Do you feel like your vision is gradually decreasing? Or do you suddenly have blurry vision and see things like spider webs floating in front of your eyes? These things can be signs of a serious eye problem. So today we are going to talk about a special surgery that can solve many of these problems and help save your vision. That is the Vitrectomy surgery. Although the name is a bit strange, let's simply understand what this does.
Simply put, what is Vitrectomy?
Imagine that our eye is like a small ball. The empty space inside this ball is filled with a clear, jelly-like fluid. This is what we medically call the vitreous humor . This jelly is what gives the eye its spherical shape. Normally, this jelly should be clean and transparent, so that light can enter the eye without any obstruction and fall on the retina at the back of the eye.
But what happens if, due to certain diseases, this jelly-like fluid becomes damaged, if blood accumulates in it, or if it shrinks and starts to pull away from the retina ? Then our vision is impaired.
Vitrectomy is the surgical removal of the problematic vitreous humor from the inside of the eye, restoring the eye to its normal state.
In place of the removed jelly, the surgeon fills the eye with sterile salt water, a special silicone oil, or a gas bubble. This helps the eye maintain its desired shape and keep the retina in place.
In what cases is vitrectomy surgery necessary?
There are many reasons why this surgery may be performed. Sometimes it may be due to bleeding inside the eye. Other times it may be due to a problem with the retina. Let's look at the main reasons.
| Medical condition | Simply explained |
|---|---|
| Retinal detachment | The retina, which is essential for vision, detaches from its place in the eye. This is an emergency. |
| Eye damage caused by diabetes (Diabetes-related retinopathy) | Diabetes can cause bleeding from small blood vessels in the eye or the formation of new, unwanted blood vessels. This blood collects in the vitreous fluid and blurs vision. |
| Macular hole | A hole in the macula, the part of the retina that helps with sharp vision, in the center of the eye. |
| Macular pucker | A thin film forms on the surface of the macula, which wrinkles and distorts vision. |
| Bleeding inside the eye (vitreous hemorrhage) | Blood accumulating in the vitreous humor due to diabetes, an eye injury, or other causes. |
| Serious eye injuries | Clean and repair the inside of the eye after an accident, such as a puncture or cut to the eye. |
| Infection inside the eye (Endophthalmitis) | A severe bacterial or fungal infection inside the eye. This surgery is performed to remove the infected fluid and inject medication. |
| Complications of cataract surgery | Sometimes, if fragments of the lens fall into the eye during cataract surgery, this surgery is necessary to remove them. |
What happens before the surgery?
Because this is a surgery, there are several steps to prepare you beforehand.
- Fasting: The day before surgery, your doctor will tell you when you should stop eating or drinking. Usually, you will not be allowed to eat or drink anything for a few hours before surgery.
- Medication Awareness: You should tell your doctor about any medications you are taking (for example, blood thinners). They may ask you to stop taking them for a few days.
- Someone to help: You won't be able to go home alone after surgery, so you'll be advised to bring someone to take you home.
- Scans: Sometimes, something like an ultrasound scan may be done to look inside the eye before surgery.
Let's see how the surgery is done.
Don't worry about this. The medical team will do everything they can to ensure you don't feel any pain.
1. Anesthesia: First, your eye will be numbed (local anesthesia) . This may involve an injection around the eye. You will be conscious, but will not feel any pain. Sometimes you may be given a medicine into a vein to make you a little sleepy (sedation) , or you may be given general anesthesia . This will depend on your condition and the nature of the surgery.
2. Eye preparation: Your eye will be dilated with medicine. Then, a small instrument called an eye speculum will be used to keep your eye open during the surgery.
3. Surgery: The surgeon makes several very small incisions in the white part of the eye and inserts very fine instruments into the eye. Then, the problematic vitreous fluid is slowly removed. If there are bleeding veins, laser treatment may be used to stop them.
4. Refilling: After removing the vitreous fluid and making the necessary repairs, the space is filled with salt water, a gas bubble, or silicone oil, as mentioned earlier.
5. Time: The time it takes for surgery varies depending on what is being done. While a simple surgery may take about an hour, a complex surgery may take longer.
What to expect after surgery?
After the surgery, you will be monitored for a while and sent home. There are a few instructions that you must follow when you go home.
The most important thing: the right posture to keep your head up!
If you have a gas bubble or silicone oil in your eye, your doctor may recommend that you stay in a face-down position for a few days or weeks to help your retina heal properly. This can be difficult, but it is essential for your eye to heal properly. Ask your doctor about pillows or other devices that can help you maintain this position.
- An eye patch: After surgery, you will have an eye patch. Your doctor will tell you when to remove it.
- Eye drops: You will need to use several types of eye drops to prevent infection and reduce swelling. It is very important to use the medicine exactly as prescribed, at the right time.
- Discomfort: The eye may be slightly red and swollen. You may also feel a little itchy and scratchy. These are normal. However, if there is severe pain , inform the doctor immediately.
- Vision: Vision may be blurry for the first few days after surgery. If a gas bubble is placed in the eye, it may look like you are looking underwater. This gas bubble will gradually dissolve over a few weeks. If silicone oil was placed, you will need to have another minor surgery to remove it.
What are the benefits and risks?
As with any surgery, there are both benefits and minor risks.
| Advantages | Possible Risks/Complications |
|---|---|
| Being able to save or improve the vision of an eye that would have gone permanently blind. | An infection inside the eye. |
| Eliminating annoying symptoms that distort vision. | Bleeding inside the eye. |
| The ability to successfully treat many eye diseases that were previously untreatable. | Retinal detachment or tear. |
| Helping to obtain an accurate diagnosis and plan treatment. | Cataract formation or rapid progression of existing cataracts. |
| Increase or decrease in eye pressure. | |
| Very rarely, loss of vision. |
Don't worry about these risks. They don't happen very often. Your surgeon will explain everything to you and do everything possible to minimize the risk.
When do you need to see a doctor immediately?
When you go home after surgery, if you have any of the following symptoms, you should inform your doctor without delay .
- If you experience unbearable, severe pain in your eye .
- If your vision is getting worse and worse .
- If the eye is extremely red, swollen, and has a pus-like discharge (these are signs of an infection).
- If you have any suspicious or unusual symptoms .
Don't ignore things like this. The sooner you report it, the easier it is to control any problem.
Take-Home Message
- Vitrectomy is a very successful surgery that can cure a number of serious eye diseases that affect vision. There is no need to be afraid of this.
- Following the doctor's instructions after surgery, especially the correct head position and the use of eye drops , is essential for the eye to heal.
- Before and after surgery, ask your doctor any questions or doubts you may have.
- If you experience severe pain, decreased vision, or signs of infection after surgery, notify your doctor or hospital immediately.
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