Vitrectomy

Vitrectomy is a modern type of surgery that removes the vitreous, which is a gelatinous substance inside the eye. Removal of the vitreous is safe as the vitreous does not provide any support to the structures of the eye.

Indications for vitrectomy:

• diabetic retinopathy if there is bleeding that does not clear or tractional detachment.
• Rhegmatogenous retinal detachment
• Endophthalmitis
• Trauma
• Epiretinal membrane
• macular hole
• extensive bleeding in macular degeneration.
• complicatedcataract surgery.

What should I know before a vitrectomy?

Anesthesia

The surgery is usually performed under local anesthesia and is a “same day surgery”, that is, it does not require you to stay in hospital.

During surgery

The duration of the operation is usually between 60-90 minutes. The surgeon makes small incisions in the sclera (white) of the eye and through special trocars inserts tools into the eye to remove the vitreous.

From the same incisions it is also possible to insert a laser (endolaser) into the eye for the treatment of pathological tears. At the end of the surgery, air or gas is placed to hold the retina in place (this will absorb itself over the next few days). In special cases, a special silicone oil is placed (requires removal in a second surgery).

After surgery

A slight degree of pain and foreign body sensation is to be expected after the operation. The eye remains closed with a patch for a day. You will be given eye several eyedrops to start the following day.  If your surgery requires gas placement your surgeon will advise you on the correct position of your head during the post-operativeperiod. You should not travel by plane or climb to high altitude until the gas is completely absorbed. The reason is that a sudden rise to high altitude can cause a dangerous increase in your eye pressure and irreversible vision loss.

Risks of vitrectomy

Every surgery has risks, but the risks are rare and outweigh the benefits for your surgery. Some of the risks are the following:

• contamination
• bleeding
• retinal detachment
• reduced visual acuity
• high intraocular pressure
• cataract

Vitrectomy accelerates the development of cataracts, especially in elderly patients. This does not happen immediately after the surgery, but usually several months after the operation.

Prognosis of vision after vitrectomy

Usually, the result in terms of visual acuity appears within months after surgery.  In some cases, it may take up to a year for the vision to return to satisfactory levels.