Vitrectomy is the most widely used surgery to treat multiple retinal pathologies, including retinal detachments, macular holes and macular folds, glassy hemorrhages... Of all of them, the most common is retinal detachment, which occurs when this layer detaches from the adjacent ones. This is a potentially serious problem for which you may have complications such as irreversible lesions of the retina or optic nerve, and chronic eye inflammation that would lead to permanent visual limitation or even legal blindness. For this reason, it is essential to apply early treatment to return the retina to its normal position.
Vitrectomy consists of the withdrawal of the vitreous humor, a gelatinous substance that fills the eye cavity behind the lens, to be able to access the retina and work on its diseases. This gel is then replaced by a saline solution, a gas bubble, or silicone oil.
In this sense, conducting specific preoperative tests will help to accurately determine the state of the retina and other eye structures to adapt the surgical procedure to the needs of each case.
This detailed examination will include a direct examination, photographs, optical coherence tomography, and ultrasounds. All these tests will clarify the more precise roadmap to follow during the intervention to achieve satisfactory results for the patient.
However, it is also important that the surgeon maintain clear, direct, and effective communication with the patient to inform them of the entire process, from the diagnostic tests up to the preoperative and postoperative periods, with the aim of managing their expectations about the results.
Evolution of intervention
Surgeons each time have to carry out this intervention with finer and more precise tools that allow minimally invasive surgeries with excellent results. Vitrectomy, star surgery on the surgical retina, was first described in 1971, had a single port of entry with a 1.5-millimeter incision.
Since then, it has evolved remarkably. Just four years later, the first vitrectomies were performed through three ports of entry, with incisions of 0.81 millimeters, which remained queens of this surgery for three decades.
However, technological evolution has allowed progress towards fewer and fewer invasive procedures, following the general rule that any intervention on the body is better, the smaller the better.
The incisions are getting smaller and smaller, so less anesthesia is required by shortening surgical times and injuries. The scars that are generated are minor, so recovery is faster. In addition, the incisions are minimal, allowing a spontaneous sealing of the incisions and disregarding the sutures. This translates into greater patient comfort and faster recovery.
Therefore, now the challenges that ophthalmologists must face are focused precisely on the arrival of new technologies. And it is necessary for a learning curve to take advantage of its full potential, as well as a homogeneous incorporation of these techniques into clinical practice so that they affect the health of the patients.
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