Vitrectomy: What is it? Why is it done? Effectiveness of Surgery and Risks

It is a surgery to remove the vitreous gel from the middle of the eye. It can be done when there is a retinal detachment or if the blood in the vitreous gel does not remove itself.

The removal of the vitreous gel gives your ophthalmologist better access to the back of the eye. Vitrectomy is performed by an oculist (ophthalmologist) who has special training in the treatment of retinal problems.

During surgery, the doctor uses small tools to remove the vitreous gel. Then, the doctor can treat other eye problems, such as retinal detachment, vitreous hemorrhage, scar tissue on the retina or tears or holes in the macula .

At the end of the surgery, the doctor can inject a bubble of oil or gas into the eye. This lightly presses the retina against the wall of the eye. If an oil bubble is used, the doctor should remove the oil after the eye has healed.

After surgery

The surgery lasts from 2 to 3 hours. Your ophthalmologist will decide if only your eye will be numb or if you will also sleep during surgery (local or general anesthesia).

You may have to spend the night in the hospital. But sometimes vitrectomy is performed as outpatient surgery.

At home, you may have to keep your head in a certain position for a while. This helps to push the gas or oil bubble against detachment. Your doctor will tell you what position to sleep in.

Call your doctor immediately if you notice any problems after surgery, such as:

  • Decreased vision
  • Signs of infection. These include increased pain, redness or swelling around the eye.
  • Any discharge from the eye.
  • Any new float, flashes of light or other changes in your field of vision.

Why is it done?

Vitrectomy can be done together with other treatments so that:

  • Repair or prevent retinal detachment by traction.
  • Repair very large tears in the retina.
  • Reduces the loss of vision caused by bleeding in the vitreous gel (vitreous hemorrhage ). Surgery may be necessary if the bleeding is severe or if the blood does not clear up on its own.
  • Treat severe proliferative retinopathy. This causes scar tissue to form or new blood vessels to grow in the retina. These new blood vessels can leak blood to the eye.

Your ophthalmologist may suggest this type of surgery for a retinal detachment because an oil bubble can be used. An oil bubble does not move in the eye as much as a gas bubble does.

This can facilitate surgery and recovery for people who have trouble keeping their head in the correct position.

How well does vitrectomy work?

Vitrectomy can greatly improve vision in many people who have severe bleeding in the eye that has not cleared up by itself.

This surgery can restore some vision in people who have retinal detachment traction. It can also help prevent the detachment from getting worse. The results may be better if the detachment has not affected the macula or its central vision.

Risks

Possible serious problems after this surgery include:

  • Waterfalls.
  • High pressure inside the eye. This occurs most often in people who have glaucoma .
  • More bleeding in the vitreous gel.
  • Retinal detachment.
  • Infection inside the eye

What to think

One of the main uses of vitrectomy is to treat vitreous hemorrhage. This surgery can have serious risks. This is why some doctors can wait up to a year before undergoing surgery. This delay allows them to see if the vitreous gel will clear up by itself, before having to proceed surgically.

Surgery can only be done earlier, as long as the vitreous hemorrhage is causing severe loss of vision or, failing that, if it is preventing the treatment of severe retinopathy. Long-term results may be better if surgery is done soon.

There are some ways to repair a retinal detachment. Your eye doctor can help you understand what may be the best option for you.