vitreoretinal surgery procedure

 

The most important points that are studied in vitreoretinal surgery procedure training

1- Anesthesia Considerations

 During the vitreoretinal surgery procedure, the surgeon must be knowledgeable
about the appropriate delivery of anesthesia and the ventilatory management
of the patient is important to the conduct of the vitreoretinal surgery procedure.
The majority of patients undergoing vitreoretinal surgery are elderly and may have systemic
diseases (such as diabetes and hypertension) which increase the operative risk.

It is important to have a clear understanding of the patient’s preoperative medical condition
by coordinating with the patient’s primary care physician and/or specialist.
This may assist in determining whether certain patients may need medical clearance
from an internist or a specialist before surgery.
While a complete medical history and physical is required for all patients undergoing surgery,
the use of preoperative laboratory testing would be at the discretion of the primary care physician,
specialist, anesthesiologist, and/or surgeon based on the patient’s age and coexisting medical conditions.
While there are debates in the literature regarding whether all vitreoretinal surgery patients
require preoperative ECG and chest X-ray, these tests are generally required for elderly
patients and those with significant medical illnesses.

2- Surgical Techniques

The wide variety of vitreoretinal procedures can be broadly classified into those where there is the removal
of intraocular tissue or a foreign body or those that involve the repair of a retinal detachment or macular hole.
The different vitreoretinal procedures are each subclassified depending on the precise indication and extent of surgery.

Various instruments are required to perform vitreoretinal surgery.
The basic ones include a slit lamp, contact lens, three-way tap, overhead lamp,
and the vitreoretinal equipment.

3- Step-by-Step Surgical Procedure

Surgeons learn during vitreoretinal surgery procedures Step-by-Step a three-port pars plana vitrectomy.
The first step is to create a conjunctival flap and a partial thickness sclerotomy is made with an MVR
blade at the inferotemporal limbus to insert a 20-gauge infusion cannula.
A paracentesis incision is made at the superotemporal limbus.
Then additional sclerotomies are made, and infusion/injection cannulas are placed into the sclerotomies.
This provides a closed system for infusion of BSS and/or air to maintain intraocular pressure.

After the surgery, the patient is positioned either supine or lateral to the affected side.
All positions should provide access to the entire eye and the uninhibited infusion of balanced
salt solution (BSS) via the pars plana during the entire surgery.

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