Vitrectomy is a surgery of the posterior segment of the eye (vitreous cavity), which consists of the removal of the vitreous gel. Originally, the technique involved the cutting and opening of the conjunctiva and the opening of the sclera, to enter the vitreous cavity, and then the conjunctiva and sclera were sutured with absorbable. Thanks to the technological development of the instruments of small calibre, the minimally invasive vitrectomy has the same capabilities and allows the creation of self-sealing incisions of 0.5 mm, which do not require sutures.
What is minimally invasive vitrectomy?
Indications for minimally invasive vitrectomy are different, and today virtually all actions of the posterior segment of the eye can be performed according to this technique. In the application of this technological development our retinal surgeons are pioneers in Italy.
The indications for the procedure are:
- Retinal detachment, simple or complicated to proliferations
- Diabetic retinopathy with or without retinal detachment
- Epiretinal membrane or macular pucker
- Macular hole full or pseudo hole
- Vitreous opacities related to bleeding or inflammatory problems
- Uveitis
- As a tool to diagnose rare diseases of the posterior segment
What are the advantages and disadvantages of minimally invasive vitrectomy?
The surgery is performed through very small incisions that do not require sutures. It follows a faster, functional recovery with less intraocular inflammation.
The safety of the technique has been validated in several clinical studies, proving to have a safety profile equal to or greater than the traditional technique.
The minimally invasive vitrectomy is also accompanied by a change in the type of anaesthesia, having replaced general anaesthesia for the loco regional anaesthesia. More than 90% of vitrectomy in our centre are performed under regional anaesthesia, which blocks the movements and the sensitivity of the eye and with a thorough patient sedation makes surgery much more tolerable for the patient. With the variation of anaesthesia the comfort of the patient has improved and at the same time the potential serious risks of general anaesthesia have decreased, as well as the time of hospitalization is reduced.
Standards of preparation
Starting with an accurate diagnosis, patients with surgical pathology of the retina are sent in clinics that are specific to the care of our surgeons.
Once there is an indication for surgery, the patient is informed of the type of intervention that will resolve the problem. The patient will have to wait for the call of the secretaries of the Department of Ophthalmology that will program all pre-admission exams necessary prior to the intervention (blood tests, visit by the anaesthetist and possibly a cardiologist or a diabetes test). At the end it will be decided on a date for the surgery.
The therapies after surgery are decided by the surgeon based on the type of surgery performed. As a general rule, all patients will have to take oral antibiotics for the first 4 days after surgery and antibiotic eye drops for about one month after surgery.
The surgeons sometimes use intraocular tamponade. If gas was used, a type of silicone oil, the patient must maintain in a particular placement for the first few days after surgery, according to the recommendations by the surgeon in order to help the proper healing of the retina.
Follow up
Once the operation is performed, all patients are visited in the first day, one week, one month and the third month after the surgery in the specific clinics of vitreo-retinal pathologies, so that the treatment path is closely followed by the same surgeons.
