Vitrectomy
Vitrectomy surgery is a procedure to remove the vitreous gel that fills the posterior chamber or cavity of the eye to treat eye problems related to the retina or vitreous. This surgery provides better access to the retina of the eye for different treatments like repair of the retinal detachments, removal of scar tissue, and treatment of macular holes.
Once the vitrectomy is complete, the ophthalmologist will replace the natural vitreous gel with either saline solution, gas bubble, or silicone oil. This helps the retina to stay in position.
Types
The two types of vitrectomy are:
Pars plana vitrectomy
A vitrectomy performed by an ophthalmologist for diseases of the posterior chamber of the eye is called a posterior or pars plana vitrectomy. Three self-sealing openings or ports are created in the eyeball to access the vitreous, which is removed using high-speed cutters with a light source providing illumination inside the eye.
Once a pars plana vitrectomy is complete, saline or silicone oil or a gas bubble may be injected into the vitreous gel to hold the retina in position.
When such a vitreous substitute is used, a period of postoperative positioning (typically face-down) by the patient helps the retina to heal.
Anterior vitrectomy
In rare cases, following complex cataract, cornea, or glaucoma surgeries, the vitreous gel comes through the pupil into the front portion of the eye. This must be cleared to reduce inflammation, prevent the cornea from decompensating, and reduce the risk of future retinal problems.
Indications
You may need vitrectomy surgery if you have one of the following eye problems:
- Retinal detachment
- Vitreous hemorrhage
- Diabetic retinopathy
- A hole in the central part of the retina (macula)
- Infection inside your eye
- Severe eye injury
- A wrinkle in the central part of the retina
- Certain problems after cataract surgery
All of these medical conditions can result in loss of vision. Some of them can even cause blindness if not treated. In some cases, vitrectomy can restore the vision that has been lost. You may require a vitrectomy in an emergency, such as an eye injury. In some cases, your eye doctor may schedule your vitrectomy as a preventive method.
Procedure
Before the procedure
- A thorough assessment of your symptoms and a detailed examination of the eye and retina is carried out.
- Specialized imaging tests of the retina, such as color photos and optical coherence tomography (OCT), are often required.
- Your surgeon will explain your vitreous and retina findings and the potential diagnoses and discuss the treatment plan for vitrectomy surgery, if appropriate.
During the procedure
- A vitrectomy is usually performed under a general anesthetic. It can take 1-2 hours. Sometimes the procedure is done under local anesthetic. In this case, your eye specialist may use eye drops and anesthetic injections to make sure you don’t feel anything.
- Your surgeon will expose your eye by making an incision in the outer layer of the cornea of an eye.
- Then your surgeon will make tiny cuts in the sclera i.e., the white part of the eye.
- Your eye specialist will remove the vitreous and any scar tissue or foreign material.
- Other eye repairs will be performed as needed by your eye specialist. They may, for example, use a laser to repair a tear in the retina or inject a gas bubble into your eye to aid in the retention of your retina in position.
- Your eye specialist will replace the vitreous with some other sort of fluid, like saline solution or silicone oil.
- Any wounds will be closed with dissolvable stitches.
- An antibiotic ointment will be applied to your eye to prevent infection.
- A patch will be placed over the eye.
After the procedure
- Most of the time, you will be able to return home the same day. Make an arrangement for someone to drive you home after the procedure.
- You need to wear an eye patch for a few days.
- Make sure to follow post-operative instructions given by the surgeon. You may need to use eye drops along with antibiotics to reduce swelling and prevent infection. After the procedure, your eye may be a little sore, but you should be able to take over-the-counter pain relievers.
- If a gas bubble or saline was placed in the eye during the procedure, you may need to follow specific positioning instructions after the surgery. To avoid complications, you should avoid traveling by flight for a few days after the procedure. Consult your eye doctor about when it is safe for you to fly again.
- You may need to see the surgeon to determine whether the procedure was successful. The day after the procedure, you may have a scheduled appointment. If you have decreased vision, increased pain, or swelling around your eye, notify your eye doctor right away.
- If silicone oil or gas bubble is injected into your eye during vitrectomy surgery, then you may require additional surgery to remove it.
- Your vision may not be completely normal following your vitrectomy surgery, especially if your condition caused permanent retinal damage. Inquire with your eye doctor about the amount of improvement you can expect.
Benefits and Risks
Benefits
Vitrectomy clears out the blood from vitreous humor that cannot be cleared by the eye itself. The surgery prevents traction of retinal detachment and helps in avoiding further or subsequent detachment. It also restores vision loss caused by the bleeding of the vitreous humor. It treats and repairs gigantic tears in the retina and stops scar tissues from forming new blood vessels leading to the retina.
Risks
Most people do well with vitrectomy surgery, but complications may occur as with any other surgery. Your risks may vary depending on your age, medical history, and the nature of your eye problem. Some of the risks of the procedure include the following:
- Eye infection
- Excess bleeding
- High pressure in the eye
- New retinal detachment caused by the surgery
- Lens damage
- Increased rate of cataract formation
- Problems with eye movement after surgery
- Change in refractive error
- Retinal tears
- Glaucoma
Vitrectomy Care at Medicover
We have the most experienced team of ophthalmologists at Medicover Hospitals, delivering exceptional eye care to our patients. Our ophthalmologists at Medicover use a multidisciplinary approach to diagnose and treat eye conditions such as retinal detachment, eye injury, etc with utmost precision. We provide a wide variety of eye treatments such as vitrectomy,blepharoplasty, cataract surgery, and many others, using the most advanced technologies that come with the benefit of a fast recovery and state-of-the-art infrastructure bringing out successful results.
