After completion of the vitrectomy, the eye impose a bandage in order to prevent postoperative infection, protection against bright light. On the second day after the procedure, the bandage is removed, processed the eyelids with a sterile wool, moistened with an antiseptic agent. The bandage should be worn 4-7 days with mandatory daily care. In the early postoperative period, it is recommended to avoid elevated physical Loads. It is necessary to protect the eyes from entering them. hygienic tools (soap, shampoo). Spectatical functions after the vitrectomy are restored gradually within 2-3 months. With a burdened history (myopia, diabetes, old age), the duration of complete rehabilitation reaches 6 months.

Complications

The most common intraoperative complication of the vitrectomy is bleeding when performing micro-breaks or damage to the inner shell of the eyeball. During the operation, a disruption of the integrity of the rear capsule of the lens is possible when using a vitreotoma. With an insufficiently careful inspection of the eye bottom before carrying out the vitrectomy through the damaged sections of the retina, the PFOS or silicone substance can be treated under the inner sheath. If an ophthalmologist observes emulsification silicone Oil, It is necessary to immediately delete it.

The accumulation of silicone or blood clots leads to the blockade of the anterior chamber of the eye and can provoke an increase in intraocular pressure. With a long-term atypical location of silicone oil, there is a high risk of a ribbon dystrophy of a horny shell. Transient ophthalmogypertension is often a normal reaction to the vitrectomy organ. In the early postoperative period, it is possible to develop painful sensations localized in the field of orbits, surveillance arcs or a divorce zone. Pain syndrome is the physiological response of the body to conduct vitrectomy. In order to relieve it, the reception of non-tarcotic analgesics is shown. In the first days after the operation, diplopia or distortion of objects may occur before the eyes that are leveled independently. In infection of the operating wound, the vitrectomy is complicated by iridocyclite or local inflammatory response.

Witrectomy cost in Moscow

The cost of the methodology is determined by the features of the anesthesiological support, the tactics of surgery, the type of equipment used. With general anesthesia, the price of Vitrectomy in Moscow is higher than when using regional installation or retrobulbar anesthesia. Vitrectomy's price additionally includes all diagnostic techniques that are used at the preoperative preparation stage. Less often pricing depends on the qualification of the operating surgeon, the type of institution in which surgery is carried out (private medical Center or state clinic).

The vitreous body protects the vessels from damage and gives the shape of eyeballs. Transparent and gel structure holds the sun's rays to the retina.

Against the background of ophthalmic diseases, the inner cavity of the organ is filled with blood or turbulent, which is why there is a loss of vision. People after 40 years come to the risk group.

The pathological process can not be eliminated conservative methods Treatment, therefore, the main technique use surgical intervention. Vitrectomy implies full or partial removal of the vitreous body.

What it is?

Vitrectomy is a microsurgical operation at which the damaged sections of the vitreous body are removed. To maintain the visual function, the gel concentrate is replaced by substances with similar physical parameters.

They differ in moderate viscosity and are completely transparent substances:

After the operation, a person restores visual functions, the risk of retinal detachment is reduced. Vitrectomy refers to microenvasive techniques, because it does not harm soft fabrics Eye apple. There is a minimal intervention in the internal environment of the organ.

In what cases are prescribed?

There are several indications for surgery:

primary stratification of retina;
hemorrhage into the cavity of the vitreous body, accompanied by an increase in intraocular pressure;
diabetic retinopathy with retinal detachment;
shift of lens;
epietal membrane on the retinal surface;
infectious damage - endophthalmite;
mechanical eye injury.

IMPORTANT. The decision to carry out the operation on the basis of the diagnostics takes the attending physician. The ophthalmologist is obliged to explain to the patient the need and advantages of the procedure, talk about the negative consequences of the disease.

It is forbidden to carry out surgical interference with suspected retinoblast - malignant tumor, characteristic children. A similar contraindication to the implementation of the vitrectomy is the presence of an active form of melanoma. Operation may damage cancer neoplasms, which will lead to the distribution of metastasis blood system.

It is not recommended to conduct a procedure when taking medications that dilute blood. In this situation, before making the decision, the ophthalmologist should consult with a cardiologist who has a patient. In case of acute need for surgery, doctors adjust drug therapy.

Types of intervention

Depending on the severity and the distribution of the pathological process are observed different changes Morphological structure of the vitreous body. The gel substance can completely lose transparency or partially fill in blood in certain areas, so surgical intervention can also be complete or partial.

Total

Total vitrectomy implies a complete removal of the vitreous body.

The procedure is carried out at:

dislocations of lens in an intraocular cavity;
extensive hemorrhages or severe injuries;
clouding gel substance due to denaturation of collagen fibers;
with the development of the epitinal membrane on the neurosensory sheath.

After complete removal The intraocular fluid cavity capsule is filled with PFOS, hydrochloric solution or gas. Silicone for this procedure is not suitable.

REFERENCE. When the intraocular cavity is filling in gas, patients are not recommended to move in the underground metro.

