What Is a Vitrectomy?
A Vitrectomy is an operation to remove the vitreous humour, the transparent jelly, from inside your eye.
The vitreous sits behind the iris (the coloured part of your eye) and the lens, and it is located in the middle of the eyeball, in front of the retina.
Why Is a Vitrectomy Necessary?
You may need a Vitrectomy if you have one or more of the following:
- Diabetic Vitreous Haemorrhage (bleeding)
- Retinal Detachment
- Removal of Macula Epi-retinal membrane (scar tissue) from the retina
- Macular Hole
- Endophthalmitis (a serious eye infection)- if untreated can lead to blindness rapidly
- Removal of intraocular foreign body
- Complicated Cataract Surgery where there are residual lens fragments that need retrieving
How Is the Vitreous Jelly Removed?
Prof. Stanga will discuss with you whether you will have the operation under local anaesthetic (while you are awake), or general anaesthetic (while you are asleep).
Three micro-cannulas will be inserted into the sclera (the white part of the eye) and instruments will be passed through each. These instruments include a tiny light source, a vitrector device (which cuts or liquefies the vitreous depending on your needs), and an infusion port which replaces the fluid in the eye to maintain the pressure in the eye during the procedure.
Once the jelly is removed, necessary repairs are carried out, such as peeling membranes, applying laser or removing foreign bodies.
The procedure normally takes up to 2 hours however the pre and post procedure mean this could take longer.
Does The Vitreous Jelly Get Replaced Naturally?
Once the vitreous jelly is removed the eye is filled with one of the following:
- A gas bubble which reabsorbs within 4-8 weeks, dependent on the type of gas used. This means that your vision will not be clear until this gas reabsorbs gradually.
- Transparent oil which is usually removed through a second surgery at a later date.
- An artificial fluid that is in time replaced by a fluid produced by the eye itself
- Air which reabsorbs within 10 days
What Are the Risks of Vitrectomy Surgery?
Although serious complications are unusual, there is always the risk of infection and possible blindness in the operated eye.
Other complications that may occur and require further surgery in theatre:
- Cataract formation requiring cataract surgery
- Retinal detachment
- Leakage from micro-cannula incisions requiring stitches (these usually self-seal)
- Bleeding inside the eye
Patients who have a vitrectomy surgery are more likely to develop a cataract (cloudiness of the lens of the eye) earlier than they would otherwise. This can also be the result of the gas or silicon oil used. If there is already a cataract present, cataract surgery may be performed at the same time as the vitrectomy. If not, the cataract surgery can be performed at a later stage when it has become more significant.
After Your Vitrectomy
Your rate of recovery and final outcome are dependent on your pre-operative condition which required a vitrectomy and how well you adhere to the postoperative instructions, such as needing to posture to encourage healing especially in those with gas or oil fill in the eye. Prof Stanga will see you the very next day after your procedure to examine the eyes and monitor the progress in 1-2 weeks and again Further appointments will be booked to ensure the eye is responding well to the surgery.
Prof. Stanga will advise you of your likely outcome and post-operative management.
You should expect:
- Blurry vision for several weeks after surgery.
- Swollen, sensitive and red eyes due to the nature of the surgery.
- To regularly administer your own eye drops once at home, this will help to reduce inflammation and prevent infection.
