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Vitrectomy for Retinal Detachment

Vitrectomy is the surgical procedure that is widely used in the treatment of retinal detachment with large tears.

The surgery may require an overnight stay or sometimes it is done as an outpatient procedure that lasts for 2-3 hours. Vitrectomy is performed under local anesthesia with an operating microscope. Three small incisions are made in the sclera (white outer wall of the eye) to infuse fluid in order to maintain the shape of the eye, for a fiber-optic light and to insert the surgical instruments. The procedure involves the removal and replacement of the vitreous (clear gel that fills the back of the eye) with a special saline solution that resembles the natural vitreous in the eye. Once the vitreous is removed, the retina can be accessed to treat the detachment by removing the scar tissue that is pulling the retina away from the underlying layers of tissue.

After the removal of the vitreous gel, the fluid that has collected underneath the retina is removed to flatten the retina into a normal position. Laser therapy (intense laser beam) or cryotherapy (freezing temperatures) is then used to scar and seal the retinal tear helping to keep the retina permanently attached. A gas bubble or silicone oil is injected into the vitreous cavity (the cavity located behind the lens of the eye and in front of the retina containing the vitreous) to hold the retina in place while the scars from the laser and/or cryotherapy heal.

With newer surgical techniques and instrumentation, the surgery can be performed through tiny 'self-sealing' incisions without the need for sutures. Surgical recovery generally takes about 6 weeks and vision recovery a little longer.

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