Subtotal (front, rear)

There are 2 forms of subtotal or partial vitrectomy: rear and front. In the latter case, surgical intervention is carried out in the penetration of the gel substance into the front chamber of the eye. Injuries or lens drift can provoke pathology. In rare cases, intraocular fluid fills the camera during the operation to remove cataracts or glaucoma.

With the back closed vitrectomy, the vitreous body can find out in the rear segment of the eye. This occurs at the high elasticity of the gel fluid when the concentration of hyaluronic acid and collagen fibers increases. When the fluid flow into the back of the eyeball increases the risk of retinal rupture, the swelling of the Macula is developing.

Training

Before carrying out the operation, a thorough examination of the eyeball is carried out. Ophthalmologist assesses general state, Fixes the presence of related pathologies.

The doctor conducts the following manipulations in the diagnostic examination:

8 hours before Vitrectomy, it should be abandoned from drinking drinks and food, especially when conducting an operation under general anesthesia. This precaution allows you to minimize the risk of asphyxia during the procedure of the contents of the stomach.

Course of operation

The operation is carried out under local anesthesia or general anesthesia. The latter is used in severe pathologies requiring additional surgical manipulations. To perform a small lap, the doctor uses a special cylindrical scalpel - Vitreot. To replace the vitreous body with artificial analogue use infusion cannula. Surgical intervention lasts about 2-3 hours.

The operation is carried out in several stages:

After anesthesia, the eyes are revealed by the eyelid.
Surgeon makes punctures or cuts 0.3-0.5 mm.
Infusion cannula is introduced into the resulting hole. The vitreous body is suused from the cavity of the eyeball completely or partly depending on the degree of damage. Blood removed.
After removal of the gel substance, air bubble or gas mesh is introduced. It supports proper position Shell in the cavity of the organ. Gas bubble disappears independently after recovery.
A special solution is introduced into the eye: silicone oil, saline, PFOS.
The surgeon imposes seams or seats a cut with a laser.

Cognitive video about how the removal of the entire vitreous body of the eye or any part of it is Vitrectomy:

Attention! The video contains frames of a surgical operation.

REFERENCE. With severe retinal detachment, the operation is carried out using silicone oil. In contrast to other substitutes, the inorganic substance is removed during the re-surgical intervention after healing the cornea.

Additional surgical stages

In some cases, additional manipulations are required during the vitrectomy. Each method uses auxiliary toolkit.

Membranapiling. Sick fabrics on the retinal surface can not be sucking, because there is a risk of damage to the neurosensory shell of the eye. During the procedure, the surgeon uses visco-dissecting or pointed tweezers. The operation is carried out in the formation of an epitinal membrane.
Photocoagulation. The operation is performed using a laser. Heat radiation helps to close the holes in the retina, remove damaged tissues or blood vesselswhich are formed against the background of diabetes.
Screed sclera. Inside the eye cavity along the walls of the capsule, the hooks are installed. The support allows you to fix the retinal position.
Tamponade retina. In order for the neurosensory shell to remain in a normal position, an air injection, sulfur hexafluoride, octafluoropropane make in the rear segment. A mixture of gas is also used to seal the hole in the retina.

In rare cases, the turbidity of the vitreous body affects the lens, which is why cataract develops. To restore the visual function during the vitrectomy, they remove the above-mentioned structure of the eye and replace artificial lenses.

Rehabilitation period

The period of recovery reaches from 3 to 6 months. With severe forms of pathology and development of recurrences, rehabilitation is delayed to 1-1.5 years.

The restoration of the function of the organ of vision depends on the state of the retina, an artificial substitute for a vitreous body and an optic nerve. Damage to these structures leads to an irreversible reduction in visual acuity. In the postoperative period, the patient can take the hospital for 5-7 days if he feels strong discomfort.

With the introduction of gas to the cavity of the organ before the patient's eyes, a darkened film can hang. The phenomenon passes independently. When using silicone fluid, vision correction is required with glasses. Lifestyle after removing the vitreous body changes: It is necessary to avoid physical overvoltage, it is impossible to create a load on organs of vision. After surgery, you need to visit an ophthalmologist 1-2 times a year.

Possible complications

After surgery, there is a risk of developing complications:

infectious infection;
an increase in intraocular pressure, especially if there is glaucoma;
hemorrhage into the cavity of the eye;
proliferation of capillaries on the surface of the iris;
corneal dermis;
retinal bundle.

Newly formed vessels in the absence of timely treatment can lead to the development of acute neovascular glaucoma. The pathological process is accompanied by painful high intensity syndrome and threatens the loss of vision.

IMPORTANT. It is necessary to monitor the shelf life of liquids or gases that replace the vitreous body. After the implant is extended, it will take a replacement replacement again.

Vitrectomy allows you to quickly restore the visual function when clouding intraocular fluid, heavy hemorrhages on the background of diabetes mellitus or long-term reception strong preparations. The high-tech method allows to reduce the likelihood of developing a relapse of the pathological process, minimizes the risk of growing new vessels on the iris. Additional surgical manipulations warn the development of bleeding in the intraocular cavity.