• Pars Plana Vitrectomy

  • Pars plana vitrectomy is a surgical procedure in which small instruments are inserted into the eye through the pars plana. The pars plana is the part of the eye lying between the retina and the pars plicata. The retina converts light energy into a signal that is sent to the brain. The pars plicata makes intraocular fluid, the aqueous humor. The pars plana has no known function in the post-fetal eye. It is thus a “safe” place through which one can insert instruments.

    Vitrectomy is used to treat a variety of blinding disorders, most commonly proliferative diabetic retinopathy, complex retinal detachment (for example, due to trauma), macular hole, and epiretinal membrane (also known as macular pucker). Various microsurgical instruments are introduced into the eye cavity (the vitreous cavity) to cut or peel away scar tissue, excise blood, or apply laser treatment. Vitreous surgery is complex microsurgery and is usually done by an ophthalmic surgeon with special training in the technique.

    Generally, vitrectomy is an outpatient procedure and is done under intravenous sedation with local anesthesia. Depending on the patient’s age and the anticipated length of surgery, however, it may be done under general anesthesia. Sometimes patients are admitted to the hospital after surgery for careful postoperative observation (for example, a patient with a postoperative intraocular infection who has undergone vitrectomy and will require intravenous antibiotics). Postoperative pain varies in intensity but is usually well controlled with narcotics. If the surgeon places an intraocular gas bubble in the eye (to maintain retinal reattachment while the eye heals from surgery), the patient will have to maintain a face-down position postoperatively.

    Vitreous surgery, although complex, has saved sight in many patients who otherwise would be blind. The final outcome often depends, however, on the underlying disease for which surgery has been done.