There are five primary reasons to have a vitrectomy or a vitrectomy combined with other procedures:
- Vitreous opacity that blocks vision (clouding)
- Conditions caused by abnormal retinal pulling
- Conditions that necessitate retinal or other types of eye surgery
- To determine the cause of a vitreoretinal problem (diagnostic vitrectomy)
- To insert a therapeutic device or a drug delivery system
- Vitreous Opacity That Blocks Vision (Clouding): Patients have foggy vision when the vitreous cavity becomes clouded. A complete pars plana vitrectomy may alleviate symptoms and enhance vision permanently if the haziness is caused by benign (mild) or inactive conditions such as asteroid hyalosis, posterior vitreous detachment, vitreous hemorrhage, vitreous condensation, or old inflammation.
The choice to conduct surgery usually depends on the severity of the patient’s symptoms vs. the vitrectomy’s unusual but measurable risks. This is the easiest of the five categories to understand.
- Conditions Caused by Abnormal Retinal Pulling: The majority of vitrectomies are conducted to address abnormal vitreous traction on the retina. Vitreoretinal traction is a common complication of age, nearsightedness, severe diabetes, critically preterm babies, head or eye trauma, YAG laser capsulotomy, and difficult anterior segment surgery.
In addition to vitrectomy, removing membranes or scar tissue from the surface of the retina is a delicate and demanding procedure that necessitates a variety of procedures.
Vitrectomy is sometimes paired with scleral buckling, a surgery that involves stitching a piece of silicone sponge, rubber, or semi-hard plastic onto the sclera or placing a band around the eye to reduce retinal traction in the eyes from retinal detachment. It can be challenging to perform vitrectomy in eyes that have been damaged by trauma or in critically preterm newborns with retinopathy of prematurity. These are some of ophthalmology’s most difficult surgical operations.
- Conditions That Necessitate Retinal or Other Types of Eye Surgery: The vitreous fluid and traction on the retina, as previously mentioned, can cause a wide range of issues. As a result, vitrectomy may be used to avoid problems or to improve the initial surgery’s prognosis. When the vitreous comes forward through the pupil during anterior-segment surgery (cataract, glaucoma, cornea, intraocular lens), an anterior vitrectomy is performed.
A vitrectomy is also performed when a cataract fragment, intraocular lens, or other foreign substance dislocates and falls back into the vitreous, allowing the object to be removed or relocated.
A vitrectomy is occasionally required when a pars plana glaucoma implant is implanted. By enabling extra fluid to escape the eye, this device relieves ocular pressure. A vitrectomy removes the vitreous that could clog the drainage canal. A vitrectomy enhances the procedure’s result and minimizes the risk of a retinal tear, retinal detachment, macular edema (swelling), and other problems.
- To Determine the Cause of a Vitreoretinal Problem (Diagnostic Vitrectomy): This particular indication for vitrectomy is used when the vitreous needs to be removed or sampled to aid in the diagnosis. In serious eye infections, when the eye is inflamed, and for some types of cancer that can spread to the eye, a diagnostic vitrectomy is performed. The vitreous is examined to ensure that the most appropriate treatment is performed.
- To Insert a Therapeutic Device or a Drug Delivery System: Vitrectomy is also performed when a therapeutic or medication delivery device is placed in the eye. Extended-drug-delivery devices for steroid or antiviral medications, glaucoma drainage, retinal prosthesis, and gene therapy are examples of these devices. The promise of new technologies is that retinal treatment can now be targeted. One option is to undergo a vitrectomy.