Vitrectomy

What is vitrectomy?

Vitrectomy is a type of eye surgery to treat problems of the retina and the vitreous. Retina is a light-sensitive tissue located in the back of the eye. Vitreous is the clear gel substance that fills the eye.

Vitrectomy consists of the extraction of the vitreous humor fluid and, usually, replacing it with a saline solution or with a bubble of gas, air or silicone oil. When the vitreous is replaced by gas or by silicone, it may be necessary for the patient to lay face down or on his side for a few days during postrecovery. Moreover, if the inside of the eye is filled with gas or air, it is forbidden to fly in an airplane or travel up higher than 500 metres above the sea level until the gas bubble is gone, since rapid altitude changes can affect it.

When is it necessary to perform a vitrectomy?

The ophthalmologist may consider necessary to perform a vitrectomy when one of the following eye problems is present:

• Diabetic retinopathy, when there is bleeding or scar tissue
• Some forms of retinal detachment
• Eye infections
• Severe eye injuries
• Epiretinal membrane
• Macular holes
• Problems after cataract surgery

How can vitrectomy improve vision?

Vitrectomy can often improve or stabilize vision. The procedure removes bleeding or the remains of an infection or inflammation that could block or blur the light by focusing on the retina. Moreover, it also eliminates scar tissue that could move, tear or rip the retina.

This surgery can also help to remove a foreign object, that has remained inside the eye after a perforating trauma,and that could damage vision if not removed.

Before the surgery

The ophthalmologist may recommend performing an ocular ultrasound scan, Retinal Optical Coherence Tomography, or other texts to examine the eye.

What happens during vitrectomy?

Vitrectomy is usually performed in an outpatient surgery center and it takes between half an hour to several hours. It is performed under local or general anesthesia to numb the eye.

During surgery, the ophthalmologist makes three small cuts or incisions of less than 1 millimeter in the white of the eye, the sclera, with the use of a microscope to see inside the eye. The surgeon will use tiny surgical instruments to do one or more of the following steps:

• Remove all cloudy vitreous
• Remove scar tissue from retina
• Remove objects that should not be in the eye
• Return retina to the correct position in the back of the eye
• Use of laser to repair torn retina
• Place a gas or air bubble in the eye to help the retina to remain in its correct position (gas bubble disappears by its own)
• Place a silicone oil bubble in the eye (the oil is removed after a second surgery)

After the surgery

The ophthalmologist will prescribe medicine to relieve pain and eye drops that should be used for several weeks. The ophthalmologist will also tell the patient when to go back to normal activities.

Risks of the surgery

Like any other surgery, vitrectomy has risks. Nevertheless, they are by far outweighted by the benefits of improved vision.

Some of the riscks are: bleeding, detached retina, high intraocular pressure or infections.