In eye surgeries, the eye is divided into two main regions as cornea and retina. The cornea is located at the front of the eye and the retina is located at the back of the eye. Elements in the front of the eye correctly refract the light coming from the outside and allow it to fall on the retina. The back part of the eye also performs the visual function and transmits the light coming from the outside to the brain via nerves. One of the substances in the back of the eye is the vitreous. This is a transparent substance that fills all the space extending from the layer of iris till the optic nerve, which is located at the back of the eye, just after the iris layer. The vitreous occupies two-thirds of the eye's volume. Thanks to the vitreous, the eye appears anatomically integrated and maintains its shape.
Vitrectomy is the process of separating and discharging the gel in the back of the eye, which fills the large space.
With vitrectomy surgery, it is aimed to clean the bleeding in the intraocular fluid, foreign bodies and infections in the eye and to restore the retina to its old anatomical structure. Otherwise, various disorders of vision may occur. In some patients, there may even be a situation such as complete loss of the eye.
Vitrectomy can be the treatment of choice in many diseases. These diseases are as follows:
- Cleaning of bleeding in the posterior cavity of the eye
- As treatment of retinal tears and detachments
- Cleaning the membranes that may develop on the retina
- Removal of yellow spot diseases and foreign bodies inside the eye
The surgery can be performed under local or general anesthesia. Incisions smaller than 1 mm that are open for interventions can be sutured after the operation, depending on the condition of the patient and the eye, or the operation can be terminated without suturing.
BEFORE THE VITRECTOMY SURGERY
Before the operation, the patient undergoes a detailed medical examination and the general health status of the patient is evaluated. Necessary examinations are also included in these processes. The doctor decides on surgery with this evaluation. It is important that the patients stop eating and drinking 8 hours before the surgery. It is also necessary for the patient to inform the doctor about the drugs he is using in advance. According to this situation, the doctor informs the patient whether to continue their medication or not.
AFTER THE VITRECTOMY SURGERY
Vicrectomy surgery is mostly performed without hospitalizing the patient. The eye, which is comfortable after the procedure, is covered to prevent possible injury. If silicone oil and gas bubbles are used to treat the eye after the procedure, the surgeon gives the necessary information to the patient to take the required position. The gas bubble puts pressure on the retina, allowing it to return to its normal position and remain there until healing occurs.
After the surgery, the patient is ready to go home within 1-2 hours. However, it is not appropriate for the patient to drive after the procedure. The patient is expected to go to a control examination 1 day after the operation. It is also important that the patient takes care to maintain the head and eye position after the procedure. Activities that may cause pressure changes after the surgery, such as boarding a plane or going to areas above sea level, should be avoided.
Are vitrectomy and cataract surgeries similar?
Cataract is not actually a disease, it is the loss of natural lens transparency and whitening at the end of the aging process. In cataract, all tissues of the eye are intact and the whitened natural lens is replaced with an artificial lens and the patient regains his vision. In other words, cataract surgery is the replacement of the defective part with a new one.
However, patients who require vitrectomy surgery have either systemic (such as diabetes and hypertension) or ocular disease affecting the retina. Drug or laser therapy was applied for the treatment of this disease, and vitrectomy surgery was needed because the progression of the disease could not be stopped.
In what situations is the retina surgery (vitrectomy) recommended?
Here are the 5 main reasons to have a vitrectomy or vitrectomy plus other procedures:
- Vitreous opacity which blocks vision (clouding)
- Disorders caused by abnormal retraction of the retina
- Conditions that require retinal surgery or other eye surgery
- Diagnosis of a vitreoretinal condition (diagnostic vitrectomy)
- Insertion of a therapeutic device or administration of medication.