Membranes that form can be cut to release their traction and in some cases peeled off. This is known as epiretinal membranectomy epiretinal membranectomy. In those cases where the bleed does not clear after an initial period of observation a procedure known as a vitrectomy can be performed. In this procedure the gel is removed, replaced by a clear salt solution initially, and eventually by the eyes own fluid. The gel is like a microscopic scaffold, allowing blood vessels a perch from which to continue growing from retina into vitreous.
Scar tissue grows with the abnormal circulation.
As scar tissue contracts risk of retinal detachment and macular pucker, or wrinkling that includes the sharp vision foveal area, can occur. C below shows scar tissue in the macula, where fluid has also accumulated. Vitrectomy can be very effective, particularly when combined with intraoperative laser treatment. A vitrectomy for this purpose is performed through 2-3 tiny incisions along the white of the eye about 0.33 inches behind the outer corneal boundary on the sclera. An instrument with a rapid, guillotine like cutter movement and hollow central opening for suction is inserted, usually along with a separate port for infusion of fluid to replace removed vitreous until the eye can make its own additional fluid, and a light pipe to improve visibility within the eye.