Vitrectomy is an intraocular surgery that affects the back of the eye and involves removing the vitreous body, which is the gel-like substance that fills the inside of the eye. After the vitreous body is removed, the surgeon, depending on the condition, removes the epiretinal membranes and/or lesions caused by diabetes, or performs other procedures in the eyeball to restore its normal anatomy.
Every vitrectomy procedure is different, as each patient needs treatment tailored to their condition. During the procedure, an ophthalmic surgeon, with the help of micro-tools, reaches the retina and treats diseases of the retina and vitreous body. Some of these diseases, such as retinal detachment, should be operated on very quickly, preferably within two-three days of their onset. Other, such as the epiretinal membrane, can be operated on within a few months, depending on the condition of the eye and the visual acuity.
The decision on the necessity and timing of surgery is made by the doctor, based, of course, on the prior examination and the condition of the patient.
Before vitrectomy it is necessary to undergo a pre-assessment at the Retina Ophthalmological Outpatient Clinic and Hospital. During the visit we will take your medical history, perform full ophthalmological exam and the necessary diagnostic tests.
Vitrectomy is performed in patients suffering from
- vitreous hemorrhage,
- retinal detachment,
- macular hole,
- epiretinal membranes,
- macular edema,
What to expect during vitrectomy?
In place of the removed vitreous body, an agent (gas, saline, silicone oil) is often injected into the eye as a tamponade to arrest hemorrhaging. It also helps to maintain optimal pressure in the eye and straighten the retina and keep it in place.
The gas bubble is naturally absorbed, but the silicone oil has to be released from the eye after some time, which means the patient must undergo another procedure.
Gas or silicone oil introduced into the eye have a negative impact on the quality of vision. It lasts for a while, and after some time the gas is naturally replaced by the aqueous humor produced by the eye, and in the case of silicone oil filling, after it is removed, saline or a gas is injected into the eye, and then, after one or two days the eye is filled with aqueous humor.
Often, along with vitrectomy, a cataract removal surgery is performed as well.
- on the day of the surgery, you should report to the Clinic wearing comfortable clothes (e,g. a tracksuit); you will be given a disposable patient bodysuit
- on the day of the surgery do not put on facial or eye makeup,
- prescribed chronic-use medications should be taken at the usual time, except the ones listed below,
- 3-7 days before the surgery patients should discontinue blood thinners, such as: Acard, Aspiryna, Aspro C, Asprocol, Polopiryna, Rhonal, Ring N, Solucytel, Thomapyrin, Pradaxa, Xarelto, Plavix, Warfin, Acenokumarol.
Prior to the scheduled surgery you will be provided with additional detailed information.
How long does the vitrectomy take
The entire procedure takes between one and two hours. The patient is discharged after they have rested for about half an hour.
Vitrectomy is performed under the so-called combined anesthesia (local anesthesia with sedation). This means cooperation between an anesthesiologist, who administers intravenous sedatives and painkillers, and an ophthalmologist, who administers local anesthesia to the eye.
After the surgery the patient usually does not feel pain. Sometimes they may feel slight stinging or a gritty sensation, which can be relieved with over-the-counter painkillers.
Important after vitrectomy
After the procedure the patient should not use public transport, and should be escorted home by an adult companion.
For 24 hours after anesthesia the patient cannot drive, operate dangerous equipment or drink alcohol.
After the surgery the face should not be immersed in water and the eye should be kept dry, as this can lead to infection. For 3 weeks caution should be exercised when bathing, until the wound becomes watertight.
For 2-3 weeks after the surgery patients should abstain from doing work that requires a lot of physical effort (e,g., moving heavy furniture or lifting over 15 kilograms).
On sunny days patients should wear sunglasses.
The dressing remains on the patient’s eye until the first follow-up visit, which takes place the day after the procedure. Then next follow-up visits are scheduled. Ophthalmic drops should be used according to the regime specified in the treatment information sheet.
Patients who had gas injected during the procedure are absolutely forbidden to fly or climb high mountains until the gas is absorbed.
After the surgery the patient receives a set of detailed information and instructions from our staff.