Vitrectomy for Vitreous Opacities

These videos show pars plana vitrectomy to remove vitreous opacities which include vitreous hemorrhage and floaters

Diabetic Vitreous Hemorrhage
25 gauge vitrectomy

60 Year old African american female was referred with 9 months of vision loss from a vitreous hemorrhage. She noticed a drop in vision 3 months ago where the vision seemed to go dark. The pre-operative ultrasound suggested a possible combined rhegmatogenous – tractional retinal detachment. There was also a dense cataract present. The video shows the surgery where the cataract is removed with a fragmatome leaving the anterior capsule intact. Toward the end of the surgery, when the macular membranes are being trimmed, the vitrectomy cutter clearly becomes dull and unable to cut and remove the membranes. Switching to a new vitrectomy probe allows safe completion of the surgery. This video illustrates that vitrectomy cutters can dull and recognizing this, switching to a new probe can allow for safe completion of surgery in select difficult cases.

Floater Vitrectomy
25 Gauge High Def

This 65 year old woman has had floaters and visio problems for 7 years. The surgical video shows the vitreous clumps and opacities directly behind the intraocular lens. She was clear and happy and visually better the first day after surgery.

Vitrectomy for Recurrent Vitreous Hemorrhage
Diabetic Tractional Retinal Detachment

62 year old man with recurrent vitreous hemorrhages from the traction around the macula and adjacent to the optic nerve. This video shows removal of the blood, release of the vitreoretinal traction, removal of the scar tissue and then laser. An air bubble was used at the conclusion of the case. The patient did very well and regained nearly normal vision within about a month of surgery.

Diabetic Vitreous Hemorrhage
18 Months Old - Dense

65 Year Old woman with vision loss for almost 2 years. Her vision was light perception when she presented. Her fellow eye had mild proliferative diabetic retinopathy. This eye had a normal ultrasound (except for the vitreous hemorrhage). Her cataract was removed about 2 weeks prior to this surgery. Diabetic vitrectomies have slightly better outcomes if done subsequent to cataract surgery. This video shows the dense vitreous hemorrhage looks yellow white.

Vitrectomy Vitreous Opacities
Floaters

70 year old man with significantly compromised visual function for 1.5 years from a vitreous opacity in his better 20/16 eye. Video shows 25 gauge vitrectomy in high definition. Over 99 percent of symptomatic vitreous floaters will improve without any treatment within 6 to 12 months. There are significant risks to surgery for vitreous floaters which have to be weighed against the benefits. Vitrectomy almost always causes a worsening of a cataract, but since this patient had already had cataract surgery that was not a concern.