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BOOK TITLE: Retina: Medical and Surgical Management
Pars plana vitrectomy involves surgical removal of vitreous gel by introducing instruments through pars plana region using three ports, placed 3–4 mm posterior to the limbus. One port is used for infusion of balanced saline solution, which maintains the intraocular pressure (IOP) intraoperatively. Vitrectomy is performed using an operating microscope with a contact lens or noncontact lens viewing system. Advantages of small-gauge vitrectomy over large-gauge vitrectomy include reduced patient discomfort and inflammation, faster wound healing and postoperative recovery, conjunctival preservation, easier instrument exchange shortened operative time, and better operating room efficiency. Potential disadvantages include an increased risk of postoperative hypotony, endophthalmitis, increased iatrogenic retinal tears, and epithelial down growth. Surgical steps in vitreoretinal surgery and complications of pars plana vitrectomy are covered in this chapter.
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