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Problems with conventional vitrectomy
Advantages of sutureless vitrectomy
The eye can be broadly divided into 2 parts. The one in front of the lens is called the “Anterior Chamber” which is filled with a clear fluid called “aqueous”. The part of the eye behind the lens is called “Posterior Chamber” which is filled with a clear gel called the “vitreous”. This vitreous is surrounded from all other sides by the “Retina” which is the part responsible for our vision. (How Does the Eye Work)
Any surgery done for treating a disease of the vitreous or retina involves removal of the vitreous gel and is called “Vitrectomy”. The vitreous can be reached only by making cuts in the walls of the eye.
The standard approach, which has been followed for the last 30 years, involves making 3 cuts around 1mm in size each, in the coats of the eyeball. But these relatively large cuts must be closed at the end of the surgery by taking sutures. Besides, the outermost covering of the eyeball, called the “conjunctiva”, also needs to be cut and sutured in this approach.
This excess trauma along with the sutures taken, cause lot of redness, watering and discomfort to the patient in the post-operative period.
Recently, a new method of performing vitrectomy has been invented and is becoming popular all over the world. Similar to the developments in Cataract surgery, even Vitrectomy can be done with a “sutureless” approach! This requires the use of special equipment that enables the surgeon to reach the vitreous using cuts that are as small as 0.5mm. These cuts close automatically and DO NOT require sutures.
Since there are no sutures taken, there is no suture-related foreign body sensation or watering. Also, there is no need to cut the conjunctiva and so there is lesser redness of the eyes and faster recovery of the patient. All this increases the comfort of the patient in the post-operative period and he/she can resume his/her routine work at the earliest. Not only that, the overall time required for surgery is also less.
In India there are only a few places where such surgeries are being performed routinely. Our foundation is one of the leading centres of India and probably has the largest series of sutureless vitrectomy cases since 2005.
No. While the sutureless technique can be used for nearly all types of diseases, there are still a few conditions that will need the conventional vitrectomy. After examining the patient, the retinal surgeon himself can decide whether it is possible to do the surgery with this special technique or not
