What is retinal surgery?
Pars plana vitrectomy (PPV) is a surgical procedure that is used to treat a range of eye conditions, including diabetic retinopathy, macular holes, retinal detachments, and vitreous hemorrhages. The procedure involves the removal of the vitreous gel from the eye, which is the clear, jelly-like substance that fills the space between the lens and the retina.
During a pars plana vitrectomy, the surgeon makes tiny incisions in the white part of the eye (sclera) and inserts small instruments through these incisions to access the vitreous gel. The vitreous is then removed using a special cutting tool, and a clear fluid is used to replace the vitreous in the eye. In some cases, the surgeon may also need to remove scar tissue or repair a retinal tear or detachment during the procedure.
Pars plana vitrectomy is typically performed under local anesthesia and may be done on an outpatient basis, meaning the patient can go home the same day. Recovery time varies depending on the individual case and the specific condition being treated, but most patients can resume normal activities within a few days to a few weeks after the procedure.
Like any surgical procedure, there are risks associated with pars plana vitrectomy, including infection, bleeding, and damage to other structures in the eye. However, overall, the procedure is considered safe and effective for treating a variety of eye conditions.
What conditions are treated with PPV?
Pars plana vitrectomy (PPV) is a surgical procedure that can be used to treat various conditions that affect the retina and vitreous of the eye. Some of the conditions that can be treated with PPV include:
- Diabetic retinopathy: PPV can be used to remove blood or scar tissue that has accumulated in the vitreous as a result of diabetic retinopathy.
- Macular hole: A macular hole is a small hole that develops in the center of the retina. PPV can be used to remove the vitreous gel and any scar tissue that may be causing the hole.
- Retinal detachment: When the retina detaches from the back of the eye, PPV can be used to remove any scar tissue or other materials that may be pulling on the retina and causing the detachment.
- Vitreous hemorrhage: A vitreous hemorrhage is bleeding into the vitreous gel of the eye. PPV can be used to remove the blood and any scar tissue that may be present.
- Epiretinal membrane: An epiretinal membrane is a thin layer of scar tissue that forms on the surface of the retina. PPV can be used to remove the scar tissue and restore vision.
- Endophthalmitis: Endophthalmitis is a severe eye infection that can lead to vision loss. PPV can be used to remove any infected tissue and help clear the infection.
- Vitreous Floaters: Small, dark specks or strands that appear in a person’s field of vision. They are caused by tiny clumps of gel or cells that form in the vitreous humor, a jelly-like substance that fills the back of the eye. While usually harmless, vitreous floaters can be a nuisance and may indicate a more serious eye condition in some cases.
- After retina surgery, the doctor may inject gas or oil into your eye to help keep the retina in place and promote healing.
- The choice between gas and oil depends on the type and severity of the retinal detachment, as well as the surgeon’s preference.
- Gas usually disappears on its own within a few weeks, but oil may need to be removed surgically once the eye has healed.
- During the recovery period, it is important to follow Dr. Gani’s instructions carefully, including any post-operative restrictions and precautions to avoid complications.
- Depending on the type of gas or oil used, you may need to avoid air travel, scuba diving, or high altitudes until it is safe to do so.
- It is also important to attend follow-up appointments with your doctor to monitor your progress and ensure that your eye is healing properly.
Remember that every patient is unique, and your doctor will tailor your treatment plan based on your individual needs and circumstances. Therefore, it is important to discuss any questions or concerns you may have with your doctor.
Complications of PPV
Some of the possible complications of pars plana vitrectomy include:
- Infection: Any surgical procedure carries a risk of infection, and pars plana vitrectomy is no exception. Infection can occur in the eye or in the surrounding tissue, and can cause significant damage including loss of vision.
- Bleeding: Pars plana vitrectomy involves removing the vitreous humor from the eye, which can cause bleeding. While this is usually minor and resolves on its own, excessive bleeding can lead to vision loss or other complications.
- Retinal detachment: Pars plana vitrectomy can increase the risk of retinal detachment, a condition where the retina separates from the back of the eye. This can cause permanent vision loss.
- Cataracts: Pars plana vitrectomy can increase the risk of developing cataracts, a condition where the lens of the eye becomes cloudy and can interfere with vision.
- Glaucoma: Pars plana vitrectomy can increase the risk of developing glaucoma, a condition where pressure builds up inside the eye and can damage the optic nerve.
- Proliferative Vitreoretinopathy: Growth and contraction of membranes on the retinal surface as well as intraretinal fibrosis. Currently, PVR is thought to be an abnormal wound healing response that is primarily driven by inflammatory, retinal, and RPE cells.
- Macular Hole: An increased risk of macular hole formation
It’s important to note that while these complications are possible, they are relatively rare.