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A surgical procedure to remove the vitreous called vitrectomy is performed for severe cases of vitreous hemorrhage to remove the blood and improve vision and also treat the underlying cause of hemorrhage.

Blood in the vitreous clears on its own with time without requiring vitrectomy. However, vitrectomy is considered if the blood in the vitreous is taking a long time to clear and frequent hemorrhages are observed and the doctor feels that an early vitrectomy could prevent further complications from vitreous hemorrhage.

Sutureless Vitrectomy

Vitrectomy refers to the removal and replacement of the vitreous (clear gel that fills the back of the eye) with saline. In this procedure, the vitreous is removed so that the doctor can access the back of the eye. The retina is then treated by removing the scar tissue that is pulling the retina away from the underlying layers of tissue. Vitrectomy generally involves three small incisions in the sclera (outer white part of the eye). But with newer surgical techniques and instrumentation, the surgery can be performed through tiny 'self-sealing' incisions without the need for sutures; the procedure is therefore called a sutureless vitrectomy. This new technique uses special equipment that enables the surgeon to reach the vitreous using cuts that are very small and close automatically without requiring sutures. This procedure does not cause excess trauma, redness, watering, and post-operative discomfort, all of which are caused by the conventional procedure. The overall time required for surgery is also less and the patient can resume his/her routine work at the earliest.

23G/25G/27G

In the conventional method of vitrectomy for a retinal detachment, a three-port 20-gauge (20G) system is used. In this context, G (Gauge) refers to the unit of measurement to express the diameter of the incisions made. 20G refers to 0.89mm diameter and these incisions require sutures to close the cuts at the end of the surgery.

With improvements in technology and instrumentation, the gauge has been made smaller and smaller. Smaller gauges, 23G, and 25G systems were developed to make vitrectomy simpler with several advantages when compared to the 20G vitrectomy. The advantages include - less trauma, redness, watering, post-operative discomfort and also shorter surgical duration. Recently in 2010, and even smaller gauge - 27 G with a diameter of 0.4mm was developed and is reported to show excellent results. The surgeon reaches the vitreous through these small cuts that close automatically without requiring sutures when the procedure is completed.

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