Our Summary

This study introduces a new surgical technique for treating a specific type of retinal detachment (when the retina at the back of the eye pulls away from its normal position). The technique uses a specially designed tool, called a beveled vitrectomy probe, to remove leftover bits of the jelly-like substance (vitreous cortex remnants or VCR) in the eye that can contribute to this condition.

The researchers looked at 54 patients who underwent this surgery between September 2019 and June 2022. They first used a substance to stain the vitreous, which made it easier to see and assess the leftover vitreous bits. If these bits were present, they were removed using surgical forceps. Then, the specially designed probe was used to remove any remaining bits on the edges of the eye.

The technique was successful in almost all cases, with vitreous remnants confirmed and successfully removed in about 30% of patients. There were no major complications during or after the surgery, except for one case where the retina detached again due to a condition called proliferative vitreoretinopathy.

The researchers conclude that this new technique is a practical and safe way to remove these leftovers during surgery for retinal detachment, as it doesn’t require additional tools and has a low risk of causing any damage to the retina.

FAQs

  1. What is the purpose of the new surgical technique introduced in this study?
  2. How effective was the use of the beveled vitrectomy probe in removing peripheral vitreous cortex remnants?
  3. Were there any complications experienced during or after the vitrectomy procedure using the beveled vitrectomy probe?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vitrectomy is to follow all post-operative care instructions carefully, including avoiding strenuous activities, taking prescribed medications as directed, and attending follow-up appointments to monitor recovery and address any concerns promptly. It is also important to protect the eyes from potential injury or infection during the healing process.

Suitable For

Patients who are typically recommended for vitrectomy include those with primary rhegmatogenous retinal detachment (RRD) with complete or partial posterior vitreous detachment and presence of vitreous cortex remnants (VCR). This new surgical technique using a beveled vitrectomy probe can effectively remove peripheral VCR in these patients without the need for additional instruments and with low risk of iatrogenic retinal damage.

Timeline

Before vitrectomy:

  1. Patient experiences symptoms of primary rhegmatogenous retinal detachment, such as floaters, flashes of light, and a sudden decrease in vision.
  2. Patient undergoes a comprehensive eye examination, including imaging tests like optical coherence tomography (OCT) and ultrasound.
  3. Surgical consultation is scheduled, and the patient is informed about the procedure, risks, and potential outcomes.

During vitrectomy:

  1. Patient undergoes vitrectomy surgery under local or general anesthesia.
  2. The vitreous is stained with triamcinolone acetonide to visualize any vitreous cortex remnants (VCR).
  3. VCR presence is assessed, and if present, they are removed using surgical forceps and a beveled vitrectomy probe.
  4. The procedure is completed without any intraoperative complications.

After vitrectomy:

  1. Patient is monitored closely for any postoperative complications, such as infection or retinal redetachment.
  2. Follow-up appointments are scheduled to assess the success of the surgery and the patient’s visual recovery.
  3. In this study, only one eye experienced retinal redetachment caused by proliferative vitreoretinopathy as a postoperative complication.
  4. Overall, using a beveled vitrectomy probe was found to be a practical and effective technique for removing VCR during vitrectomy for primary RRD.

What to Ask Your Doctor

  1. What is a vitrectomy and why is it recommended for my condition?
  2. What are the risks and potential complications associated with vitrectomy surgery?
  3. How long is the recovery process after vitrectomy surgery?
  4. Will I need any additional follow-up appointments or treatments after the surgery?
  5. How successful is the beveled vitrectomy probe technique compared to traditional vitrectomy methods?
  6. Are there any specific post-operative care instructions I should follow to ensure optimal healing?
  7. What are the chances of the retina redetaching after the surgery?
  8. How soon after surgery can I expect to see improvements in my vision?
  9. Are there any long-term effects or risks associated with vitrectomy surgery?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: Hwang SH, Lee DY, Nam DH. Journal: Retina. 2023 Dec 1;43(12):2173-2176. doi: 10.1097/IAE.0000000000003779. PMID: 36913622