What is Vitrectomy?
Vitrectomy is an operation performed by entering the eye with the help of various micro-surgical instruments through incisions smaller than 1 mm in the white part of the eye, called the sclera, in order to eliminate various problems in the retina in the back of the eye and the vitreous covering the inside of the eye.
With the vitrectomy operation, the vitreous fluid in the eye can be removed and a special solution can be injected instead of the removed fluid, and various interventions can be made on the retina at the same time.
For problems involving the posterior region of the eye, posterior vitrectomy (pars plana vitrectomy) applied to this region is performed by retinal diseases specialists. In order to reduce various risks, vitrectomy operations applied to the anterior region due to eye trauma and various lens problems can be performed by ophthalmologists.
Because many eye diseases cannot be cured before vitrectomy surgery, these diseases can cause permanent vision loss and blindness at advanced levels, however, vitrectomy operation can now be applied for the treatment of various eye diseases.
When it comes to eye surgeries, the eye is generally handled by dividing it into two main areas. The cornea and lens are present in the anterior part of the eye, while the retina is located in the posterior part of the eye. The main function of the elements in the front of the eye is to refract the light coming from outside correctly and to allow it to fall on the retina. The process of transmitting the light coming from the outside to the brain through the nerves during the visual function is the back part of the eye.
The vitreous is the transparent substance that fills the inside of the eye, just after the iris layer in the front, up to the optic nerves on the retina at the back. It occupies two-thirds of the eye volume. Thanks to this substance, the eye can maintain its shape by appearing anatomically integrated.
All diseases that prevent the retina from functioning properly, such as bleeding caused by various reasons in the vascular system in the vitreous, serious inflammations in the eye, foreign objects in the eye, and fluid leaking behind the retina after retinal rupture are corrected by vitrectomy surgery. Because these problems seriously affect the quality of vision and some of them can cause permanent blindness if not intervened.
Why is Vitrectomy Surgery Performed?
Vitrectomy surgery can be applied for many different reasons. Vitrectomy operation can be performed in many cases related to the vitreous and in which the retinal health is in danger. The situations in which vitrectomy surgery is applied are as follows:
- Diabetic retinopathy,
- Removal of foreign body from the eye,
- Vitreous Bleeding,
- Retinal detachment,
- Retinal tears,
- Macular hole,
- Macula pucker,
- Foreign object getting into the eye,
- Infections in the eye after cataract and intraocular lens surgeries,
- Epiretinal membrane,
- Retinopathy of prematurity.
How is Vitrectomy Surgery Performed?
The operation can be performed with general anesthesia or local anesthesia according to the patient’s request and special condition. The operation is performed in the operating room using a vitrectomy device and an operating microscope.
In the vitrectomy operation, first of all, the vitreous gel is cleaned after entering the inner region from the outside of the eye. Surgery can be performed to clean the intraocular hemorrhages that occur in the eye and cause vision problems, to remove various foreign objects in the eye, to repair the retinal tissue and to clear various infections. The aim of all these surgeries is to prevent vision loss and to preserve the anatomical integrity of the eye while preserving vision as much as possible.
Depending on the type and level of the disease in the eye, it may be necessary to introduce liquid, air, silicone or gas into the eye instead of the vitreous fluid removed during the surgery. Since the entrances to the eye will be made through millimetric incisions, suturing is usually not applied after the surgery.
How Does the Post-Surgery Healing Process Occur?
In the post-operative period, the liquid formed by the eye itself replaces the vitreous fluid with gas bubbles and a special solution placed in the eye during the operation, instead of the vitreous liquid. If a special silicone oil is put into the eye during the surgery, it is removed with a second operation after a certain period of time after the first operation, and in this way, the fluid formed by the eye itself is allowed to function.
At the end of the operation, conditions such as redness and bruising around the eyes and swelling of the eyelids can be seen. However, these situations are improving rapidly. There may also be a feeling that something has gotten into the eye for a short time.
The most decisive factor in the healing process is the healthier the eye is before the surgery, the faster and more efficient the healing process is.
Things to Pay Attention Pre-Operation
Before the surgery, your ophthalmologist will perform a detailed examination of your eye. These examinations are performed by methods such as OCT, retinal ultrasound, slit lamp examination, and fluorescent angiography. If the operation will involve the anterior region, additional investigations may be required.
Before the operation, the ophthalmologist can give the patient certain recommendations that should be followed. These may vary from patient to patient.
Your ophthalmologist usually asks the patient not to eat or drink anything 8 hours before the surgery. Again, as a result of various tests, he may ask you to stop using the medication on the surgery day.
What are The Points to Be Considered After the Operation?
Following the ophthalmologist’s recommendations after the vitrectomy operation will make the healing process more comfortable for the patient and contribute to a more efficient treatment.
If air is placed into the eye instead of liquid or silicone during the surgery, intraocular pressure changes may occur between one and three weeks. Therefore, getting on a plane or going to high places such as plateaus and mountains during this period poses a danger to the healing process. The main danger here is the eye pressure that will occur in the eye.
If liquid or silicone is injected into the eye, the ophthalmologist will want the patient to maintain a certain lying position for a certain period of time. Maintaining this position is important for the success of the treatment. It is absolutely necessary to sleep in the lying position described by the ophthalmologist for the period specified.
After the operation, it is normal to have blood, redness and stinging sensation in the eye for a certain period of time. These complaints will pass in time. In this process, various medications given by the ophthalmologist should be used in accordance with the procedure without interruption.
Hygiene of the eyes and their surroundings should be given importance. Eyes should not be touched with water for 1 week.
In the post-operative period, movements that will put pressure on the eye and cause impact should be avoided. It is important not to interrupt regular doctor checks during the specified period, to monitor the success of the treatment and to determine the necessity of taking additional measures.
