Deep Vitrectomy
Vitrectomy (vitreous removal surgery) is a surgery to remove some or all of the vitreous humor from the eye in order to eliminate vitreous opacity. Retina is a light-sensitive tissue on the back of the eyeball. The vitreous is a transparent, gelatinous tissue filling the space between the lens and the retina. During this surgery, the vitreous is removed and usually replaced with a BSS solution. If the surgery involves the anterior eye segment it is called anterior vitrectomy, but if the deeper and posterior segments of vitreous are removed it is called Pars Plana Vitrectomy.
How does a vitrectomy improve vision?
Vitrectomy surgery often improves or stabilizes the vision. Blood or residues caused by infection or inflammation that may block or fade the image to focus on the retina are removed by surgery.
Damaged tissues that may cause retinal detachment or wrinkle on the retina are removed via Vitrectomy. If the retina is not in its normal position the vision decreases. With this method, an external object that is trapped inside the eye following a blow can also be removed. if these objects are not removed the vision will often be damaged in most cases.
What Happens in Vitrectomy?
Before surgery: Your ophthalmologist will decide on your preferred anesthesia (local or general). Before surgery, a physician may need to do some clinical examinations for specific medical risks.
Vitrectomy: depending on your general condition the length of the vitrectomy may vary from one to several hours. In some cases, the ophthalmologist may also perform other procedures concurrently, including retinal detachment repair, or cataract removal. Surgery is performed by a microscope while the eye is being observed. The delicate surgical instruments are inserted into the eye by making a small incision in the sclera (the white part of the eye). In order to achieve the best possible vision for you, the ophthalmologist will do one or more of the following steps:
Removing all opaque vitreous
Extracting the damaged tissue and trying to get the retina back to its original location
Extracting the external object that may be in the eye
Laser treatment to reduce the possibility of future hemorrhage or to fix the retinal break
Replacing gas or air in the eye to help keep the retina in the right place (The bubble will slowly disappear)
Replacing silicone oil in the eye, which usually requires further surgery
In some cases, more sophisticated devices can be used for surgery. With these tools, there will be no need for sutures to repair the wound, thus on the one hand the operation is performed in a shorter time and on the other hand the patient's pain and discomfort is minimized after surgery.
After surgery: Pain or discomfort after surgery is expected. It is recommended to wear an eye shield for a few days after the surgery. The ophthalmologist will talk to you about using eye drops and when to resume your daily routine activities.
Take notice of your ophthalmologist's advice on how to place the head in a particular position, because not paying attention to this issue can lead to treatment failure. Until the gas bubble has cleared, flying or traveling to the heights is prohibited, as the rapid increase in altitude may results in significant ocular hypertension. In cases where silicone oil is used, it is necessary to monitor the patient regularly and at certain intervals, since silicone oil can cause problems over time and there is a need to remove it as soon as possible.
What are the risks and complications of vitrectomy surgery?
According to the Noor Ophthalmology Research Center, All surgeries have some risks, but complications in vitrectomy are far less than the benefits of surgery.
Some of the risks of vitrectomy include: Infection, bleeding, retinal detachment, visual impairment, and elevated eye pressure. There is also a potential risk in vitrectomy surgery to increase the rate of cataract formation. Although in rare cases cataract develops shortly after vitrectomy, in elderly patients it often develops after a few months.
Tips to consider after vitrectomy surgery: You should use a plastic eye shield for 2 to 3 weeks after vitrectomy to protect your eyes against any potential injury. Ask ophthalmologists how to sleep and place the head on the pillow according to the type of vitrectomy surgery. Due to elevated intraocular pressure, traveling on a plane after vitrectomy and expandable gas injection is not allowed, and should be avoided until the gas bubble is disappeared. In case silicone oil is used in your surgery, make regular follow-up appointments with your ophthalmologist to determine the time of surgery to remove it. To make the healing process faster, avoid eye trauma, rubbing and pressing the eyes after vitrectomy surgery. Also use the medication prescribed by your ophthalmologist.
What are the complications of vitrectomy surgery?
Retinal detachment, bleeding, vision loss, Elevated intraocular pressure, infection, increased risk of cataracts.