Vitrectomy: Understanding the Procedure, Meaning, and Recovery

Many experience sudden decrease in vision . Such instances can disrupt everyday activities and might even lead to permanent damage if left untreated. That’s where vitrectomy steps in. It is a procedure designed to save and improve vision. Let’s learn what vitrectomy involves, why it’s essential, and what to expect from the surgery and recovery.

What is Vitrectomy?

Vitrectomy is a surgical procedure that involves the removal of  vitreous humour, a clear gel filling the space between the lens of the eye and the retina. This surgery addresses several eye issues where the vitreous gel becomes a hindrance, such as in cases of bleeding, retinal detachment, or infections. By clearing the affected vitreous, the surgeon can better access the retina to treat conditions threatening vision.

Given the rising prevalence of diabetic retinopathy and cataract-related complications in India, vitrectomy has become increasingly common. Nethradhama Super Specialty Eye Hospital offers advanced treatment options, making such surgeries safer and more accessible.

The surgery can be performed under local anaesthesia, although in some cases, general anaesthesia may be required. It usually takes place in day care settings, with some patients needing an overnight stay, depending on the complexity of the procedure. Patients can return home the same day, though the full recovery process requires several weeks.

What conditions are treated with a vitrectomy?

Several eye disorders may require vitrectomy for treatment. These include the following conditions.

•       Retinal detachment: When the retina  is pulled away from its normal position.
•       Advanced diabetic retinopathy: A complication of diabetes causing significant vitreous haemorrhage and/or retinal detachment.
•       Vitreous haemorrhage: Leakage of blood into the vitreous gel.
•       Macular hole: A small break in the macula, the part of the retina responsible for central vision.
•       Eye infections: Severe infections like endophthalmitis that may spread within the eye.
•       Traumatic eye injuries: Serious damage requiring immediate surgical intervention.

These conditions can severely impair vision if left untreated, making timely vitrectomy essential for maintaining eyesight.

Types of vitrectomy

Vitrectomy is categorised into two types (Posterior Pars Plana and Anterior Vitrectomy) based on the part of the eye being treated.

Posterior Pars Plana Vitrectomy focuses on conditions affecting the back of the eye, such as retinal detachment or macular holes. This surgery, performed by a retinal specialist, involves accessing the vitreous cavity through the pars plana—an area behind the iris. It allows for precise treatment of retinal disorders, ensuring minimal disruption to other eye structures.

In contrast, Anterior Vitrectomy addresses issues in the front part of the eye. It is usually performed when the vitreous gel leaks into the anterior chamber due to trauma, complications from cataract surgery, or lens dislocation. While less common than posterior vitrectomy, it aims to remove the displaced vitreous from the front chamber to restore clear vision and prevent further complications.

Each type of vitrectomy targets different eye areas to manage vision-threatening conditions effectively, ensuring tailored care based on the problem’s location.

Vitrectomy Procedure

It is typically performed as an outpatient surgery, using precise tools to access the eye through small ports

Depending on the condition being treated, the surgeon may also repair retinal damage, remove scar tissue, or insert a gas bubble or silicone oil to maintain pressure on the retina. If silicone oil is used, a second surgery may be required to remove it, whereas the gas bubble will dissolve naturally.The procedure aims to restore or preserve vision by providing better access to the retina for treatment.

What happens before a vitrectomy?

Before the surgery, the surgeon will conduct detailed eye examinations and possibly perform an ultrasound scan to assess the vitreous and retina. Instructions will be given to stop certain medications, and fasting may be required a few hours before the surgery. Patients need to arrange someone to drive them home after the procedure.

What happens during a vitrectomy?

The surgery involves making 25Gauge ports in the sclera (the white part of the eye) to access the vitreous. The vitreous humour is removed using specialised instruments. If needed, the surgeon may insert a gas bubble or silicone oil to maintain the retinal position. Laser treatment might also be done to seal retinal tears.

What happens after a vitrectomy?

Patients are usually discharged on the same day. A patch covers the eye initially, and eye drops are prescribed to prevent infection. Doctor may advice some patients to keep their face down after surgery depending on retinal pathology.

Recovery After Vitrectomy Surgery

Recovering from vitrectomy surgery generally takes 4 to 6 weeks. During this time, patients may experience temporary blurriness or discomfort. It is essential to follow the surgeon’s instructions, including the use of prescribed eye drops, maintaining positioning  and avoiding activities such as air travel (if a gas bubble was inserted). For some patients, full visual recovery may take up to three months or more, with vision gradually improving over time.

It’s crucial to have regular follow-up appointments to monitor healing and avoid complications. Nethradhama Super Specialty Eye Hospital provides comprehensive post-operative care to ensure a smooth recovery process.

Risks and Complications of Vitrectomy

While vitrectomy is a safe procedure, rare risks and complications can occur such as Re bleeding, high eye pressure or re detachment. In cases where the natural lens remains intact, vitrectomy almost always leads to cataract formation, often requiring cataract surgery later. Incase of high intraocular pressure, glaucoma treatment is required to prevent optic nerve damage.

In some instances patients might need repeat surgeries if complications arise during recovery or if the initial surgery does not fully address the condition. It’s crucial to discuss these risks with the surgeon beforehand and understand the steps to mitigate them.

Proper post-operative care and close follow-up with your eye care provider are essential to ensure a smooth recovery and lower complications.

Conclusion

Vitrectomy surgery offers a lifeline for those experiencing severe vision problems. Whether it’s addressing retinal detachment or managing complications from diabetic retinopathy, this procedure has become an essential tool in modern eye care.

With eye care providers like Nethradhama Super Specialty Eye Hospital offering cutting-edge facilities, patients have access to the best possible care. If you or someone you know is dealing with a condition affecting the retina, consulting a specialist for a vitrectomy could be the first step towards preserving and restoring vision.