What is vitrectomy?
Vitrectomy is eye surgery to remove the vitreous (the gel that fills the eyeball). The procedure is also performed when it is necessary to remove the vitreous to work directly on the retina, even when the vitreous is in good condition. This surgery has enabled many patients, who a few years ago would have irretrievably lost their vision, to maintain or recover it to satisfactory levels.
When is it performed?
There are many ocular diseases that require vitrectomy, mainly retina related:
- Diabetic retinopaty
- Retinal Detachment
- Eye injury or trauma, diseases of the macula, macular holes or neovascular macular degeneration
- Secondary problems or eye inflammation
- Pathologies related to high myopia
- Occasionally, after cataract surgery when complications have arisen
What tests are necessary before surgery?
Before the procedure, a detailed eye examination, and often an ultrasound, is performed to determine the condition of the eye tissue. Other tests include:
- Retinal Optical Coherence Tomography (OCT): a scanner used to capture tomographic images of the eye in high definition
- Fluorescein angiography: a contrast test to detect possible fluid loss or damage to blood vessels in the eye
- Electrophysiological test:a test that records electrical stimulation of the eye to detect problems in the retina and throughout the visual pathway to the cerebral cortex
|Dr. Corcóstegui in operating room|
How is it performed?
Vitrectomy is the removal of the clear gel (vitreous) from the eye. The procedure is carried out with delicate instruments that are inserted into the eyeball through small incisions in its outer wall (sclera). Some of the instruments used include: a fibre optic light to illuminate the retina, an irrigation cannula to maintain intraocular pressure and an instrument that cuts and removes the vitreous. Also used are scissors, forceps and numerous other instruments selected for each operation. During surgery, the eye may receive an injection of gas or a gas and air mixture to repair a retinal detachment, close a macular hole or correct other defects. The procedure is performed under local anaesthesia and lasts one to two hours, depending on the condition of the eye. Occasionally, the ophthalmologist has to repair other tissue and perform other parallel procedures, such as removing a cataract or carrying out a corneal transplant.
After the surgery
Following surgery, the occlusion patch is usually removed after a few hours. The patient may have some pain in the eye, which should only be treated with eye drops and ointment to relieve the symptoms and intraocular inflammation. In general, postoperative patients can lead a normal life, except in cases where gas has been inserted into the eye during surgery. The gas is slowly absorbed by the eye over a period of time that may last several weeks depending on the type of gas used. When the eye is filled with gas, vision is very poor. As the gas is absorbed, various uncomfortable visual effects are produced, which eventually disappear completely. While the gas is dissolving, the patient should not fly or travel up to altitudes of 800-1000 metres rapidly. If this is unavoidable, it is advisable to consult with the ophthalmologist.
The risks of vitrectomy are by far outweighed by the benefits of improved vision after surgery. Some of the potential risks are postoperative bleeding, retinal detachment, increased ocular pressure after surgery, cataracts and infection.
- Can a patient do sport or exercise physically after vitrectomy?
- Is it normal for a diabetic patient to suffer from bloodshot eyes after surgery?
- What are the symptoms of a detached retina and should it be treated as an emergency?
- What are the symptoms of an infection inside the eye and should it be treated as an emergency?
- What position should a patient with intraocular gas keep his head in?
- What position should a post-operative retina patient sleep in?
- What should a post-operative vitrectomy patient not do?
- When are patients with intraocular gas able to fly?