What is Vitrectomy?

Vitrectomy is a type of surgery in which the vitreous fluid is removed from within the eye. The vitreous sits right in the middle of the eye, and its purpose is to preserve the shape of the eye. It has a clear structure. Where this fluid becomes cloudy over time or because of a condition, it needs to be removed. Thanks to its removal, repair is carried out on the retina, and thanks to that repair the problem with vision is removed. The procedure carried out is a microsurgical operation. It is therefore usually performed under local anaesthetic with sedation, and under general anaesthesia if needed. During the operation the vitreous is replaced with a fluid, gas or silicone oil. The vitreous does not grow back: its place is taken by the eye's own fluid, and any gas or silicone used is temporary. Although the length of the operation varies with the person's situation, it takes between 30 minutes and 2 hours depending on the case.

What Are the Types of Vitrectomy?

The types of vitrectomy vary with the person's situation. They can be examined in five different forms, which can be explained as follows:

Pars plana vitrectomy

Pars plana vitrectomy is one of the types used most commonly. In this operation, small incisions are made in the pars plana region. Thanks to those incisions the vitreous is reached, and once it has been reached the vitreous is removed through that area. This method is used in more than one type of operation.

Anterior vitrectomy

In this method the aim is to remove the vitreous gel at the front part of the eye. Various kinds of damage can be met at the front of the eye after operations such as cataract surgery in particular, and this method is used to remove that damage. Thanks to the procedure, complications at the front of the patient's eye are treated, and the quality of vision improves.

Minimally invasive vitrectomy

Also known as MIVS, this is a method carried out with far smaller incisions than standard pars plana vitrectomy. Smaller instruments are used during the operation, and the damage the eye takes is thereby kept to a minimum. Recovery is shorter in people operated on with this method. Today it is the standard technique for most vitrectomy operations.

Total vitrectomy

Unlike the other methods, this operation involves the complete removal of the vitreous from the eye. Where there is an infection in the eye, all the vitreous tissue is taken. The doctor decides on this according to the patient's situation.

Partial vitrectomy

In this procedure, unlike total vitrectomy, only a certain part of the vitreous is removed. It is generally carried out in limited areas. The main aim is small interventions and the removal only of the area causing trouble.

Why is Vitrectomy Surgery Carried Out?

Vitrectomy surgery is one of the operations carried out where the retina has taken damage and in situations such as a tear arising from a macular hole and a vitreous haemorrhage. Alongside these, vitrectomy can be drawn on in treating a great many different eye conditions. The reasons vitrectomy surgery is carried out are these:

• Retinal detachment

The retina is one of the tissues with the greatest part to play in people's sight. Detachment arises as a result of the retina separating from the wall of the eye. In situations of this kind, vitrectomy surgery is carried out, the vitreous is removed and the retina is fixed back to the wall of the eye. Sudden flashes of light, a marked increase in floaters or a curtain coming down across your vision can be signs of a retinal tear; if you notice them, see an ophthalmologist without delay.

• Diabetic retinopathy

This situation generally arises in people with diabetes as the small blood vessels within the eye take damage. It appears with signs such as bleeding over the retina, loss of vision and a build-up of fluid. Through the procedure, the bleeding is removed.

• Macular hole

The macula is the small central area of the retina responsible for sharp central vision. It can also be described as a region of the retina. A macular hole is a situation in which a tear or a gap occurs in this region. Through vitrectomy surgery, it is possible to repair the damaged macular hole and remove the loss of vision.

• Vitreous haemorrhage

Where a vitreous haemorrhage forms, a fall in the quality of vision or a loss of sight is faced. Through the operations carried out, this bleeding is cleared and the structures at the back of the eye are healed.

• Eye injuries

The vitreous tissue can take damage as a result of wounds or injuries to the eye. Through vitrectomy surgery, foreign bodies in the eye are removed. The aim is thereby to remove the existing problem with vision.

• Epiretinal membrane

The epiretinal membrane is a thin layer of tissue lying on the surface of the retina. It can generally appear with puckering of this membrane and loss of vision over time. It is commonly known as a macular membrane. Through vitrectomy surgery, the epiretinal membrane is removed.

What to Observe After Vitrectomy Surgery

Microsurgical procedures are carried out in vitrectomy operations. The operation is performed with special microsurgical instruments and with saline solutions or gases. To protect the health of the eye, the points the doctor recommends after surgery should always be observed. The points to observe after vitrectomy surgery are these:

• The eye drops the operating doctor recommends should be used.
• So that no infection forms in the eye after surgery, the rules of hygiene should be followed and the eye cleaned in the way the doctor recommends.
• Lifting heavy objects should be avoided for a period after surgery.
• Check-ups with the doctor should not be neglected.
• If gas has been placed in the eye, do not fly or travel to high altitudes until the gas has cleared; your surgeon will tell you which head position to keep.
• Where severe pain, blurred vision or a sudden loss of sight occurs after surgery, the nearest hospital should always be attended.

When Does Vision Return After Vitrectomy?

Vision after vitrectomy surgery can vary with the person's situation, with the type of the operation and with the state of the eye. In many people who have this operation, vision generally clears within the first few weeks once recovery is complete. No definite date can be given for full recovery in general, as it varies with the person's situation. Recovery usually takes 2-4 weeks, and longer if gas or silicone oil was placed in the eye. What is a Vitreous Disorder?