67036 Vitrectomy, mechanical, pars plana approach

Name of the Procedure:

Vitrectomy, mechanical, pars plana approach

Summary

A vitrectomy is a surgical procedure where the vitreous gel (the clear, gel-like substance inside your eye) is removed to treat eye disorders. The pars plana approach is a common method where small incisions are made in the eye to access the vitreous cavity.

Purpose

Vitrectomy addresses several conditions such as retinal detachment, diabetic retinopathy, macular hole, and vitreous hemorrhage. The goal is to restore vision or prevent further vision loss by removing or repairing affected sections of the eye.

Indications

This procedure is indicated for patients experiencing severe eye problems like:

• Retinal detachment
• Severe vitreous hemorrhage
• Proliferative diabetic retinopathy
• Macular holes
• Epiretinal membranes
• Certain infections or eye injuries

Preparation

• Patients may be instructed to fast for 6-8 hours before the procedure.
• Adjustments to medications, especially blood thinners, may be necessary.
• A comprehensive eye examination and imaging tests such as an ultrasound or optical coherence tomography (OCT) are usually required.
• Pre-procedure clearance from a primary care physician may be necessary.

Procedure Description

1. The patient is given anesthesia – either local or general, depending on the specific case.
2. Small incisions are made in the sclera (white part of the eye) near the pars plana (a region near the iris).
3. A vitrectomy probe is inserted to remove the vitreous gel.
4. Additional instruments may be used for repairs, such as lasers or tiny scissors.
5. The vitreous cavity might be filled with a saline solution, gas bubble, or silicone oil.
6. The incisions are sealed, sometimes using self-healing methods or small sutures.

Duration

The procedure typically takes 1-2 hours, depending on the complexity of the case.

Setting

Vitrectomies are usually performed in a hospital or a specialized outpatient surgical center.

Personnel

Involved healthcare professionals may include:

• Ophthalmic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common risks: infection, bleeding, increased eye pressure, cataract development
• Rare risks: retinal detachment, vision loss, reaction to anesthesia Management of complications may involve additional medications, surgeries, or follow-up care.

Benefits

The main benefits are improved vision and prevention of further damage to the eye. Benefits may be realized immediately for some patients, while for others, it may take weeks to months.

Recovery

• Post-procedure instructions may include using antibiotic and anti-inflammatory eye drops.
• Patients may need to maintain a specific head position if a gas bubble is used.
• Avoid strenuous activities and follow prescribed restrictions.
• Follow-up appointments are necessary to monitor healing and eye health.
• Full recovery might take several weeks, with gradual improvement in vision.

Alternatives

• Laser therapy for certain retinal issues.
• Intravitreal injections for diabetic retinopathy or macular degeneration.
• Observation and less invasive treatments depending on the condition.

Patient Experience

• The procedure itself is painless due to anesthesia.
• Some discomfort, redness, and blurry vision are common post-procedure.
• Pain management may include over-the-counter pain relief and prescription medications if necessary.
• Gradual improvement in vision is expected, though immediate results can vary.

The above information is a general guide and should be discussed with a healthcare provider to understand all the details and implications specific to the individual's condition.