Vitrectomy is indicated when progression of a tractional
retinal detachment threatens the macula.
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Goal The goal of vitrectomy surgery is to relieve vitreoretinal
traction to facilitate retinal reattachment.
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Vitreous Hemorrhage The least difficult surgical presentation
is vitreous hemorrhage. a. May be with PVD and no fibrous
proliferation, or b. Persistent attachment of the post hyaloids to
the retina
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Dense vitreous hemorrhage Vitrectomy performed within the first
6 months increased the chances of better visual acuity. ( DRVS
diabetic retinopathy vitrectomy study )
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Premacular Hemorrhage 1) Is subhyaloid hemorrhage overlying the
macula. 2) Most of these hemorrhages clear spontaneously. 3) Some
of eyes progress to develop premacular fibrosis and traction
macular detachment.
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Anterrior to Posterior Traction
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Posterior Attachments Usually in Both Optic Nerve and Along the
Vascular Arcades
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Fine neovasclar tufts growing at right angles to the retina and
attached to the posterior hyaloid
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Fibrovascular proliferation growing from optic nerve along both
vascular arcades (wolf-jaw configuration)