The indications for modern vitreous surgery are expanding, not only can the diseased vitreous in the vitreous cavity be removed, but also the soft cataract, pupillary membrane and the crystals, vitreous and blood entering the anterior chamber can be removed forward; the mechanized materials on the surface of the retina can be removed backward. The scope of surgery is almost the whole eye except for cornea and sclera, so that many difficult cases that could not be treated or even unimaginable in the past can be cured.
I. Indications for the anterior segment of the eye.
1.Soft cataract
It can remove the crystal cortex more thoroughly.
2.Pupillary membrane
Pupillary membrane caused by various reasons can be removed.
3.Ocular segment perforation injury
When anterior segment perforation injury combined with traumatic cataract, especially when there is vitreous detachment, crystal and anterior vitreous excision can be made immediately after suturing the wound, which can improve visual acuity and reduce posterior cataract and intraocular mechanized membrane.
4.Crystal detachment in anterior chamber
The crystal can be removed if there is no hard nucleus.
5.Vitreous corneal contact syndrome
During cataract surgery, if the vitreous enters the anterior chamber through the pupil and contacts with the corneal endothelium, it can make the corneal endothelium lose its function, so the vitreous that enters the anterior chamber should be completely removed.
6, malignant glaucoma: remove the anterior vitreous cortex, lift the atrial water forward drainage block, so that high intraocular pressure is controlled.
Second, the posterior segment of the eye indications.
1.Vitreous hemorrhage
It is one of the main indications for vitrectomy. When vitreous hemorrhage is not absorbed after 3 months of conservative treatment, vitrectomy should be performed. However, surgery should be performed promptly once retinal detachment is observed, rather than waiting for 3 months. In children, early surgery is generally advisable to prevent amblyopia. Traumatic vitreous hemorrhage surgery can be done earlier.
2.Intraocular foreign body
Vitrectomy to remove foreign bodies is performed under direct vision, especially for non-magnetic foreign bodies, or when accompanied by other eye tissue damage, it is easy to handle together.
3.Endophthalmitis
Surgery can remove bacteria and their toxins, remove necrotic tissue and inflammatory material, and inject drugs directly into the vitreous cavity.
4.Retinal detachment
Combined with vitreous opacity, giant fissure combined with proliferative vitreoretinopathy, macular fissure, vitreous proliferation caused by traction retinal detachment, diabetic retinopathy caused by retinal detachment and other cases, suitable for vitrectomy. Some recurrent retinal detachments can also be selected for vitrectomy.
5.Other
Dislocation of the lens into the vitreous; fragment of the nucleus of the lens falling into the vitreous during cataract surgery; macular folds, macular anterior membrane; intravitreal pig cysticercus and other diseases are also indications for vitrectomy.