1.Retinal detachment due to various causes.
(1), Retinal detachment with fissure: according to the status of retinal detachment and the location of fissure, combined with the characteristics of intraocular pathology, extra-scleral pad pressure or vitrectomy is performed;
(2), large vesicular retinal detachment without a previously detected fissure is a difficult point of treatment. Now, after excluding intraocular tumors, Harada disease and other lesions through various examinations, it can be combined with intraocular lesions
characteristics and progress, vitrectomy can be considered.
(3), retinal detachment that can be caused by lesions such as choroidal defect, petunia syndrome, small concave optic disc, and permanent vitreous hyperplasia, these lesions need to be treated by vitreous surgery
and extra-scleral surgery to reset the retina.
2. Diabetic vitreoretinopathy combined with vitreous hemorrhage and retinal detachment.
Diabetic retinopathy combined with long-term vitreous hemorrhage, intravitreal fibrovascular membrane formation and retinal detachment have an important impact on the prognosis, and vitreous surgery should be considered in these cases, and timely surgical treatment will result in less damage to the retina and better postoperative vision. If delayed for a longer period of time, the postoperative reaction is large, the prognosis is poor, and there are many complications.
3. The following cases of vitreous hemorrhage should be considered for timely consultation and treatment in our department, and vitrectomy should be performed if necessary to prevent further complications.
(1), secondary to diabetic retinopathy, branch vein obstruction, retinal hemangioma, retinal perivasculitis, etc., where the accumulated blood cannot be absorbed by itself for more than 1 month;
(2) If the blood accumulates in the vitreous without any cause, please refer to our department for indirect ophthalmoscopy to exclude the formation of retinal fissure;
4.Macular fissure.
According to years of clinical experience and with reference to international macular fissure staging, macular fissure with/without retinal detachment is an indication for surgery, and intraocular gas injection or vitrectomy can be performed to peel off the residual vitreous cortex or inner boundary membrane in front of the macula to promote the healing of macular fissure;
5. Submacular hemorrhage.
Trauma or age-related macular degeneration (wet) leads to dense subretinal blood accumulation in the macular area, which can lead to damage of retinal photoreceptor cells. Consideration should be given to drainage of the accumulated blood, and vitrectomy and intraocular gas injection surgery should be performed to peel off the subretinal scar tissue;
6. Pre-macular membrane.
Pre-macular membrane causes distortion of vision in the affected eye and unbalanced vision in both eyes, which affects normal life. For macular pre-macular membrane with visual acuity below 0.3, surgical stripping should be considered, and the effect of visual acuity improvement is obvious.
7.Endophthalmitis.
Endophthalmitis can be caused by ocular trauma, systemic infectious diseases and intraocular surgery, etc. It requires emergency intraocular injection or vitrectomy treatment to preserve vision and save the eye;
8. Coat’s disease.
Depending on the progression of the lesion, cryotherapy, laser and vitrectomy may be considered;
9. Retinal branch vein obstruction combined with macular edema.
Consider vitreous injection or vitreous surgery to peel off the inner boundary membrane to reduce macular edema, increase the oxygen supply to retinal tissue and improve visual acuity.
10.If retinal degeneration and macular retinal splitting occur in high myopia, combined with cataract formation, combined anterior and posterior segment surgery can be considered.
11.Intermediate uveitis, acute retinal necrosis can be treated by vitreous surgery if it cannot be relieved by drug treatment
12. Intraocular parasites, lens detachment in the vitreous cavity, etc. can be treated by vitreous surgery.