Pars plana vitrectomy is a surgery that is meant for removing the vitreous humor inside the eye. Let us take a look at the various aspects of this surgical procedure.
Inside the eye, the void between the lens and the retina is filled with vitreous humor, which is a clear, viscous substance. Besides holding the retina in place, vitreous humor gives shape to the eye. However, there are various eye problems, like macular hole, eye floaters, proliferative diabetic retinopathy, traumatic eye injuries, retinal detachment, macular pucker, and vitreous hemorrhage; that necessitate partial or complete removal of vitreous humor. Such surgical removal of vitreous humor is called vitrectomy.
Once the vitreous humor is removed, the space is filled with gases or air, so as to hold the retina in place. Gradually, the gases are replaced by the natural fluids produced by the eyes. Vitrectomy procedures are classified into two main types – anterior vitrectomy and pars plana vitrectomy. The basic difference between them is that the former procedure involves partial or complete removal of vitreous humor from the anterior parts of the eye, whereas the latter involves deeper areas of the eye.
Procedure
In this surgical procedure, tubular surgical instruments are inserted into the eyes through the pars plana; which is the ciliary body that is located near the meeting point of the iris and sclera. Pars plana is around four millimeters in length. It is considered a safe place for making incisions, as pars plana has no specific function in post-fetal eyes. So, vitrectomy procedures that make incisions through the pars plana came to be known as pars plana vitrectomy. As mentioned above, this surgery is usually done to remove vitreous humor from deeper areas of the eye.
Vitrectomy is mostly done as an outpatient procedure, and sometimes an overnight hospital stay may be required. The surgery is done under general anesthesia, and the affected eye will be held open with the help of a special speculum. Three incisions are made through the pars plana for insertion of instruments. One of the incisions is used to insert a tube that supplies fluid to replace the vitreous humor (that is removed through the surgery). This maintains the eye pressure, and keeps the eye inflated during the vitrectomy procedure.
Another tubular device is used to cut the vitreous humor into fine bits and suck it out. The third incision is used to insert a high intensity fiber optic light source that will light up the interior of the eye, so that the surgeon will get a clear view. The surgeon uses a special operating microscope with contact lenses, and this device allows him/her to get a clear view of the inner eye parts at different magnifications.
In order to reattach the retina, sterile air is injected into the space, from where vitreous humor is removed. While gases are used in some cases, liquid silicone may also be used. While gases and sterile air can be gradually replaced with the natural liquids in the eye, liquid silicone needs to be removed through another surgery.
Usually, a pars plana vitrectomy takes around one to two hours. In some complex cases involving additional surgical steps, more time will be required. In normal cases, recovery time is said to be around four to six weeks; and the patient has to strictly follow the doctor’s instructions regarding aftercare, which may vary from one person to another. It has been observed that, complications include eye infection, retinal detachment, glaucoma, cataract, and bleeding. Even vision loss may happen in some cases.
In short, pars plana vitrectomy is a surgical procedure that involves removal of vitreous humor. It is recommended for those with eye problems, like macular hole, retinal detachment, diabetic retinopathy, and traumatic eye injuries. It is always advisable to have a clear idea about the possible risks and complications, before resorting to this method of treatment.
Disclaimer: This article is for informational purposes only and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.
