Vitreous or vitreous humor is a transparent gel that makes up around 80 percent of the eyeball. It provides a transparent medium for the light to travel within the eye and reach the retina. Vitreous is present between the eye lens and the retina.
Vitrectomy is a surgical procedure to remove the abnormal vitreous so that the image can be properly projected over the retina. Sometimes, a vitrectomy is performed for a normal vitreous, so that the surgeon can access the retina properly. This is done during the repair of a retinal hole or tear.
How long does it take to clear vision after vitrectomy?
It may take around two-four weeks or even more to get a clear vision after the vitrectomy procedure.
The clarity of the vision after the procedure may be affected by the following factors:
- The eye drops used to dilate eyes during surgery may also cause blurry vision. Your doctor may also prescribe these drops for a few days after the surgery. This may cause the persistence of blurry vision.
- The surgery involves making multiple cuts on the whites of the eyes. If these stitches are very close to the cornea, they change its shape causing blurry vision.
- If the vitrectomy was done to repair a large hole in the retina, the damage to the retina may not fully recover. Such vision loss may persist.
- If the vitrectomy was done to repair the retinal swelling due to diabetes, it may recover to some extent. The time for this may vary depending on individuals and the blood sugar levels.
What are the applications for vitrectomy?
The vitrectomy is done for the following conditions:
- Retinal detachment or hole or tear: Separation of the retina (the light-sensitive layer at the back of the eye where an image is projected) from surrounding blood vessels.
- Chorioretinitis: Infection and severe retinal swelling due to viruses or bacteria.
- Diagnostic Vitrectomy: Done in very severe infections to find the organism responsible for it.
- Endophthalmitis: Severe infection and swelling of the inside of the eye including the vitreous. It may be due to bacteria, viruses, or even fungus.
- Foreign body in the eye
- Retinopathy in Diabetes: Swelling of the retina and development of abnormal blood vessels in the retina which may cause scarring.
- Vitreous hemorrhage: bleeding inside the vitreous.
What is the vitrectomy procedure?
Vitrectomy may be performed as an emergency procedure or a planned procedure.
The procedure is done under local anesthesia. You will be given drugs that make you sleepy. The operation is done with the help of a microscope. The eye surgeon makes three cuts on the whites of the eye, around the iris (colored part of the eye) each cut 3mm apart. The cuts are called sclerotomies. Each cut is used for a specific function.
- Through the first cut, a balanced salt solution is pushed into the eye, so that the eyeball shape does not collapse as the vitreous is removed.
- The second cut is used for inserting light, for better visibility of structures.
- The third cut is used to insert the instruments inside the eyeball. These instruments cut and suction the jelly-like vitreous humor out of the eye.
A laser probe may be used during the procedure to seal a macular or a retinal hole. It may also be used to burn away any abnormal blood vessels over the retina. If there is bleeding or infection inside the gel, it is also suctioned out. Sometimes, a gas bubble or silicon droplet is injected inside the eye after vitrectomy to provide better support to the retina.
The silicon droplet if inserted is removed after a few weeks in a separate surgery.
The purpose of vitrectomy is to re-establish a transparent medium for the light to travel from the lens to the retina (which transmits the image to the brain).
Does vitrectomy have any side effects?
The success rate of vitrectomy is around 90 percent.
However, like any procedure, even vitrectomy has complications. Here are some of the side effects of vitrectomy.
- Infection: These may be due to improper sterilization of tools used in the surgery. The risk of infections is also high in patients with poor immunity.
- Bleeding: It is more common on the patients on the blood thinners such as heparin and warfarin.
- Retinal damage and swelling: This may be due to inadvertent contact between surgical tools and the retina.
- Damage to the lens: This may be due to contact with the tools with the lens. This may make you more prone to cataracts in the future.
- Change in the refractive power: This may need you to use specs
- Increased eye pressure: This can damage the optic nerve and cause blindness.
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Parson’s Diseases of the eye, 22nd edition