The vitreous cutter clears the vitreous gel and any associated blood. The light pipe provides light for viewing. The other 2 ports are for the insertion of instruments into the vitreous cavity, usually a light pipe and a vitreous cutter. This to maintain the pressure within the eyeball and to prevent the eye from collapsing. One port is for continuous infusion of balanced salt solution into the vitreous cavity. Vitrectomy surgery involves creating 3 entry sites (or 'ports') into the vitreous cavity. This is important to prevent the retina from developing other tears due to vitreous gel tugging on it. By removing the vitreous gel, there will no longer be areas of the retina that is being pulled by the vitreous. Vitrectomy: This procedure is considered as the 'internal approach' for retinal detachment surgery because it involves the removal of the vitreous humor gel from inside the vitreous cavity of the eyeball. If your detached retina is not repaired, you will eventually lose all your vision in that eye. The later you postpone surgery, the lower the chances of success due to scarring from proliferative vitreoretinopathy. Ideally, the retinal detachment should be repaired before the macula (central part of the retina) becomes detached and your central vision becomes affected. Both techniques have a high success rate if performed appropriately and early enough. When you are diagnosed with retinal detachment, you will be advised on one of the two main types of retinal detachment surgery procedures (which can be combined together if required): vitrectomy and scleral buckling surgery. It is not always possible to detect a retinal tear early enough before the retina detaches. For laser retinopexy to be successful, the laser burns must be applied as soon as possible around the tear before retinal detachment develops. Fluid is prevented from accumulating under the neurosensory retina, thereby preventing the retina from detaching. This 'fuses' the neurosensory retina with the retinal pigment epithelium, and seals off the retinal tear. In laser retinopexy, laser 'burns' are applied all around the tear. If the retinal tear is not too big and there isn't too much hemorrhage obscuring its view, it can be successfully treated with laser retinopexy. If you have a retinal tear, and this has not yet progressed to become a retinal detachment, you may be able to avoid having to undergo surgery provided the retinal tear is dealt with early enough. IS RETINAL DETACHMENT SURGERY ALWAYS NECESSARY? These days, day case surgery is the norm and you should be able to go home the same day after surgery if you prefer. You should choose the anesthetic option that you are most comfortable with. Although retinal detachment surgery can be performed safely with local anesthesia, some people prefer to have surgery under general anesthesia. Surgery can be complicated and may take around 1 to 2 hours. During the operation, the fluid between the neurosensory retina and retinal pigment epithelium will be drained out, so that both layers can be pushed back together. The aim of retinal detachment surgery is to 'glue' the neurosensory retina back where to it is meant to be positioned. This tear allows fluid to track under the neurosensory retina, thus separating the neurosensory retina from the retinal pigment epithelium. This means that the retina detached because of a retinal tear (or more). Most cases of retinal detachments are rhegmatogenous in nature. If you develop a retinal detachment, you will almost certainly need to undergo an operation to reattach the retina. When the retina detaches, the process is similar to when wallpaper peels away from the living room wall. A retinal detachment occurs when the neurosensory retina is separated from the retinal pigment epithelium.
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