Pars Plana Vitrectomy
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Pars Plana Vitrectomy
Vitrectomy is a surgery to remove some or all of the vitreous humor from the eye. Anterior vitrectomy entails removing small portions of the vitreous humor from the front structures of the eye—often because these are tangled in an intraocular lens or other structures. ''Pars plana'' vitrectomy is a general term for a group of operations accomplished in the deeper part of the eye, all of which involve removing some or all of the vitreous humor—the eye's clear internal jelly. Even before the modern era, some surgeons performed crude vitrectomies. For instance, Dutch surgeon Anton Nuck (1650–1692) claimed to have removed vitreous by suction in a young man with an inflamed eye. In Boston, John Collins Warren (1778–1856) performed a crude limited vitrectomy for angle closure glaucoma. Anesthesia for vitrectomy Options for anesthesia for vitrectomy are general anaesthesia, local anesthesia, topical anesthesia and intracameral lidocaine irrigation. Each anesthesia te ...
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Vitreous Humor
The vitreous body (''vitreous'' meaning "glass-like"; , ) is the clear gel that fills the space between the lens and the retina of the eyeball (the vitreous chamber) in humans and other vertebrates. It is often referred to as the vitreous humor (also spelled humour, from Latin meaning liquid) or simply "the vitreous". Vitreous fluid or "liquid vitreous" is the liquid component of the vitreous gel, found after a vitreous detachment. It is not to be confused with the aqueous humor, the other fluid in the eye that is found between the cornea and lens. Structure The vitreous humor is a transparent, colorless, gelatinous mass that fills the space in the eye between the lens and the retina. It is surrounded by a layer of collagen called the vitreous membrane (or hyaloid membrane or vitreous cortex) separating it from the rest of the eye. It makes up four-fifths of the volume of the eyeball. The vitreous humour is fluid-like near the centre, and gel-like near the edges. The vitreous hu ...
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Macula
The macula (/ˈmakjʊlə/) or macula lutea is an oval-shaped pigmented area in the center of the retina of the human eye and in other animals. The macula in humans has a diameter of around and is subdivided into the umbo, foveola, foveal avascular zone, fovea, parafovea, and perifovea areas. The anatomical macula at a size of is much larger than the clinical macula which, at a size of , corresponds to the anatomical fovea. The macula is responsible for the central, high-resolution, color vision that is possible in good light; and this kind of vision is impaired if the macula is damaged, for example in macular degeneration. The clinical macula is seen when viewed from the pupil, as in ophthalmoscopy or retinal photography. The term macula lutea comes from Latin ''macula'', "spot", and ''lutea'', "yellow". Structure The macula is an oval-shaped pigmented area in the center of the retina of the human eye and other animal eyes. Its center is shifted slightly away from the ...
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Macular Pucker
Epiretinal membrane or macular pucker is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes. Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in posterior vitreous detachment (PVD). PVD can create minor damage to the retina, stimulating exudate, inflammation, and leucocyte response. These cells can form a transparent layer gradually and, like all scar tissue, tighten to create tension on the retina which may bulge and pucker, or even cause swelling or macular edema. Often this results in distortions of vision that are clearly visible as bowing and blurring when looking at lines on chart paper (or an Amsler grid) within the macular area, or central 1.0 degree of visual arc. Usually it occurs in one eye first, and may cause binocular diplopia or double vision if the image from one eye is too different from the image of the other eye. The distortions ...
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Retinal Detachment
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a surgical emergency. The retina is a thin layer of light-sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, posterior vitreous detachment, injury or trauma to the eye or head may cause a small tear in the retina. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper. Diagnosis Symptoms As the retina is responsible for vision, persons experiencing a retinal detachment have vision loss. This can be painful or painless. Imaging Ultraso ...
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Cataract Surgery
Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract, and its replacement with an intraocular lens. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract, causing impairment or loss of vision. Some infants are born with congenital cataracts, and certain environmental factors may also lead to cataract formation. Early symptoms may include strong glare from lights and small light sources at night, and reduced acuity at low light levels. During cataract surgery, a patient's cloudy natural cataract lens is removed, either by emulsification in place or by cutting it out. An artificial intraocular lens (IOL) is implanted in its place. Cataract surgery is generally performed by an ophthalmologist in an ambulatory setting at a surgical center or hospital rather than an inpatient setting. Eit ...
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Scleral Buckle
A scleral buckle is one of several ophthalmologic procedures that can be used to repair a retinal detachment. Retinal detachments are usually caused by retinal tears, and a scleral buckle can be used to close the retinal break, both for acute and chronic retinal detachments. Scleral buckles come in many shapes and sizes. A silicone sponge (with air filled cells) is a cylindrical element that comes in various sizes. An encircling band is a thin silicone band sewn around the circumference of the sclera of the eye. A solid silicone grooved tyre element is also used. Buckles are often placed under a band to create a dimple on the eye wall. The scleral buckle is secured around the eyeball under the conjunctiva. This moves the wall of the eye closer to the detached retina. This alteration in the relationships of the tissues seems to allow the fluid which has formed under the retina to be pumped out, and the retina to re-attach. The physics or physiology of this process are not fully un ...
