More than 35 years since the introduction of pars plana vitrectomy
passed, and vitreoretinal has developed to advanced techniques to treat
retinal diseases. Removing the vitreous gel and bleeding not only
deletes the optical axis of the eye, but it allows the surgeon to
approach the retina and vitreoretinal interface directly and thereby
discharge traction and removal of pathological tissue such as
epiretinal membranes. Removal of internal limiting membrane has proven
to be a safe and effective technique in macular surgery, macular hole
in cap. Twenty years ago nobody could have imagined. Today is
definitely a success rate of more than 90% in the macula and
reattachment surgery be achieved.
However, there are limitations of current vitreoretinal techniques
based mechanically. Removal of the vitreous is incomplete, especially
at the vitreous and retina-vitreous interface on the base. This can
lead to persistent or recurrent traction on the retina in retinal tear
formation or repro proliferation. More aggressive removal of the
vitreous body by mechanical means, but carries the risk of damage to
the retina. If epiretinal membranes in PVR cases removed, and in
diabetic eyes with traction retinal detachment, gliotic scar tissue is
removed, but neural retina is not treated. Thus, despite anatomic
reattachment, visual results are often disappointing.
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