Vitrectomy: An expert guide

Vitrectomy is a surgical procedure conducted to remove the vitreous gel from the eye. By extracting the vitreous gel, the ophthalmologist can access and treat underlying retinal or vitreous issues, helping to restore or improve visual outcomes.

Here, Mr Serafeim Antonakis, renowned consultant ophthalmologist and vitreoretinal surgeon, offers an expert insight into vitrectomy surgery, addressing common patient concerns and questions.

Why would I need vitrectomy surgery?

Vitrectomy surgery is a highly specialised procedure indicated for various eye conditions that affect the retina and vitreous gel, a clear substance that can become cloudy or filled with blood. Common indications for vitrectomy surgery include retinal detachment, macular hole, vitreous haemorrhage, diabetic retinopathy, and epiretinal membrane.

What specific preparations do I need to make before undergoing vitrectomy surgery?

Before undergoing vitrectomy surgery, patients will need to make several specific preparations to ensure the procedure goes smoothly and the recovery process is as comfortable as possible:

Medical evaluation: Patients will undergo a comprehensive eye examination and medical evaluation by their ophthalmologist to assess their overall eye health and identify any underlying conditions that may affect the surgery or recovery.

Medication review: Patients should inform their ophthalmologist of all medications they are currently taking, including prescription medications, over-the-counter drugs, and supplements. Certain medications may need to be adjusted or temporarily stopped before the surgery takes place.

Medical history: Patients should provide their medical history, including any previous eye surgeries, allergies, and chronic health conditions. This information will help the ophthalmologist assess the patient's suitability for vitrectomy surgery and plan the procedure accordingly.

Pre-operative instructions: Patients will receive specific pre-operative instructions from their ophthalmologist regarding eating, drinking, and taking medications before the surgery. It's essential to follow these instructions carefully to ensure the surgery can proceed safely.

How is vitrectomy surgery performed?

Before the procedure begins, the patient will receive anaesthesia to ensure comfort throughout the surgery. Depending on the patient's medical history, either local anaesthesia (numbing the eye and surrounding area) or general anaesthesia (inducing unconsciousness) will be used.

Once the anaesthesia has taken effect, the surgeon will make tiny incisions in the sclera, which is the white part of the eye, to access the vitreous gel.

Using specialised instruments such as a vitrector, the surgeon will then carefully remove the vitreous gel. This step will allow the surgeon to access and treat the underlying retinal or vitreous conditions. For example, if the patient has a retinal detachment, the surgeon will reattach the retina using various techniques such as laser therapy or the injection of a gas or silicone oil bubble.

Once the vitrectomy and any additional procedures are complete, the surgeon will use small stitches to close the incisions in the sclera. In some cases, the incisions may be left to heal on their own without stitches.

After the surgery, the patient will be monitored in a recovery area to ensure stability before being discharged. Patients will receive instructions on postoperative care, including the use of eye drops, activity restrictions, and follow-up appointments.

The duration of vitrectomy surgery will vary depending on the complexity of the condition being treated. Generally, the procedure will take about one to two hours to complete. While rare, in certain cases where both eyes require treatment, vitrectomy will be performed on both eyes in separate procedures, with adequate time for recovery between surgeries.

Are there any risks or potential complications associated with vitrectomy surgery?

As with any surgical procedure, vitrectomy surgery carries certain risks and potential complications, including:

• infection after the procedure
• bleeding during or after the procedure
• retinal detachment
• fluctuations in intraocular pressure
• cataract formation after the procedure

How soon will my vision improve after vitrectomy surgery?

While the primary goal of vitrectomy surgery is to improve or stabilise vision, immediate improvement may not be noticeable. It will take time for the eye to heal and for vision to gradually improve, often over the course of several weeks to months. The extent of vision improvement will also depend on several factors, including the underlying condition being treated, the success of the surgery, and individual healing responses.

If you would like to schedule an appointment with Mr Serafeim Antonakis, head on over to his Top Doctors profile today.