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Pars Plana Vitrectomy

Microsurgical procedure using small-gauge instruments inserted through pars plana sclerotomies to remove vitreous gel and treat retinal disorders including detachment, macular hole, epiretinal membrane, and diabetic retinopathy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Pars Plana Vitrectomy?

Pars plana vitrectomy is a microsurgical procedure introduced by Robert Machemer in 1971 that removes the vitreous gel through 3-4 small (0.4-0.7 mm) sclerotomies in the pars plana region (3.5-4 mm posterior to the limbus), avoiding damage to the retina or ciliary body.

Modern small-gauge vitrectomy (23G, 25G, 27G) uses self-sealing transconjunctival trocars eliminating the need for sutures. High-speed cutters (10,000-20,000 cuts per minute), wide-angle viewing systems (BIOM, Resight), and chandelier illumination enable bimanual surgery with excellent visualization.

Indications include rhegmatogenous and tractional retinal detachment, macular hole, epiretinal membrane, vitreous hemorrhage, endophthalmitis, dropped lens fragments, vitreomacular traction, proliferative diabetic retinopathy, and retained intraocular foreign body. Tamponade options: BSS, SF6, C3F8 gas, silicone oil.

Symptoms

Sudden onset floaters and flashing lights
Curtain-like vision loss (retinal detachment)
Central distortion or scotoma (macular hole, ERM)
Persistent vitreous hemorrhage
Diabetic tractional retinal changes
Decreased vision from vitreomacular traction
Postoperative complications of cataract surgery

Risk Factors

High myopia (axial length >26 mm)
Diabetic retinopathy (proliferative stage)
Previous retinal detachment in fellow eye
Family history of retinal detachment
Lattice degeneration with retinal holes
Trauma to the eye
Pseudophakia and aphakia
Uveitis with vitreous opacities

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden flashes of light and increased floaters
  • Curtain or shadow over part of vision
  • Central distortion (metamorphopsia)
  • Persistent vitreous hemorrhage despite observation
  • Visually significant epiretinal membrane
  • Stage 2-4 macular hole
  • Tractional retinal detachment threatening macula
  • Endophthalmitis requiring vitreous tap and intravitreal antibiotics

Treatment Methods

01
Comprehensive vitreoretinal examination with OCT, B-scan ultrasound, fundus photography
02
Pre-operative anesthesia: peribulbar block, retrobulbar block, or general anesthesia
03
Conjunctival displacement and trocar insertion through pars plana (3.5-4 mm from limbus)
04
Insertion of infusion line, light pipe, and vitreous cutter through trocars
05
Core vitrectomy and posterior vitreous detachment induction with triamcinolone staining
06
Membrane peeling using ILM forceps with brilliant blue or indocyanine green dye
07
Endolaser photocoagulation around retinal breaks or peripheral retinal tears
08
Fluid-air exchange and tamponade with gas (SF6 6 weeks, C3F8 8-10 weeks) or silicone oil
09
Trocar removal with conjunctival massage; sutures only for leaking sclerotomies
10
Postoperative face-down positioning if gas/oil tamponade for macular hole repair

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.