Pars Plana Vitrectomy (PPV) Surgery in Delhi, India

There are multiple reasons for a Pars plana vitrectomy. It may be done to drain virus fluids which have become cloudy or bloody or filled with bits of tissue affecting vision. It may also be done to gain access to retinas. More conditions when vitrectomy is needed:

• Vitreous became opaque
• Infection of Vitreous
• Vitreous is inflamed or filled with blood and/or floaters.
• Reducing vitreoretinal traction and restoring the retina's normal anatomical relationship with the retinal pigment epithelium
• Accessing subretinal space

Specific conditions where pars plana vitrectomy is used are:

• Macular hole
• Cataract
• Diabetic Retinopathy
• Traumatic injury to the eye
• Epiretinal membrane
• Vitreomacular traction
• Vitreous haemorrhage
• Tractional retinal detachment
• Rhegmatogenous retinal detachment
• Refractory macular oedema
• Vitreous biopsy
• Endophthalmitis
• Dislocated intraocular lens
• Retained lens material
• Intraocular foreign bodies

Pars plana vitrectomy is a low-risk surgery and has a success rate of 90%. Even if the patient is 60 or older. The patient might be a good fit if:

• If they are mentally and physically healthy,
• They are facing visual issues and can benefit from vitrectomy

The patient should avoid the surgery if:

• If they have significant systematic co-morbidities,
• If they suffer from intraocular tumours such as retinoblastoma,
• Diagnosed with an aggressive tumour of the eye

The patient should have an in-depth conversation with their eye doctor. The doctor will explain the surgical procedure, risks and complications, and prognosis.

• Routine check-up

  The patient will need to have a physical exam from their primary care physician before surgery to be sure they can survive the procedure. Plus, they can take any measurement if required.

  Before surgery, the doctor will most likely examine the eye once more with tools and light. They may need to dilate their pupils. They may choose to perform an ultrasound to examine the retina more precisely.

• Stop taking blood-thinning and pain medication

  Patients should inform their healthcare practitioner about all medications and supplements they are taking. Some medications must be continued or discontinued on the day of surgery. Blood thinners and pain medicines should be discontinued at least one week before surgery.

• Avoid alcohol

  Avoid alcohol one week before and two weeks after surgery to avoid bleeding problems.

• Stop taking blood-thinning and pain medication

  Patients should discuss all medications and supplements they are taking with their healthcare provider. Some medicines need to be continued or stopped on the day of surgery. Drugs such as blood thinners and pain relievers should be stopped at least one week before the surgery.

• Fasting

  Patients may need to avoid eating and drinking anything the night before the surgery.

• During the procedure, the patient may be awake. A drug will be given to the patient to relax them. To ensure that the patient does not feel pain, the surgeon may employ anaesthetic eye drops and injections. The patient will sleep during the surgery if they are under general anaesthesia.
• The surgeon will expose the eye and create an incision in the outer layer of the eye, known as the sclera (The white part of the eye.) Surgeons will use specific equipment to remove the vitreous and any scar tissue or foreign substances.
• If more repairs are required, the surgeon will perform them. They may, for example, use a laser to repair a tear in your retina. In some situations, the eye doctor may inject a gas bubble into the eye to keep the retina in place.
• The vitreous will be replaced by another fluid, like silicone oil or saline. After that, the surgeons will close the surgical incisions with stitches. However, stitches are not always necessary. To prevent infection, an antibiotic ointment will be applied to the eye. A patch will be placed over the affected eye.

Possible complications of pars plana vitrectomy include:

• Retinal tearing or detaching
• Bleeding in the eye
• Infections
• Complications from anaesthesia, such as pneumonia or stroke
• Formation of cataracts or progression of existing cataracts
• Decrease in vision
• Blindness
• Night vision loss, blurriness, or loss of depth perception
• Double vision
• Retinal detachment
• Dislocation or discolouration of the intraocular lens
• Increased pressure (glaucoma) or reduced pressure in the eye
• Cataract formation or progression of existing cataracts
• Surgical injury, such as an improper cut or tear, necessitating additional corrective surgery
• Swelling of the central part of the retina

These medical issues can result in eyesight loss. Some of them can even end in blindness if not addressed. In some circumstances, vitrectomy can restore lost vision. In an emergency, such as an eye injury, the patient may require a vitrectomy. In other circumstances, the eye doctor may schedule a vitrectomy ahead of time.

A pars plana vitrectomy is a low-risk treatment with a high success rate that can treat plenty of eye problems.

• Following your recovery, the doctor will monitor the patient's condition and notify them when they are ready to leave the hospital. They should be able to go home the same day, but if other procedures were performed, they might need to stay overnight. Because vitrectomy procedures are frequently performed with other eye surgeries, individual recovery times and recommendations vary.
• Activities like driving, reading, and exercise should be avoided for a few days following the surgery. Patients should avoid travelling to high-altitude places without consulting with their doctors.
• The doctor may suggest laying with their face down or turning their head to one side for a prolonged time. It may help maintain eye pressure if it is filled with gas or other substance.
• Follow all instructions religiously for a better prognosis. Use eye drops and pain medications, as suggested. The doctor may also suggest the patient wear an eye patch.
• Some people will need to lie face down for a while to allow their eyes to heal correctly. Eye drops are frequently administered to help prevent infection and relieve inflammation. The whole recuperation time after vitrectomy surgery is 4 to 6 weeks.