Vitreoretinal Surgery

Anaesthetic
Vitreoretinal surgery is typically performed under local anaesthetic with sedation. Sometimes general anaesthetic is used.

Techniques

• Pars Plana Vitrecomy (PPV)

Three small openings (ports) are made through the sclera (the white of eye) during a pars plana vitrectomy (PPV) to access the vitreous gel in the back of the eye. A high-speed cutting instrument (vitrector) is inserted into one of the ports to cut and remove the vitreous gel. Other instruments can be inserted through this port. A light pipe is inserted through a second port to allow the surgeon to visualise the retina. The 3^rd port is used to infuse fluid into the eye while the vitreous gel is removed.

The vitreous gel is not required for normal function of the eye and is replaced with a saline solution similar to the eye’s natural fluid. At the end of the surgery a gas or air bubble may be inserted into the eye. If this is required, then it is not safe to fly or to travel to elevated altitudes until the gas/air has dissolved. Once it dissolves the normal fluid of the eye (aqueous humour) replaces the gel that has been removed. In some cases, heavy liquid or silicon oil is inserted into the eye at the end of the surgery and a subsequent PPV will be required to remove this.

Various procedures may be combined with PPV including retinal laser, cryotherapy  or scleral buckle.

• Scleral Buckle

A scleral buckle is a flexible silicon band that is stitched to the outside wall of the eye and is positioned under the eye muscles. It may be performed in combination with various other procedures including retinal laser, cryotherapy or pars plana vitrectomy. Once the eye has healed, you cannot feel the scleral buckle.