What is a Vitrectomy?
Vitrectomy surgery is a form of eye surgery that treats disorders of the retina and vitreous. It is a microsurgical procedure in which the vitreous is removed with a miniature handheld cutting device and replaced with a special saline solution similar to the liquid being removed from the eye.
A vitrectomy may be combined with another surgical procedure, such as repairing a retinal detachment or removing a cataract.
When is Vitrectomy surgery required?
A vitrectomy is required for a variety of conditions. They include:
- Removal of scar tissue that may be growing on the vitreous or the surface of the retina. It can pull on the retina and cause a retinal detachment
- Haemorrhage (blood) that prevents the passage of light through the eye to the retina
- Diabetic traction retinopathy – bleeding and scar tissue forming in the eye of a diabetic patient
- Proliferative vitreoretinopathy – formation of scar tissue following severe retina detachment
- Infection inside the eye (endophthalmitis)
- Epiretinal Membranes
- Macular Hole surgery
- Intraocular foreign body
- Complications following cataract surgery
How is a Vitrectomy performed?
A vitrectomy is performed in our day surgery unit, usually under local anaesthesia.
In a vitrectomy, the 23 gauge microsurgical instruments are placed into the eye through three tiny incisions in the sclera (the white part of the eye). The vitreous gel is removed from the centre of the eye. During the course of the surgery, a fluid, which is similar to the fluid naturally produced by cells inside of the eye, is used to replace the vitreous.
A variety of instruments may be used to remove the vitreous gel and any scar tissue that may be growing on the surface of the retina. A laser probe can be inserted into the eye so that laser can be performed during the surgery. Vitrectomy surgery can take 30 minutes or longer depending on the severity of the eye problem.
This surgery is sutureless. New smaller gauge instrumentation has made it possible to perform vitrectomy surgery without using any sutures. A self retaining trochar/cannula system is used to introduce various instruments into the eye.
At the end of surgery, the cannula system is withdrawn and the small incision sites self seal without needing any sutures.
The benefits of sutureless surgery include minimal conjunctival scarring, less post- operative inflammation and discomfort, quicker healing time and shorter operating times.
What will my eye be like following surgery?
Any significant pain following surgery is not common. The patient may experience some discomfort and a scratchy sensation in the eye. This usually settles very quickly. If the eye becomes very painful, you must notify your surgeon immediately.
The Day Surgery will give you post operative instructions when you are discharged. You will be discharged with an eye pad on which needs to be removed in our clinic the following day. You will be required to use eye drops post operatively.
If a gas bubble has been placed into your eye, be sure not to fly in an aeroplane or climb high altitudes until the gas bubble has gone. A rapid increase in altitude can cause a dangerous rise in eye pressure. If gas is used, your vision will be poor until the gas is absorbed by the body.
What are the risks of vitrectomy surgery?
All types of surgery have risks, but at times, the risks are less than the expected benefits to your vision.
Some of the risks of vitrectomy include:
- Retinal detachment
- Increase in eye pressure
- Formation of cataract
Will my vision improve following vitrectomy surgery?
Visual improvement following vitrectomy surgery will depend on the severity of your eye problem before the surgery. If your eye problem caused permanent damage to your retina before the vitrectomy, then the improvement following surgery may not be significant. Surgery is sometimes performed to save the eye only, rather than to achieve an improvement in vision. Your Opthalmologist will discuss your situation with you and how much vision you can expect to gain.