Name of the Procedure:

Aspiration or Release of Vitreous, Subretinal, or Choroidal Fluid, Pars Plana Approach (Posterior Sclerotomy)

Summary

This procedure involves the removal or drainage of fluid from the vitreous body, subretinal space, or choroidal area in the eye. It is performed using a pars plana approach, which is a surgical technique used to access the back portion of the eye.

Purpose

This procedure addresses conditions such as retinal detachment, subretinal hemorrhage, or vitreous hemorrhage. The goal is to relieve symptoms, prevent further damage, and restore or preserve vision.

Indications

• Retinal detachment
• Subretinal or choroidal hemorrhage
• Vitreous hemorrhage
• Persistent vitreous opacities
• Severe eye trauma

Preparation

• Patients may need to fast for several hours before the procedure.
• Preoperative blood tests and imaging studies, such as an ultrasound or OCT (optical coherence tomography), may be required.
• Adjustments to medications, especially blood thinners, may be necessary.

Procedure Description

1. The patient is positioned on the operating table, and local or general anesthesia is administered.
2. The surgeon makes small incisions (sclerotomies) in the pars plana region of the sclera (the white part of the eye).
3. Specialized instruments are inserted through these incisions to access the vitreous cavity or subretinal space.
4. Fluid is carefully aspirated or drained using a suction device.
5. Additional steps may include laser photocoagulation or cryotherapy to repair retinal tears.
6. The incisions are closed, and antibiotic and anti-inflammatory medications may be administered.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection
• Bleeding
• Increased intraocular pressure
• Retinal detachment
• Cataract formation
• Vision loss

Benefits

• Relief of symptoms such as vision blurring or floaters
• Prevention of further retinal damage
• Restoration or preservation of vision

Recovery

• Patients may be given an eye patch or shield to protect the eye.
• Use of prescribed eye drops to prevent infection and control inflammation.
• Follow-up appointments to monitor healing and check for complications.
• Recovery time can range from a few days to several weeks.
• Avoid strenuous activities and heavy lifting during the recovery period.

Alternatives

• Observation or monitoring for less severe conditions.
• Laser therapy to address small retinal tears.
• Intravitreal injections for certain types of vitreous hemorrhage.
• The pros of alternatives include being less invasive; cons may include less effectiveness for severe cases.

Patient Experience

During the procedure, the patient under local anesthesia might feel a slight pressure but no pain. Post-procedure, they may experience some discomfort, redness, and swelling. Pain management includes prescribed pain medication or over-the-counter pain relief.