Routine Vitrectomy for Retinal Detachment - a Step-by-Step Video | Dr Sami A. SAAD скачать в хорошем качестве

Routine Vitrectomy for Retinal Detachment - a Step-by-Step Video | Dr Sami A. SAAD

Retinal detachment is the separation of the retina, the light-sensitive tissue at the back of the eye, from its underlying layer attached to the inner back surface of the eye. Rhegmatogenous retinal detachment is when the separation results from retinal breaks or tears, usually due to pulling (traction) from the vitreous, the substance that fills the center of the eye. Rhegmatogenous retinal detachment typically presents with the perception of light flashes, floaters, or a “dark curtain.” In most cases, the retinal tear is a consequence of degeneration of the vitreous body. Rhegmatogenous retinal detachments with superior breaks that threaten the macula require urgent vitreoretinal intervention. This case is a typical surgical repair of rhegmatogenous retinal detachment using pars plana vitectomy, endolaser retinopexy & gas tamponade. In vitrectomy, the vitreous is removed to relieve traction on the retina from the vitreous. The gas provides a mechanical seal (tamponade) for the retinal breaks until the breaks can be sealed with heat (laser) or cold (cryotherapy). Although I usually prefer scleral buckle technique for phakic patients, I chose pars plana vitrectomy technique in this particular case because of 2 main reasons. First, the patient was 69 years old and I noticed an early stage of cataract at admission (hence, cataract surgery will be necessary in the next few months anyway). Second, I noticed multiples and posterior retinal tears at the pre-operative clinical examination. Performing pars plana vitrectomy on phakic patients is always challenging. Care must be taken to avoid lens injury during surgery. If not needed, I advise avoiding combined phako-vitrectomy procedure in retinal detachments cases, in order to lower the risk of post-operative inflammation and PVR (proliferative vitreoretinopathy). #surgery #ophthalmology #retinaldetachment #retina #eye #medical #medicaleducation