Name of the Procedure:

Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (e.g., macular pucker)

Summary

A vitrectomy is an eye surgery designed to treat disorders of the retina and vitreous. This procedure involves the removal of the vitreous gel from the eye's interior and, specifically, the removal of the preretinal cellular membrane, which can cause vision issues like macular pucker.

Purpose

The procedure aims to improve or stabilize vision by removing abnormal tissue and vitreous gel from the eye. It is often performed to address conditions like macular pucker, which can distort vision.

Indications

• Distorted or blurred central vision
• A diagnosis of macular pucker or other similar retinal conditions
• Symptoms that significantly affect daily activities
• Patients who do not respond to less invasive treatments

Preparation

• Patients may need to fast for several hours before the surgery.
• Medications like blood thinners may need to be adjusted.
• Preoperative tests might include a comprehensive eye exam and imaging tests such as optical coherence tomography (OCT).

Procedure Description

1. The patient is given local or general anesthesia to ensure comfort.
2. Small incisions are made in the eye's pars plana (a part of the sclera).
3. Specialized instruments are used to remove the vitreous gel.
4. The preretinal cellular membrane (macular pucker) is carefully peeled away from the retina.
5. The vitreous cavity may be filled with a saline solution or other substances.
6. The incisions are closed, and the eye is bandaged.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Vitrectomy is performed in a hospital operating room or a specialized outpatient surgical center.

Personnel

• Ophthalmic surgeon
• Anesthesiologist (if general anesthesia is used)
• Surgical nurses and technicians

Risks and Complications

• Infection
• Bleeding
• Retinal detachment
• Cataract formation
• Recurrence of macular pucker
• Elevated intraocular pressure

Benefits

• Improved or stabilized vision
• Reduced visual distortion
• Enhanced ability to perform daily activities

Recovery

• Patients may need to wear an eye patch for a day or so.
• Eye drops will be prescribed to prevent infection and reduce inflammation.
• Avoid heavy lifting or strenuous activities for several weeks.
• Follow-up appointments will be necessary to monitor healing progress.

Alternatives

• Observation and regular monitoring if symptoms are mild.
• Anti-vascular endothelial growth factor (anti-VEGF) injections for associated conditions.
• Laser treatment for specific retinal issues.

Patient Experience

• Some discomfort and blurred vision immediately after the surgery.
• Mild to moderate pain, managed with prescribed pain relievers.
• Vision improvement may be gradual, taking several weeks to months.