A vitrectomy is a surgical procedure that removes the vitreous in the central cavity of the eye so that vision can be corrected. It is beneficial in many disease states including diabetic retinopathy, retinal detachments, macular holes, macular puckers and vitreous hemorrhage.
The vitrectomy procedure is usually performed as an outpatient procedure. Local or general anesthesia may be used. The eye will be held open using a special speculum and the eye that is not being operated on will be covered.
I begin the procedure by making a small (less than 2mm) slit in the side of the eye and inserting an infusion line to maintain constant eye pressure. Next a microscopic cutting device is inserted which will aspirate (suck out) the vitreous fluid.
A microscopic light source is also inserted to illuminate the inside of the eye through the procedure. Additional instruments may also be used to perform additional maneuvers such as cauterizing blood vessel leaks or removing scar tissue.
Pars Plana Vitrecomy Illustration
I will be looking through a microscope while performing the procedure and may also use special lenses to help see the anatomy of the eye.
After the vitreous is removed, I will refill the eye with a special saline solution that closely resembles the natural vitreous fluid in your eye.
Vitrectomies have been commonly performed for over 40 years. However, certain risks do exist. They include:
- retinal detachment
- development of glaucoma (increased pressure in eye)
- cataract formation or progression
- bleeding and/or infection inside or outside of the eye
- red or painful eye
- loss of depth perception, blurring of vision, double vision or blindness
- swelling of layer under the retina (choroidal effusion)
- change in focus, requiring new spectacle lenses (refractive changes)
- wrinkling of retina (macular pucker)
- swelling of the retina (cystoid macular edema)
- loss of night vision
- loss of eye (extremely rare)
- need for additional treatment and/or surgeries.
Normal vitrectomy healing time is between 4 to 6 weeks. Normal restoration of vision can take several weeks. Physical activity will be restricted during this time to prevent complications.