![]() ![]() In this surgical procedure, the vitreous gel is removed to stop it from pulling on the retina, and most commonly a gas bubble is placed in the eye to gently hold the edges of the macular hole closed until it heals. Vitrectomy is the most common treatment for macular holes. No laboratory tests are needed in cases of idiopathic macular holes (those without a known cause). This quick, non-invasive imaging technique allows for evaluation of the macula in high resolution using reflected light, and helps your doctor differentiate a hole from other eye conditions with similar symptoms. Optical coherence tomography (OCT) is the current gold standard in the diagnosis, staging, and management of macular holes (Figure 1). Retinal detachment Genetics, environmental factors, and systemic causes don’t seem play a role in macular hole formation.Macular pucker: formation of a scar tissue layer over the macula that can warp and contract, causing wrinkling of the retina.High degree of myopia (nearsightedness).Injury or trauma: some young people develop macular holes after blunt trauma.With normal aging, the vitreous can shrink and pull away from the retina, sometimes creating a macular hole in the process. Vitreous traction: the vitreous is the “gel” that fills up the inside of the eye.Several conditions can increase the risk of macular hole formation, including: If a macular hole develops in one eye, there is a 5% to 15% risk of one developing in the other eye. For this reason, there is currently no effective way to prevent their formation and development. The vast majority of cases develop spontaneously without an obvious cause. ![]() Macular hole commonly affects people over the age of 55 and most often occurs in women. The degree to which vision is affected will depend on the size and location of the macular hole, as well as the stage of its development. Distortion (straight lines appearing wavy).Risks of a vitectomy include, loss of vision, bleeding, infection, elevated intraocular pressure, retinal detachment and cataract if the patient has not previously had cataract surgery.The most common symptom of macular hole is a gradual decline in the central (straight-ahead) vision of the affected eye. In the case of more complex retinal cases whereby a longer lasting agent to hold the retina in place is required, options include silicone oil, heavy silicone oil or heavy liquids. This results in a sensation as if walking around with a spirit level in the eye. With both gas and air being left in the vitreous cavity, a meniscus that represents a gas/fluid level will be observed by the patient especially after the first few days. Whilst there is air in the eye, the patient is also not allowed to fly. Often, a bubble of air is left in the eye as this will help in the self sealing of the vitrectomy key holes once the instrument ports have been removed. Whilst there is a gas bubble in the eye, one is not allowed to fly, as this will result in severe elevation of intraocular pressure causing permanent blindness. In Most cases the gas bubble lasts for a period of 2.5 – 3 weeks only. ![]() This gas bubble splints the retina into place and allows any laser or cryotherapy treatment to heal and will resorb spontaneously over 3-8 weeks depending on which gas bubble is being used. Once the vitreous has been removed via a vitectomy procedure, the saline solution which has been infused into the eye during the operation may be replaced with a gas bubble. ![]() The vitreous gel which is being removed needs to be replaced with a saline like solution at the time of vitrectomy surgery in order to maintain the inflation of the eye and this occurs via the infusion line which enters the eye via the third key hole.Ī Vitrectomy is used in the treatment of several retinal disorders including, retinal detachments, vitreous haemorrhage due to any cause, epiretinal membranes and macular holes. The second key hole is to allow for the insertion of the ocutome which is long thin instrument with a guillotine like mechanism at the end which cuts and aspirates small pockets of vitreous gel. One key hole allows an illuminating light to be introduced into the vitreous chamber so that the surgeon can visuallise the retina and vitreous gel. Using specially designed instruments the vitreous is removed via 3 small keyhole incisions that are made through the sclera far enough back to avoid the lens, but not too far back as to damage the anterior retina. A Vitrectomy is a procedure to remove the vitreous gel from the posterior chamber of the eye. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |