WHAT IS A VITRECTOMY SURGERY?
A Vitrectomy is a surgery which involves making small incisions, about 1mm in length in the white of the eye, to enable fine instruments to go into the eye. Some or all of the vitreous gel (clear, jelly-like material) inside the eye is then drained out and replaced with a salty fluid (saline). Depending on the motive for your surgery extra procedures may be necessary; these will be discussed with you, before going on the waiting list for surgery.
Once the major part of the surgery is completed, the retinal lining (a light-sensitive tissue on the inner surface of the eye) is checked for any weak areas. As such, you may need further treatment such as; a freezing treatment (Cryotherapy) or laser treatment to those weak regions. This would be in order to lower the risk of post-operative complications such as retinal detachment.
During the surgery, you may be aware of some shadows and lights within your eye; this is quite normal as your retina is still functioning. The amount of light and shadow you may notice can vary because of the intensity of the local anesthetic.
Your doctor may use a gas bubble to aid the eye to heal. The gas will be injected into your eye during the operation. This gas bubble will work as an internal splint to support the retina through the healing process. Following the operation, it is very vital that you do not fly in an airplane, until the gas has been thoroughly absorbed (this can be up to eight weeks). Sometimes, you may also be asked to keep your head in a particular position so as to help the gas bubble do its job. You will be given a diagram and specific directives on how to do this.
If you need a general anesthetic for another operation, during the 8 week period following your vitrectomy surgery, it is important that you inform the anesthetist that you have gas inside the eye. This will be discussed with you prior to the operation and specific directions will be given to you after the operation and before you go home.
On occasions a special kind of medical oil (silicone oil) is used in place of gas. This is generally removed many months later at a second operation. Your doctor will give you fuller information on do’s and don’ts should it have been necessary to use silicone oil.
Why do I need the Surgery?
Your personal circumstances will be discussed with you by the surgeon. Successful surgery will typically bring back some of your sight; however, it may not totally restore your vision.
Vitrectomy surgeries are carried out for a number of serious eye conditions such as those listed below:
· To remove hemorrhages (blood) as a result of bleeding in the retinal blood vessels from the vitreous gel inside the eye
· To manage scar tissue formation which can affect vision in conditions such as diabetes or following retinal vein occlusion (a blockage in the blood supply to the eye)
· To take away foreign bodies from inside the eye following an injury
· To clear away cloudy gel following a serious internal infection called Endophthalmitis
Can there be any complications or risks?
This type of operation has similar risks to other types of eye surgery such as:
· You may develop an infection in the eye. This is called Endophthalmitis and is very uncommon but can give rise to serious loss of sight
· Bleeding inside the eye
· Retinal detachment which can occur at any time following the operation and will need further surgery in order to repair it
· Almost all patients develop a cataract (a cloudy lens which impairs vision) more quickly than normal, following this sort of surgery. This is because the internal fluid has been distressed and also because of the gas present in the eye. In some situations, the cataract may be removed during the operation, to enable a clearer view for the vitrectomy surgery to be conducted. Cataracts can also be removed in a separate surgery. Your surgeon will discuss the best choice for your eye condition.
· High pressure inside the eye. You may need additional eye drops to manage the pressure, for a period of time, following the surgery
· Inflammation within the eye
· Bruising to the eyelids and eye – this will resolve after a few weeks.
· Allergy to the medication taken
If you notice any of the following issues following your return home:
· Excessive pain
· Loss of vision
· Increasing redness of the eye
· Discharge from the eye
You should contact the ward right away.
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