Vitrectomies: The Ultimate Guide

What is a vitrectomy?

A vitrectomy is a surgical procedure done by an eye specialist. During the procedure, the vitreous humor gel is being removed from the eye cavity to provide better access to the retina. This allows the specialist to perform a variety of repairs such as laser repair, retinal detachments, the removal of scar tissue and the treatment of macular holes. After the surgery, the vitreous humor gel is being injected with gas bubble, silicone oil or saline to hold the retina in place. 

When do you need a vitrectomy?

A vitrectomy procedure might be needed when you suffer from the following eye problems:

• Infections inside your eye/severe eye injury
• Retinal Detachment
• A wrinkle in the central part of your retina
• Vitreous hemorrhage 
• Certain problems after a cataract surgery 
• A hole in the central part of your retina (macula) 
• Diabetic retinopathy 

All of the above mentioned eye problems can cause vision loss. When it is not treated well, it could even cause blindness. However, in some cases, a vitrectomy can restore your vision. A vitrectomy is not the only way to treat some of the above mentioned eye problems. Sometimes, a floater laser treatment can do the trick. This will all be discussed during the first consult. Also, never forget to discuss the benefits and the risks of all treatment options with your treating doctor or ophthalmologist. 

What to expect from a Vitrectomy? 

When you have your first consult with the ophthalmologist it is likely you get to hear what kind of treatment is needed. This gets decided after carefully examining the eye and your general health. Think of tests like a dilated eye exam, retinal photography and/or an ultrasound. When your eye is suffering from bigger injuries, the doctor might do some extra tests. 

When the tests are done and the conditions of the retinal or vitreous are positive, you and you ophthalmologist will start making a plan on how to proceed. You will need to sign a contract for your  permission to schedule and proceed with the procedure.

How to prepare before surgery

It is important discuss with the doctor or ophthalmologist what needs to be done to prepare yourself for the surgery. This all has to do with knowing if you can take medicine, eat before the procedure or for example smoke. We made a list of different preparations before going into the surgery:

• Discuss risks, benefits and alternatives with your physician.
• Coordinate extra help after the surgery is done. Think about home care and transportation.
• You are not allowed to eat at least 8 hours before the surgery. Sometimes this is from the midnight before the surgery, so check this! 
• Ask if you can take your regular medication on the day of surgery.
• Always arrive early for surgery.
• Confirm procedure and operative eye with the medical team! You don’t want them to treat the wrong eye. 
• You normally have an evaluation visit the day after your eye surgery. Make sure you have time and a driver who can take you!

What happens during the surgery

It is always a good idea to ask the doctor or ophthalmologist what he will be doing during the procedure. It can help you calm down and you will understand better what is going on. However, let us give you a small sneak peak of how a vitrectomy could go:

• If your awake, you will receive a medicine to help you relax. An ophthalmologist usually issues anesthetic eye drops and injections to make sure the procedure is painless for you.
• In some cases, you may have full anesthesia. When this is the case, you will sleep during the surgery and won’t remember anything afterwards.
• The ophthalmologist will expose your eye and make an incision in the outer layer of your eye.
• He will make a small cut in the sclera, which is the white part of your eye.
• Afterwards he will remove the vitreous humor (the jelly-like fluid) and any scar tissue or other material in the eye.
• The ophthalmologist will do other repairs to your eye as needed. For example, a laser treatment. Sometime, the ophthalmologist may inject a gas bubble into your eye to help keep your retina in place.
• The ophthalmologist will replace the vitreous with some fluid like silicone oil or saline.
• The ophthalmologist may close the surgical incisions with stitches, but stitches are often unnecessary.
• An antibiotic salve will be placed on your treated eye to help prevent infections.
• Your eye will be covered with a patch.

It is common to have a surgery check up one day after the vitrectomy to see whether it was effective. So, make sure that you have time to go and have someone who can drive you!

How is the recovery process

The recovery of an eye surgery depends on what procedure has been performed. For example, you are not always allowed to fly for a period of time after the surgery. Sometimes you will need to wear an eye patch the day after the procedure. It is also common that you will need to take eye drops with antibiotics to prevent any infections in the eye. 

Also take in mind, your vision will not always be completely normal after the vitrectomy. It is important to discuss the amount of improvement you can expect after the procedure. 

What are the risks of a Vitrectomy

All surgeries have risks also a vitrectomy. It is important to be informed about the risks before you choose to get this procedure. Unfortunately, vitrectomies can still damage your eye and cause vision loss or blindness. Some other risks are listed below:

• Cataracts
• Raised pressure inside the eye
• More bleeding in your vitreous
• Retinal detachment
• Infections
• Problems moving your eyes
• Damage to your eye’s lens

Before you make a choice, be sure to discuss these risks with your eye doctor or ophthalmologist. Even though the risks are present, new and modern techniques have decreased the complications to about 1%.  

Do you suffer from vision loss or have a severe injury? And still have questions about a vitrectomy? Don’t hesitate to contact us for a consult or more information! Call us on +31 20 261 83 10 or send an email to info@floaterlaser.nl!