Vitrectomy 

What is vitrectomy (vitrectomy)?

Vitrectomy or vitrectomy is a surgical procedure in which the vitreous is removed from the inside of the eye. The vitreous is often responsible for retinal diseases and its removal leads to retinal healing. The retina is a light-sensitive tissue located at the back of the eye. The vitreous is a clear jelly that fills the inside of the eye.

Why might someone need a vitrectomy?

• Retinal detachment.
• Severe eye injury.
• Membrane with retinal wrinkles or otherwise epi-retinal membrane.
• Macular hole.
• Problems after cataract surgery.
• Internal bleeding in the eye mainly due to diabetic retinopathy.

How is vitrectomy performed and how can it improve our vision?

According to vitrectomy special instruments of 25, 23 or 27 G are used with which special manipulations are made inside the eye. Through small trocars placed on the sclera (white part of the eye), forceps are inserted into the eye with which scar tissue or some membrane that distorts the retina can be removed. Our vision is blurred when the retina is distorted. Also a foreign body can become lodged in the eye after trauma. Most foreign bodies cause vision loss if not removed in time. Vitrectomy often improves or stabilizes our vision. During the surgery, all opacities are removed from the inside of the eye, whether from bleeding or inflammation or infection, so that light can focus on the retina. During surgery, the vitreous is replaced by a liquid that looks like salt water.

What is the vitrectomy surgery procedure?

Preoperative

Before the surgery you will need to do some general blood tests and a cardiogram. If it is a general anesthesia, a chest X-ray will also be needed. Surgery is usually performed under local anesthesia and sedation.

Interoperative
The surgery can last one or more hours depending on the condition of the eye. The surgery is performed using a microscope. The manipulations inside the eye are done using a trocar cannula that is tiny and the incisions are made in the sclera, which is the white part of the eye. During surgery your ophthalmologist may laser the retina to reduce the chances of future bleeding or to treat a retinal tear. At the end of the surgery, an air or gas bubble is often placed inside the eye to attach the retina. The bubble will be absorbed slowly. In selected cases it may place silicone oil which will need to be removed in the future.

After surgery

The vitrectomy is now in most cases done without the use of sutures, with the result that the recovery of the patients is very fast. After the surgery the eye will remain closed until the next day when you will be examined by your ophthalmologist. There may be some tenderness, foreign body sensation and mild pain in the eye. The eye will need to be covered with some gauze. Your eye doctor will prescribe some eye drops and advise you about your daily activities. If a gas bubble is placed inside the eye your ophthalmologist will tell you if a specific position of the head is needed until it is absorbed. Do not fly by plane or climb to a high altitude until the bubble is absorbed. A sudden change in altitude causes a dangerous increase in intraocular pressure with disastrous consequences.

What are the risks associated with the surgery?

• All surgeries have some risks, but the risk is far less than the benefit that asurgery. The most common side effect of vitrectomy is a cataract, which usually occurs months after surgery.

Some of the other risks may be:

• Retinal detachment, uncommon.
• Reduced vision, not common.
• High pressure in the eye, not common.
• Infection, rare.
• Bleeding, rarely.

How much will vision improve after vitrectomy surgery?

Your vision after surgery depends on many factors, but mainly what caused your vision to decrease before surgery. Macular lesions or macular detachment are major aggravating factors. Your eye doctor will discuss your prognosis with you before surgery.