Retinal Detachment Vitrectomy

1. Anesthesia: Typically local with sedation or general if complex.
   
   
2. Three-port vitrectomy performed via pars plana (23-25-27 gauge).
   
   
3. Infusion cannula maintains internal pressure.
   
   
4. Vitrector removes the core vitreous and peripheral vitreous, especially near any tears.
   
   
5. Induce posterior vitreous detachment (PVD) if not already detached.
   
   
6. Shave vitreous base to prevent future traction on retinal tears.
   
   
7. Retinal breaks identified using a wide-angle viewing system.
   
   
8. Subretinal fluid is drained, often using perfluorocarbon liquid (PFCL) to flatten the retina.
   
   
9. Laser photocoagulation or cryotherapy is applied around breaks to seal them.
   
   
10. Tamponade placed:
    
    

• Gas bubble (SF₆, C₃F₈) for temporary support.
• Silicone oil if long-term tamponade is needed or if the patient can’t posture.

11. Ports removed, wounds assessed for leakage.