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Types of vitrectomy ,indication s and complications

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Types of vitrectomy ,indications and complications

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Types of vitrectomy ,indication s and complications

  1. 1. Dr: SANAM RAHUJA UNITII EYE HOSPITAL LUMHS HYDERABAD SINDH PAKISTAN TYPES OF VITRECTOMY INDICATIONS AND COMPLICATIONS
  2. 2. The vitreous is a gel like structure that fills posterior cavity of globe.Accupying 80% of eye volume. Type ii collagen is major structural component, other include hyaluronic acid, ascorbic acid and soluble proteins. Volume is about 4 ml. 1. Vitreous base; it is a attachment with pars plana and to the adjacent ora serrata. 2. Anterior vitreous cortex; lies anterior to vitreous base. 3. Posterior vitreous cortex ;lies posterior to vitreous base and adherent to ILM of retina. VITREOUS
  3. 3. Function of vitreous body • Maintain eyeball shape. • Supports the posterior surface of lens. • Refractive media. • Holding the neural part of retina against the pigmented part . • Retinal metabolism by serving as a repository for chemical substances and influencing movement of solvent and solutes. PHYSIOLOGY
  4. 4. DEFINATION; Vitrectomy is surgical removal of a vitreous of the eye . VITRECTOMY
  5. 5. Anterior vitrectomy Core vitrectomy Posterior vitrectomy TYPES OF VITRECTOMY
  6. 6. TYPES OF VITRECTOMY PARS PLANA VITRECTOMY MINIMALLY INVASIVE TRANSCONJUNCTIVAL VITRECTOMY or SMALL GAUGE VITRECTOMY
  7. 7. Pars Plana Vitrectomy;  Surgical removal of vitreous by aspiration through a needle inserted over the pars plana ciliaris.  It is a closed-system technique that uses three ports, placed 3-4 mm posterior to the surgical limbus. TYPES OF VITRECTOMY
  8. 8.  A recent advance in vitreous surgery ,in which 23 or 25 gauge trocars are used that allow access in to vitreous cavity.  It is a self-selling procedure and do not require suture closure.  Advantages include shortened operative time, increased postoperative patient comfort, and faster visual recovery. MINIMALLY INVASIVE TRANSCONJUNCTIVAL VITRECTOMY OR SMALL GAUGE VITRECTOMY TYPES OF VITRECTOMY
  9. 9. INDICATIONS OF VITRECTOMY VITRECTOMY FOR SELECTED MACULAR DISEASES. VITRECTOMY FOR COMLICATIONS OF ANTERIOR SEGMENT SURGERY. VITRECTOMY FOR DIABETIC RETINAL DETACHMENT. VITRECTOMY FOR COMPLEX RETINAL DETACHMENT. VITRECTOMY FOLLOWED BY PENETRATING TRAUMA.
  10. 10. Macular Epiretinal Membrane. Vitreomacular Traction Syndrome. Idiopathic Macular Hole. Submacular Hemorrhage. VITRECTOMY FOR SELECTED MACULAR DISEASES ;
  11. 11. Postoperative endophthalmitis. Cystoid macular edema . Suprachoridal hemorrhages. Retinal detachment. Needle penetration of globe. Retained lens fragments and drooped nucleus. Posteriorly dislocated intraocular lenses. Malignent glaucoma. VITRECTOMY FOR COMLICATIONS OF ANTERIOR SEGMENT SURGERY;
  12. 12. Vitrectomy is indicated when progression of a TRD threatens or involve macula. The goal of surgery is to relive vetroretinal traction in order to facilitate reattachment by elevating or peeling cortical vitreous /posterior hyaloid off the retinal surface. Vitrectomy is always combined with internal panretinal photocoagulation to prevent postoperative neovascularization. VITRECTOMY FOR DIABETIC TRACTIONAL RETINAL DETACHMENT;
  13. 13. It include giant retinal tears ,recurrent retinal detachments, vitreous hemorrhage and sever proliferative vitroretinopathy . vitrectomy is necessary to remove proliferative tissue ,unfold retinal structures and media opacities. VITRECTOMY FOR COMPLEX RETINAL DETACHMENT;
  14. 14. • Manly associated with an intraocular foreign body . VITRECTOMY FOLLOWED BY PENETRATING TRAUMA;
  15. 15. Complications associated with pars plana vitrectomy. COMPLICATIONS OF VITRECTOMY
  16. 16. Postoperative nuclear sclerotic cataract. Long term risk of open-angel glaucoma. Intraoperative or Postoperative retinal break. Intraoperative or Postoperative retinal detachment. Intraoperative cataract. Postoperative vitreous hemorrhage. Postoperative massive fibrin accumulation. Postoperative anterior segment neovascularization.  Endophthalmitis. COMPLICATIONS ASSOCIATED WITH PARS PLANA VITRECTOMY;

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