Vitrectomy

Vitrectomy in Chattanooga, Knoxville, and the Tri-Cities Region

In cases where your retina surgeon requires clear, unobstructed access to the retina and its neighboring components, a vitrectomy surgery may be necessary. Minimally invasive, safe, and effective, with little, if any pain or discomfort, this procedure involves the partial or full removal of the vitreous from the back of the eye. Vitrectomies may be performed alone or in conjunction with other procedures, such as laser therapy. At Southeastern Retina Associates, our retinal specialists and surgeons are highly trained and experienced in performing vitrectomies.

The Primary Uses of Vitrectomy

Ophthalmologists and retinal specialists may perform a vitrectomy in cases involving impaired retinal function, such as from interference or if retinal scar tissue has developed.

Retinal Interference

Retinal interference refers to when obstructions inside the vitreous prevent incoming light from reaching the retina, disrupting normal vision function. Vitrectomy can be used to remove whatever is causing the interference. Examples of these include:

• Complications after cataract surgery, such as displaced lenses
• Autoimmune diseases targeting the eye
• Vitreous hemorrhage
• Eye infections
• Severe eye floaters

Retinal Scar Tissue

As we age, the vitreous gradually shrinks, pulling on the retina. This may lead to scar tissue developing and accumulating, which can displace or tear the retina. However, removing part or all of the vitreous allows surgeons to decrease the retinal tension, improving access to the retina. Common conditions involving scar tissue removal that would benefit from a vitrectomy include:

• Macular holes
• Macular puckers and epiretinal membranes
• Vitreomacular traction (VMT)
• Retinal tears or detachments

The Steps Involved in Vitrectomy Surgery

A vitrectomy typically takes 45 minutes to two hours to complete and is usually performed in an operating room at a hospital or ambulatory surgery center. Here are the specific stages of the procedure:

1. The eye requiring treatment is carefully cleaned with antiseptics.
2. The eye is draped with sterile coverings placed around it.
3. A smooth wire speculum (a wire device with curved ends designed to fit into a surgical site) is situated to gently keep the eye open.
4. Using tiny surgical instruments, the surgeon makes microscopic incisions into the sclera (the outer white part of the eye).
5. Using a microscope and under direct visualization, the vitrectomy probe carefully cuts tiny pieces of the vitreous; suction is then applied to remove these fragments.
6. Depending on the surgical type and purpose, once the vitrectomy is completed, you may have additional procedures performed, including laser treatment or repairing retinal detachment.
7. Air, gas, silicone oil, or a balanced saline solution may be used to replace the removed vitreous gel. In the following days, this substance will dissipate and be replaced with natural aqueous humor fluid.
8. The surgical incisions are examined for leaks. Stitches are typically not required, but a single one may be used to seal the incision.
9. Antibiotic ointment is applied, and then a patch and shield is placed over the eye.
10. Once the procedure is finished, you’ll first be observed in the post-operative room or area.

Vitrectomy FAQ

• Are there any risks or complications associated with vitrectomy?

  Vitrectomy is considered to be a safe procedure, however, as with any surgery, there are some potential risks and complications, including infection, scar tissue, and cataract development. You may also be more likely to develop a retinal tear or detachment, which are medical emergencies. Your retina surgeon will discuss all potential risks and complications before the procedure, including signs of retinal tears and detachments. Should serious symptoms manifest, like significant pain or vision loss, quickly tell your retinal surgeon.

• What should I expect with the vitrectomy recovery process?

  Patients typically do well after vitrectomy surgery, with little pain or discomfort. A full recovery can take a week or more, though, depending on the procedure performed, and the type of bubble used to replace the vitreous. Your doctor may advise you to stay close to home for two weeks for follow-up exams.

  In most cases, you’ll be prescribed antibiotics and/or steroid eye drops to prevent infection and inflammation. You will also have to keep your head in a downward position, avoid strenuous activity, and avoid air travel for some time. Your surgeon will provide you with all the necessary details you need for a successful vitrectomy recovery.

• Are you awake for a vitrectomy?

  It depends on the situation. In some cases, you’ll receive general anesthesia to put you to sleep for the vitrectomy procedure. In other cases, your doctor may instead recommend using local anesthesia to numb the afflicted eye and surrounding area. If local anesthesia is used, you will be awake for the procedure, but you will be given medicine to help you relax.