What is vitrectomy?
Vitrectomy is a type of eye surgery to treat retinal and vitreous disease. The retina is the light-sensitive tissue located at the back of the eye. The vitreous humor is a clear, gelatinous substance that fills the center of the eye. During a vitrectomy, the vitreous is removed and replaced with saline.
Anatomy of the eye
When do I need a vitrectomy?
Your ophthalmologist may recommend a vitrectomy for the following eye problems.
1. diabetic retinopathy complicated by vitreous hemorrhage and proliferation.
2. retinal detachment.
3, intraocular infection (endophthalmitis).
4, severe ocular trauma.
5, macular anterior membrane (retinal folds).
6, macular fissure (partial loss of fine vision).
7, certain complications after cataract surgery.
How does vitrectomy improve vision?
The accumulation of blood and clouding within the vitreous (caused by infection or inflammation) can block or diminish external light, preventing it from being projected and focused on the retina, resulting in vision loss. Vitrectomy can remove these blood pools and clouding, thereby improving or stabilizing vision.
Proliferative membranes and scar tissue can lead to retinal dislocation, wrinkling or traction fissure formation, which can lead to vision loss. Vitrectomy removes these tissues and allows the retina to reset.
Vitrectomy also removes foreign bodies that have entered the eye as a result of trauma. Most foreign bodies that remain in the eye can cause vision impairment and need to be removed promptly.
If you have decided to undergo a vitrectomy, what should you be aware of?
Before surgery
It is up to your ophthalmologist to decide whether to use local or general anesthesia during surgery. You may need to stay in the hospital for 3-5 days. Before surgery, you will need to undergo a physical examination, including blood tests, ECG, and chest X-ray to alert your ophthalmologist to any specific surgical risks. An ocular ultrasound will also be performed to check the vitreous, retina and other intraocular conditions prior to surgery.
Vitrectomy
The length of surgery can vary from one hour to several hours, depending on the condition of your eye. Sometimes your ophthalmologist may combine other surgical procedures, such as an external retinal repositioning or cataract extraction, at the same time.
Your ophthalmologist will use a microscope to look at your eye during the procedure. Various microscopic instruments are inserted into the eye through microincisions in the sclera (the white part of the eye).
Vitrectomy to remove blood from the vitreous
In order to give you the best possible vision, your ophthalmologist will perform one or more of the following.
1. removal of all cloudy vitreous.
2. removal of all proliferating membranes and scar tissue in an attempt to reset the retina.
3. removal of any foreign bodies that may remain in the eye.
4, Application of intraocular laser to reduce postoperative bleeding or repair retinal fissures.
5. filling the eye with air or air bubbles to help reset the retina (the air bubbles will slowly absorb themselves)
6. intraocular filling with silicone oil, which usually requires subsequent surgery to remove the silicone oil.
Post-operative period
There is usually some discomfort in the early post-operative period. You will need gauze to cover the operated eye for 1-2 days after surgery. Your ophthalmologist will prescribe eye drops and give advice on when you can resume normal activities.
If the eye was filled with gas during surgery, your ophthalmologist may recommend that you keep your head in a certain position until the gas bubbles disappear for best results.
Do not fly or travel to high altitudes until the gas has been absorbed! Rapidly rising altitudes can cause a dramatic increase in eye pressure. Traveling on high speed trains and through long tunnels also carries a higher risk.
What are the risks of vitrectomy?
All types of surgery have some risks, but the vision benefits of vitrectomy far outweigh the risks.
1. infection.
2. hemorrhage.
3. retinal detachment.
4. continued poor vision.
5, high intraocular pressure.
6. Another potential risk of vitrectomy is accelerated cataract formation. Cataracts are usually less likely to develop initially after surgery, but older patients often develop cataracts within a few months.
How much will your vision improve?
Your post-operative vision depends on a number of factors and is difficult to predict, especially if your eye disease has permanently damaged your retina before surgery. Your ophthalmologist will discuss your condition with you in detail and tell you how much your vision is likely to improve.