What Is Vitrectomy Surgery? Description, Risks & Considerations
Surgery of any kind can be scary, especially on something as precious as your eyes. This article aims to provide in-depth yet digestible information about vitrectomy surgery. In simple terms a vitrectomy surgery is an operation on the eye to remove the vitreous fluid, which is a gel like fluid in the back of your eye, from your eye.
There are a number of reasons why you may need to have this procedure. Read on to find out what happens during the procedure, what is to be expected following the operation and any risks that may be involved.
What Is Vitrectomy Surgery?
The human eye is filled with a gel-like substance called vitreous humor gel. This gel is typically clear in a healthy human eye however, there are a few different reasons why this gel may cause difficulties and the vitrectomy procedure may be necessary. There are two different kinds of vitrectomy surgery, one used to treat diseases of the posterior segment of the eye, or the back of the eye, where the humor gel is located.
The other kind of vitrectomy is used to treat rare cases where this gel may have moved to the front of the eye. This is usually caused by eye trauma or as a result of a previous complex eye surgery. There are a small number of reasons why someone may be advised to have a vitrectomy.
Who Should Consider Vitrectomy Surgery?
A vitrectomy will also only be advised if a doctor finds that there is a real risk to a patient losing their vision, if it is unlikely their symptoms will heal naturally without surgery and if the potential benefits outweigh the potential risks. The doctor will also ensure that the patient is fully aware of the risks and benefits of having the surgery and will be informed of any alternatives that they may have. Here are some of the specific reasons why a vitrectomy surgery may be necessary for a patient.
If The Patient Is Suffering With Cloudy Vision
If a patient is experiencing hazy or cloudy vision this is most likely caused by the humor gel in the vitreous cavity losing its clarity. This can happen for a number of reasons but the most common of which being natural aging of the eye.
Depending on how bad the patient's vision is, the gel will be drained and replaced typically with saline solution which will in most cases vastly improve vision quality. This is one of the easiest vitrectomy procedures to perform and will be recommended by an eye doctor based on the severity of patient’s symptoms.
If There Is Evidence Of Pulling On The Retina
The most common reason a vitrectomy will be performed is due to some sort of pulling on the retina in the eye. This is typically associated with a number of other health issues including aging, nearsightedness, severe diabetes or head and/or eye injuries.
Vitrectomies of this nature require great skill and technique as they typically involve a number of steps in addition to draining the humor gel from inside the vitreous cavity. These steps can include removing scar tissue, removing retinal tractions and separating the retina from the vitreous (the gel filled section of the eye).
If There Has Been A Complication During Another Or Previous Eye Surgery
A vitrectomy may need to be performed as part of or as a result of an existing eye problem or surgery. When other eye surgeries are performed a vitrectomy will also usually be performed in order to enhance the results of this surgery. During any eye surgery there is a risk that some humor gel may escape the rear of the eye and move to the front of the eye.
In the event of this happening a vitrectomy will be performed in order to stop any excess fluid moving to the front of the eye. When a vitrectomy is performed in the following instances it serves to reduce the likelihood of any other complications that may arise such as retinal tears or detachment.
If A Diagnosis Is Needed For Another Eye Or Vitreoretinal Condition
A diagnostic vitrectomy may be performed to help try and diagnose an existing problem within the eye, specifically in the vitreous cavity. For example, if a patient has a severe eye infection, has an extremely inflamed eye, or is at risk of certain cancers that may affect the eye they may be given the surgery to help make the correct diagnosis.
The procedure involves removing all of the humor gel or taking a small sample. Once the fluid has been collected it can then be taken for closer examination in order to ensure that the correct diagnosis has been made and that the patient is receiving the best treatment for their illness.
What Happens During Vitrectomy Surgery?
After having the eye thoroughly inspected by an eye doctor the eye in need of surgery will be marked with a pen to make sure the correct eye is operated on. Once in the surgery room the patient will lie on a special bed designed specifically for eye surgery. The eye is completely numbed with anaesthetic drops during the procedure so the patient will feel minimal to no pain and may only experience some mild discomfort.
Typically, this procedure is performed by making extremely small incisions, measuring only half a millimetre in size into the eye to drain the fluid. Due to the level of technology used the operation is relatively non-invasive into the eye and is considered more comfortable than operations that involve the use of larger tools.
Such small incisions in the eye also mean that the recovery time from this procedure is generally quite quick. During this operation, most cases are treated as outpatients and involve minimal anaesthesia and pain, unless the patient is of particularly ill health or suffering with severe diseases of the eye.
What Happens After Vitrectomy Surgery?
As this operation is usually performed on an outpatient basis, following the surgery, the eye will be patched up and the patient allowed to return home at once. The patient will be prescribed some eye drops to use in the following few weeks, these are very important to help the eye heal quickly and correctly.
In some cases patients may experience mild redness or bruising around the eye which will heal quite quickly. It is also rare for patients to experience any severe pain following the surgery with most feeling mild discomfort and possibly the feeling there is something in their eye. There is also the possibility in the days following the surgery that you can experience a decrease in vision. If a patient does experience a decrease in vision during the recovery it will typically improve quite quickly however, in some cases it may take a few weeks to fully improve.
To aid recovery you will also be provided with a patch that must be worn for a few days following the operation in order to protect your eye. The doctor will also provide advice about what activities you can and cannot do during your recovery. If there are any activities that you have been advised refrain from during recovery they will also let you know when you will be able to continue with these activities as normal.
What Are The Risks Of Vitrectomy Surgery?
As with any kind of surgery there will always be risks however, severe complications with vitrectomies are rare. In most cases the success rate of vitrectomy surgery is over 90%. However, in the rare event that something does go wrong some risks that are associated with a vitrectomy include infection, bleeding, poor vision, torn or detached retina and even glaucoma.
Another risk that is also associated with vitrectomy is an increased possibility of getting cataracts in the eye that received surgery, especially if you have had the surgery over the age of 50. Your doctor should discuss all the possible risks with you prior to your surgery as all risks are dependent on the health of the patient before the surgery is given.
There are a number of reasons why this surgery may be recommended and in most cases with modern technology the process is pain free and non-invasive. However, like most medical cases the speed and quality at which you recover also depends on the patient and their eye condition and health before the procedure takes place. The healthier the eye the more likely a quick and positive recovery will take place. If the surgery is advised due to more serious health issues the chances of regaining extended full and healthy eyesight is less.
When going for this surgery ensure to ask any questions and raise any worries or concerns you may have with your eye doctor to gain a good picture of what the likelihood of a successful operation is as well as the possibility of a full and healthy recovery.