Vitrectomy surgery is a type of eye surgery that treats disorders of the retina and vitreous. The eye is like a camera and the retina is like the film of the camera with its light-sensing tissue at the back of the eye. The retina processes the image from the front of the eye and sends a signal to the brain allowing for vision.
How the Eye Works
The vitreous is the clear, jelly-like substance that fills the middle of the eye. The vitreous is removed during vitrectomy surgery and is usually replaced by a saline solution.
Dr. Comaratta may recommend vitrectomy surgery to treat the following eye problems:
- Diabetic retinopathy, if bleeding and scar tissue are present
- Retinal detachments
- Infection inside the eye
- Severe eye injury
- Macular pucker
- Macular hole
- Vitreomacular traction syndrome
- Certain problems after cataract surgery
- Vitreous floaters
- Asteroid hyalosis
How a vitrectomy can improve vision?
Vitrectomy surgery often improves or stabilizes vision. The operation removes any blood[from diabetic retinopathy, retinal vein occlusion or trauma] or debris (from infection, inflammation or aging) that may be blocking or blurring light as it focuses on the retina.Vitrectomy surgery removes scar tissue that can displace, wrinkle, or tear the retina. Vision is poor if the retina is not in its normal position.This surgery can also remove a foreign object stuck inside the eye as a result of an injury. Most foreign objects will damage vision if they are not removed.
What happens if you decide to have a vitrectomy surgery?
Before Surgery:
Before surgery you may need to have a physical examination to alert Dr. Comaratta to any special medical risks. If the vitreous is cloudy, and there is a poor view of the retina, an ultrasound test may be performed to evaluate the retina. If their is a macular condition a scan of the macula will be performed [ophthalmic coherence tomography or OCT].
Surgery:
The length of the operation varies from 1-2 hours, depending upon your condition. In certain situations, Dr. Comaratta may do another surgical procedure simultaneously, such as placing a scleral buckle in repairing a detached retina or removing a cataract. Dr. Comaratta will perform the operation while looking into your eye with a microscope. He will use various miniature instruments that he will place in your eye through small incisions in the sclera (the white part of your eye). In order to get the best possible vision for you, Dr. Comaratta may do one or more of the following:
- Remove all cloudy vitreous
- Remove any scar tissue present, attempting to return the retina to its normal position
- Remove any foreign object that might be in the eye
- Treat the eye with a laser to reduce future bleeding or to fix a tear in the retina
- Place an air or gas bubble in the eye to help the retina remain in its proper position (this bubble will slowly disappear on its own)
- Place silicone oil in the eye, which usually requires later surgical removal
What To Expect During Your Surgical Experience.
After Surgery
You can expect some mild discomfort after surgery. Over the counter pain medications such as Tylenol and/or ibuprofen should be sufficient to ease any postoperative pain. Dr. Comaratta will prescribe eye drops for you and advise you when to resume normal activity. Most vitrectomy surgery is done on an outpatient basis, allowing you to return home the same day. If your surgery requires a gas bubble to be placed in your eye, Dr. Comaratta may recommend that you keep your head in a special position until the gas bubble is gone. You may not fly in an airplane or travel at high altitude until the gas bubble is gone. A rapid increase in altitude can cause a dangerous rise in eye pressure.
Risks of Vitrectomy Surgery
All types of surgery have certain risks, but the risks of vitrectomy are much lower than the expected benefits to your vision. Some of these risks may include:
- Infection [1in 3,000]
- Retinal detachment {1%]
- Bleeding
- High pressure in the eye
Another possible risk of vitrectomy surgery is accelerated cataract formation. If you are over the age of 50, you will develop a cataract after surgery. In most patients, cataract surgery will be be required 6-12 months following the vitrectomy. For patients with previous cataract surgery, the vitrectomy surgery is performed around the implanted lens and does not disturb it.
How much will your vision improve?
Your vision after surgery will depend on many variables, especially if your eye disease is caused by permanent damage to your retina before the vitrectomy. Dr. Comaratta will discuss your situation with you to explain how much improvement in your eyesight may be possible.