Vitrectomy

Vitrectomy is a surgical procedure that entails the partial or complete removal of the vitreous gel from the eye. The vitreous gel is a gel-like substance that fills the space between the retina and the lens, contributing to the maintenance of the eye's shape. During a vitrectomy, a small incision is made in the eye to access the vitreous gel, and a specialized instrument known as a vitrectome is employed to cut and aspirate the gel.

In addition to vitreous gel removal, vitrectomy may also encompass other techniques, such as the use of lasers or the insertion of gases or oils into the eye. These additional techniques aim to stabilize the retina or address specific eye conditions.

Vitrectomy may be indicated for various eye conditions, including:

Macular hole: It is an opening in the macula, the central part of the retina responsible for detailed vision. Vitrectomy is performed to close the macular hole and improve vision.

Retinal detachment: Vitrectomy is used to treat retinal detachments in which the retina has separated from its normal position at the back of the eye. During vitrectomy, laser or cryotherapy may be used to seal tears or breaks and reposition the retina.

Vitreous hemorrhage: Vitrectomy may be necessary in cases of severe vitreous hemorrhage, where bleeding in the vitreous gel affects vision. By removing the vitreous gel and replacing it with a saline solution or gas, vision can be improved.

Epiretinal membranes: These are layers of fibrous tissue that form on the surface of the retina, distorting vision. Vitrectomy can be used to remove these membranes and restore macular anatomy.

Diabetic retinopathy: It is a common complication of diabetes mellitus that affects retinal function. Vitrectomy is performed in advanced cases with intraocular bleeding and/or retinal detachment.

Uveitis: It involves inflammation inside the eye that affects one or more parts of the uvea. Vitrectomy is performed when there is persistent opacity in the vitreous, intraocular hemorrhages, or retinal detachment.

Vitrectomy is performed under local or general anesthesia, depending on the case and the patient's and surgeon's preferences. During the procedure, small incisions are made in the eye to introduce the necessary surgical instruments, such as the vitrectome.

Through these incisions, access to the vitreous gel is gained, and it is carefully removed. During vitrectomy, other instruments may be used to perform additional techniques, such as using a laser to treat retinal tears or inserting gases or oils to stabilize the retina.

After the surgery is completed, a bandage is applied for a few hours.

The results of vitrectomy vary depending on the specific condition treated and the individual characteristics of each patient. In general, vitrectomy aims to treat the pathology and minimize its consequences. Improvement in visual acuity will depend on the patient's condition and the time required for it to happen.

While vitrectomy is a safe technique, like any surgical procedure, there are risks and possible complications. Some potential risks of vitrectomy include:

Ocular infection: There is a risk of infection after surgery. It is important to follow postoperative care instructions and take prescribed medications as directed to reduce the risk of infection.

Intraocular hemorrhage: During surgery, bleeding in the eye can occur. However, this risk is controlled and managed during the procedure.

Cataracts: Vitrectomy can increase the risk of developing cataracts, which are lens opacities that affect vision. In some cases, additional surgery may be necessary to treat cataracts.