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Retinal Surgery

Vitrectomy for Retinal Detachment
Vitrectomy Surgery for Macular Holes
Vitrectomy for Diabetic Retinopathy – Vitreous Hemorrhage

Vitrectomy for Retinal Detachment
Vitrectomy is currently the standard technique for treating most retinal detachments. It involves creating 3 little holes on the sclera (white of the eye) through which 3 different instruments are put through. It allows for the removal of the vitreous gel inside the eye, after which we identify where the holes in the retina are. The holes are then treated with either freezing treatment or laser. A bubble of gas is then placed inside the eye to help push the retina in its place. This bubble of gas is then gradually absorbed by the eye, a process that takes some weeks. During this time the vision will be very blurry. Occasionally, we have to use oil inside the eye to help the retina stay in its place. The oil is then removed after a few months, a process that requires another operation. Sometimes we leave the oil in the eye, usually when the surgeon feels that removing it may cause the retina to detach again.
Following the operation drops are used for a few weeks to reduce the inflammation in the eye. Regular post-operative check-ups are required to ensure a good outcome.

Vitrectomy Surgery for Macular Holes
The only current treatment for macular holes is surgery called vitrectomy, where the “gelly” (vitreous) inside the eye and the very superficial layer of the retina (Internal Limiting Membrane – ILM) are removed. A bubble of gas is placed inside the eye that acts as a splint to close the macular hole. The vision will be very blurred after the surgery because of the gas inside the eye. This gas is gradually absorbed by the eye, and when it disappears the vision usually improves.
Eye drops are required for a few weeks after the surgery the reduce the inflammation in the eye. There is a 90-95% chance of closure of the hole with this type of operation, and the improvement in vision will depend on how long the hole has been present.

Vitrectomy for Diabetic Retinopathy – Vitreous Hemorrhage
Vitrectomy is the current standard technique for removal of blood within the eye. There are numerous conditions that can cause bleeding inside the eye, and by far the commonest is Proliferative Diabetic Retinopathy. The technique consists of creating 3 tiny holes on the sclera (white of the eye) through which 3 different instruments are put through. This allows for the removal of the vitreous gel and blood inside the eye. Once the blood has been removed from inside the eye, the cause of the bleeding is identified and treated. Scatter laser is then applied to the retina, causing the bleeding vessels to shrink and disappear. A bubble of air, gas or oil in then put in the eye to prevent bleeding in the immediate post-operative period. In the event that silicone oil is used, it is usually removed a few months later once the condition of the eye has stabilized.
After the surgery, drops are used routinely for a few weeks to reduce the inflammation in the eye. Regular checks after the operation are required to detect and treat any complications that may arise.

 

 


San Josť, Costa Rica, CIMA Hospital, Tower 3, Office 221