Vitrectomy is a procedure that involves removing the vitreous humor (the gel-like substance that fills the inside of the eye). In most cases the vitreous is replaced with a saline solution, silicone oil, air, or gas.
Why Vitrectomy Is Done
Vitrectomy can often improve a patient’s vision, or at least stabilize it, preventing it from worsening due to whatever condition made the vitrectomy necessary.
During the course of vitrectomy surgery, the surgeon may remove blood that has clouded the patient’s vision, or possibly debris that was introduced by an injury. Such blood or debris can block light from reaching the retina, causing vision to become blurred.
Other reasons for vitrectomy include:
- Treatment of bleeding and removal of scar tissue caused by diabetic retinopathy, a condition suffered by diabetics that causes new, unnecessary blood vessels to form in the eye and scar tissue to form on the retina
- Macular pucker, a condition in which the area of the retina called the macula becomes wrinkled and disrupts vision
- To treat problems caused by cataract surgery
- To treat problems caused by eye infection
- To treat intraocular bleeding or other problems caused by an eye injury
- To treat eye floaters
Different Types of Vitrectomy Surgery
Anterior vitrectomy involves the removal of small amounts of the vitreous from the anterior, or front part of the eye.
Pars plana vitrectomy is the removal of some or all of the vitreous from deeper within the eye. This procedure was developed in the early 1970s as a way to remove vitreous gel that had become clouded, usually by blood. The success of the procedure led to the development of other procedures related to it, including methods for removing scar tissue from the retina.
The Vitrectomy Procedure—What to Expect
Vitrectomy surgery is generally preformed with local anesthesia, rather than general—i.e., the patient is awake (although usually sedated). The procedure often takes less than an hour, although treating more complex problems can take longer.
After anesthetic has been administered, the surgeon will make an incision into the sclera (the white part of your eye). The surgeon will then use a suction tool to remove a portion of the vitreous gel, along with whatever may be causing a visual obstruction (blood, a foreign object, etc.). He or she may then place a gas bubble against the retina to ensure that it remains in place while you heal (this gas bubble will dissolve on its own within a few weeks).
The space left by the vitreous gel that has been removed may be filled with saline solution, or it may be filled with silicone oil, in which case another operation may be necessary a few months later in order to remove the oil, which will not dissolve into the eye.
What Are the Possible Complications of Vitrectomy?
As with any type of surgical procedure, it possible for things to go awry during a vitrectomy. One possible complication that can arise is a retinal detachment, a condition in which the retina peels away from the back of the eye.
Other possible complications include:
- Increased pressure within the eye
- Cataract formation (this is the most common complication of vitrectomy)
Recovery Following Vitrectomy
There will be some discomfort after vitrectomy surgery, and you may need to wear an eye patch and avoid physical exercise for a while. If a gas bubble has been placed against your retina it is very important that you not fly in an airplane until your doctor tells you it is safe to do so.
Most people can expect to go home the same day. Recovery takes approximately six weeks without complications, during which time vision should improve. During the first week after surgery you will likely use antibiotic eye drops to prevent infection, and a follow-up schedule with your doctor will be set.