Vitreo-retinal surgery in Special conditions Medical Literature Review

Abstract

Backgrund: spescial cases in vitreo-retinal surgery might be a challenge  to the surgeon  and need special attention as well as using maneuvers that can make the surgical  procedure easier and improve both  anatomical and visual outcomes, and  avoide intraperative and postoperative complications. most of these conditions exist during  vitrectomy in eyes with proliferative diabetic retinopathy and in eyes of  high myopia as well as pediatric vitreoretinal disorders.

Purpose: review of medical literature to discuss challenging conditions for vitreo-retinal surgeon in eyes with roliferative diabetic retinopathy or with high myopia and coats disease.

Methods: review of medical literature about :

• vitrectomy in special conditions of proliferative diabetic retinopathy:

combined tractional-rhegmatogenous retinal detachement caused by diabetic retinopathy, dense asteroid hyalosis, Iatrogenic break associated with tangential traction, vitreo-macular traction, combined vitrectomy with phacoimulsification.

• Vitrectomy in high myopia:
• introduction .
• elongated anterior-posterior length
• Visualization of epiretinal membranes and internal limiting membrane (using vital dyes and there toxic effects, peeling of ILM, inverted ILM flap, using of iOCT and 3D systems, peripheral vitrectomy shaving in patients with clear lens.
• Retinal detachement
• Scleretomy leakage
• Surgery in Coats disease

Conclusion: surgical management of many vitreo-retinal conditions( as in special conditions in PDR and in high myopia) is still a challenge even to best qualified surgeons. Due to development of surgical instruments, and vitrectomy machines, and in microscopes and in non-contact wide-field viewing systems, a great shift was achieved in pars plana vitrectomy , the matter that served to reduce operation time and intra- and postoperative complications, and enabled reaching better anatomical and visual outcomes.