What is pars plana vitrectomy?
Pars plana vitrectomy (PPV) removes vitreous gel through tiny openings in the eye. This gives Mr Rabie access to treat problems such as retinal detachment, macular hole, epiretinal membrane, vitreomacular traction or bleeding into the vitreous. The treatment depends on the condition.
Preparing for your operation
Bring a medicines list and tell your team about allergies, blood thinners, diabetes treatment or difficulties lying flat. If neck, back or mobility problems might make posturing difficult, raise this before surgery. Vitrectomy is often a day-case operation under local anaesthetic around the eye.
Fluid, air, gas or silicone oil
The eye is left with fluid or a support chosen for the retinal condition. Gas or air can support the retina while it heals and gradually clears. Silicone oil may need a later operation to remove it.
If you have an air or gas bubble
Do not fly or travel to high altitude while a bubble remains. Tell any healthcare professional that there is gas in your eye, as nitrous oxide can dangerously expand the bubble. Vision is usually very blurred at first and changes as the bubble shrinks.
Positioning after surgery
Face-down positioning is commonly used for macular hole surgery to bring the bubble against the macula. If prescribed, keep your face parallel to the floor, with your nose pointing down. You can lean forward at a table with your forehead supported, avoiding pressure on the eye. Follow the specific positioning and sleeping instructions from your team.
Recovery and urgent advice
Use the prescribed drops and attend your reviews. Your team will explain restrictions on activity, work, driving and travel. Seek urgent advice for severe or increasing pain, unexpected worsening of vision, a new shadow, flashes, a sudden increase in floaters, increasing redness or significant discharge. Use the urgent contact details on your discharge instructions.
Risks of surgery
Risks include cataract progression, retinal tears or detachment, pressure changes, inflammation, bleeding and infection. Further surgery may be needed. Mr Rabie will discuss which risks apply and what improvement is realistic.