Outpatient Retina Surgery Procedures Vitreous Surgery & Scleral Buckle

Pars Plana Vitrectomy

Vitreous surgery, also known as vitrectomy, is performed to treat a variety of serious retinal and vitreous conditions, including retinal detachment, vitreous hemorrhage, macular hole, macular pucker (epiretinal membrane), intraocular infection (endophthalmitis), ocular trauma, and complications following prior eye surgery. It is typically an outpatient procedure performed in an operating room, most often under local anesthesia with sedation (“twilight” anesthesia), though general anesthesia may be used in select cases. The term “vitrectomy” refers to the removal of the vitreous gel from the eye during the procedure.

Tiny incisions, approximately the size of a needle used for a blood test, are made through the sclera (the white part of the eye) to allow insertion of specialized surgical instruments into the vitreous cavity. A fiber optic light is used to illuminate the inside of the eye while a microsurgical cutting instrument removes the vitreous gel along with any blood, scar tissue, or lens fragments that may be present. Additional instruments, such as fine forceps and laser probes, may be used as needed to address specific problems. While sutures are occasionally required, most modern vitrectomy procedures are sutureless, thanks to advanced small-gauge techniques that allow the incisions to self-seal.

The removed vitreous is typically replaced with a saline solution that is compatible with the eye’s natural fluid. Within 24 hours, the eye begins to produce its own fluid to replace the saline. In certain cases, a gas bubble is used instead of saline to help support the retina during healing. The gas is gradually absorbed and replaced by the eye’s own fluid over several weeks. In other cases, silicone oil is used when longer-term support is needed. Because silicone oil does not absorb on its own, a second surgery is usually required to remove it after the retina has fully healed. When gas or silicone oil is used, patients may be instructed to maintain a specific head position, often face-down or on one side, to ensure the bubble applies the necessary pressure to the retina for optimal healing.

Pars Plana Vitrectomy Treatment

Pars Plana Vitrectomy is a Treatment Option for:

  • Vitreous Hemorrhage
  • Retinal Detachment
  • Diabetic Retinopathy
  • Macular Hole
  • Macular Pucker
  • Complications of Cataract Surgery
  • Scleral Fixated Lens Surgery
  • Complications of Glaucoma Surgery
  • Eye Infections
  • Trauma
  • Visually Significant Floaters

Scleral Buckle

Scleral Buckle is a surgical procedure used to repair a retinal detachment. Retinal detachments are usually caused by retinal tears, and a scleral buckle can be used to close the retinal break, both for acute and chronic retinal detachments. The sclera, or the white of the eye, is the outer supporting layer of the eyeball. In this surgery, your retina surgeon attaches a piece of silicone or a sponge onto the white of the eye at the spot of a retinal tear. The buckle is designed to repair retinal detachment by pushing the sclera toward the retinal tear or break. Sometimes, the retina doesn’t completely detach from the eye, but instead forms a tear. Scleral buckling can sometimes be used to repair retinal tears, which can prevent retinal detachment. Scleral buckling is used to treat different types of retinal detachments. Retinal detachment surgery usually also involves the use of cryotherapy or laser photocoagulation. The laser or cryotherapy forms a permanent adhesion around the retinal break and prevents further accumulation of fluid and re-detachment. Retinal detachment is a medical emergency requiring immediate medical care. If left untreated, retinal detachment can cause permanent loss of vision.

Scleral Buckle Treatment

Scleral Buckle is a Treatment Option for:

  • Retinal Detachment

Scleral-Fixated Intraocular Lens (IOL)

Surgery Scleral-fixated intraocular lens surgery is a specialized procedure performed when there is insufficient support within the eye to hold a standard intraocular lens, often due to trauma, prior complicated cataract surgery, dislocated lens implants, or conditions like zonular weakness. In these cases, a custom approach is required to securely place the new lens. Rather than resting in the capsular bag, the IOL is sutured or anchored to the sclera-the white outer wall of the eye-for stable and long-term positioning.

This procedure is typically performed in the operating room under local or general anesthesia, depending on patient and surgical needs. Very small incisions are made to allow insertion of microsurgical instruments and the IOL itself. Using fine sutures the lens haptics (support arms) are fixated to the sclera, ensuring precise centering of the lens behind the iris. In many cases, this surgery is combined with a vitrectomy to clear any vitreous gel that may interfere with lens positioning or has prolapsed due to prior surgeries or trauma.

Scleral-fixated IOL surgery provides an excellent option for visual rehabilitation in patients who are not candidates for standard lens implantation. Recovery is typically outpatient, and while vision may take time to stabilize, patients often experience significant improvement in visual function once healing is complete.

Scleral-Fixated Intraocular Lens (IOL) Surgery Treatment

Scleral-Fixated Intraocular Lens (IOL) Surgery Is a Treatment Option for:

  • Dislocated Intraocular Lens
  • Aphakia Cataract
  • Complications