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Photocoagulation
Laser coagulation or laser photocoagulation surgery is used to treat a number of eye diseases and has become widely used in recent decades. During the procedure, a laser is used to finely cauterize ocular blood vessels to attempt to bring about various therapeutic benefits. The procedure is used mostly to close blood vessels in the eye, in certain kinds of diabetic retinopathy; it is no longer used in age-related macular degeneration in favor of anti-VEGF drugs. Medical uses Diabetic retinopathy The American Academy of Ophthalmology practice guidelines recommend laser coagulation for people who have both mild to moderate nonproliferative diabetic retinopathy (NPDR) and clinically significant macular edema outside the fovea; treatment with anti-VEGF drugs is better than laser coagulation for clinically significant macular edema in the fovea. For people with severe NPDR and no macular edema, the AAO recommends laser photocoagulation for the whole retina; when there is macular edem ...
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Silicone Oil
A silicone oil is any liquid polymerized siloxane with organic side chains. The most important member is polydimethylsiloxane. These polymers are of commercial interest because of their relatively high thermal stability, lubricating, and Liquid dielectric, dielectric properties. Structure Like all siloxanes (e.g., hexamethyldisiloxane), the polymer backbone consists of alternating silicon and oxygen atoms (...Si−O−Si−O−Si...). Many groups can be attached to the tetravalent silicon centres, but the dominant substituent is methyl or sometimes phenyl. Many silicone liquids are linear polymers end-capped with trimethylsilyl groups. Other silicone liquids are cyclosiloxanes. Applications Silicone oils are primarily used as lubricants, thermic fluid oils or hydraulic fluids. They are excellent electrical insulators and, unlike their carbon analogues, are non-flammable. Their temperature stability and good heat-transfer characteristics make them widely used in laboratories for he ...
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Silicone Oil Injection
A silicone or polysiloxane is a polymer made up of siloxane (−R2Si−O−SiR2−, where R = organic group). They are typically colorless oils or rubber-like substances. Silicones are used in sealants, adhesives, lubricants, medicine, cooking utensils, thermal insulation, and electrical insulation. Some common forms include silicone oil, silicone grease, silicone rubber, silicone resin, and silicone caulk. Chemistry More precisely called polymerized siloxanes or polysiloxanes, silicones consist of an inorganic silicon–oxygen backbone chain (⋯−Si−O−Si−O−Si−O−⋯) with two organic groups attached to each silicon center. Commonly, the organic groups are methyl. The materials can be cyclic or polymeric. By varying the −Si−O− chain lengths, side groups, and crosslinking, silicones can be synthesized with a wide variety of properties and compositions. They can vary in consistency from liquid to gel to rubber to hard plastic. The most common siloxane i ...
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Tamponade
Tamponade () is the closure or blockage (as of a wound or body cavity) by or as if by a tampon, especially to stop bleeding. Tamponade is a useful method of stopping a hemorrhage. This can be achieved by applying an absorbent dressing directly into a wound, thereby absorbing excess blood and creating a blockage, or by applying direct pressure with a hand or a tourniquet. There can, however, be disastrous consequences when tamponade occurs as a result of health problems, as in the case of cardiac tamponade. In this situation, fluid collects inside the pericardial sac. The pressure within the pericardium prevents the heart from expanding fully and filling the ventricles, with the result that a significantly reduced amount of blood circulates within the body. If left unchecked, this condition will result in death eventually. Bladder tamponade is obstruction of the urinary bladder outlet due to heavy blood clot formation within it.
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Sulfur Hexafluoride
Sulfur hexafluoride or sulphur hexafluoride (British spelling) is an inorganic compound with the formula SF6. It is a colorless, odorless, non- flammable, and non-toxic gas. has an octahedral geometry, consisting of six fluorine atoms attached to a central sulfur atom. It is a hypervalent molecule. Typical for a nonpolar gas, is poorly soluble in water but quite soluble in nonpolar organic solvents. It has a density of 6.12 g/L at sea level conditions, considerably higher than the density of air (1.225 g/L). It is generally transported as a liquefied compressed gas. is 23,500 times more potent than as a greenhouse gas but exists in relatively minor concentrations in the atmosphere. Its concentration in Earth's troposphere reached 10.63 parts per trillion (ppt) in 2021, rising at 0.39 ppt/year. The increase over the prior 40 years was driven in large part by the expanding electric power sector, including fugitive emissions from banks of gas contained in its med ...
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