Our Summary

This research paper talks about a technique used to stop the excess fluid build-up in the eye during a type of cataract surgery (phacoemulsification) in eyes with a specific abnormality (lenticular coloboma). This abnormality can cause communication between the front and back chambers of the eye leading to this fluid build-up. The technique involves placing a special device at a specific site near the abnormality, which allows for the careful removal of some of the fluid during the surgery. By doing this intermittently and pausing the surgery as needed, this technique helps prevent the jelly-like substance in the back of the eye (vitreous) from pushing into the front chamber of the eye. This also limits further damage to the fibers (zonules) that hold the lens in place, making the surgery safer. It allows for a better expansion of the capsule (the bag that holds the lens) and better placement of devices to hold the new artificial lens in place.

FAQs

  1. What is the purpose of the valved trocar in this vitrectomy technique?
  2. How does this technique prevent vitreous hydration during phacoemulsification in eyes with lenticular coloboma?
  3. What are the benefits of intermittent vitrectomy with a moderate cutting rate and low vacuum parameters during phacoemulsification?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vitrectomy is to avoid any strenuous activities or heavy lifting for a period of time after the procedure to prevent any complications or damage to the eye. It is important to follow the doctor’s post-operative instructions carefully to ensure proper healing and recovery.

Suitable For

Patients who may be recommended for vitrectomy include those with:

  1. Retinal detachment or tears
  2. Diabetic retinopathy with vitreous hemorrhage
  3. Macular hole or epiretinal membrane
  4. Vitreous opacities or floaters that significantly affect vision
  5. Complications during cataract surgery, such as zonular dehiscence or vitreous prolapse
  6. Endophthalmitis or severe inflammation within the eye
  7. Trauma to the eye leading to vitreous hemorrhage or retinal detachment

Timeline

Before Vitrectomy:

  1. Patient presents with symptoms such as floaters, flashes of light, blurry vision, or a shadow or curtain over part of their visual field.
  2. Patient undergoes a comprehensive eye examination, including a dilated eye exam and possibly imaging tests such as optical coherence tomography (OCT) or ultrasound.
  3. The ophthalmologist determines that a vitrectomy is necessary to treat a condition such as a retinal detachment, macular hole, diabetic retinopathy, or vitreous hemorrhage.
  4. The patient is informed about the risks and benefits of the procedure, and any questions or concerns are addressed.

During Vitrectomy:

  1. The patient is given local or general anesthesia, depending on the specific case and the surgeon’s preference.
  2. The surgeon makes small incisions in the eye and inserts instruments, including a light source, a cutting device, and a suction device, to remove the vitreous gel from the eye.
  3. The surgeon may also perform additional procedures, such as repairing a retinal tear or removing scar tissue.
  4. The surgery typically takes 1-2 hours to complete, and the patient may be able to go home the same day or stay overnight for observation.

After Vitrectomy:

  1. The patient may experience some discomfort, redness, or swelling in the eye, which can usually be managed with over-the-counter pain medication and eye drops.
  2. The patient will need to follow post-operative instructions, such as using eye drops as prescribed, avoiding strenuous activities, and attending follow-up appointments with the surgeon.
  3. The visual recovery process can vary depending on the underlying condition being treated and the individual patient’s healing response.
  4. The surgeon will monitor the patient’s progress and may recommend additional treatments or adjustments as needed to optimize the outcome of the vitrectomy.

What to Ask Your Doctor

  1. What is the purpose of a vitrectomy in my specific case?
  2. What are the potential risks and complications associated with vitrectomy?
  3. How long is the recovery period after a vitrectomy?
  4. Will I need any special follow-up appointments or care after the procedure?
  5. Are there any alternative treatments to vitrectomy that I should consider?
  6. How successful is a vitrectomy in improving my condition or symptoms?
  7. What type of anesthesia will be used during the vitrectomy procedure?
  8. How long will the vitrectomy procedure take?
  9. Will I need to take any medications before or after the vitrectomy?
  10. Are there any specific lifestyle changes I should make before or after the vitrectomy procedure?

Reference

Authors: Agarwal A, Narang P, Agarwal A. Journal: J Cataract Refract Surg. 2017 Feb;43(2):156-161. doi: 10.1016/j.jcrs.2016.10.028. PMID: 28366360