A less common eye surgery is a vitrectomy—a procedure in which the vitreous humor of the eye is removed and replaced with an artificial fluid.
Some examples of when a vitrectomy may be performed include for individuals with an excessive number of “floaters” within their vision, those with blood in the vitreous, serious eye infections, some cases of retinal detachment, excessive eye inflammation/swelling, uncontrolled diabetic retinopathy, some cases of macular holes, and in some cases of eye trauma.
What is the Vitreous Humor?
To best understand the process of a vitrectomy, you will need to know what the vitreous humor is.
The eye is composed of two major compartments—the anterior chamber and the posterior chamber.
The posterior chamber is filled with a fluid called the vitreous humor.
The vitreous humor consists of mostly water, but also collagen and hyaluronic acid.
The vitreous humor’s main role occurs during development. It is used to provide nutrition to growing eye structures during the first few weeks of fetal development.
After the eye has developed fully, the vitreous humor no longer needs to provide nutrition. Therefore, it remains stagnant in the eye with its only remaining role to be structural support.
Over time, the vitreous components begin to separate in a process called a posterior vitreous detachment. During a posterior vitreous detachment, the vitreous humor shrinks up and can pull away from the retina
Typically, posterior vitreous detachments are harmless, however they can also induce serious problems such as vitreous hemorrhages or retinal detachments if the vitreous is too firmly adhered to the retina and rips it as it pulls away.
For this reason, vitrectomies may be performed in some cases to preserve the integrity of the retina and prevent retinal detachments.
In other cases, vitrectomies may be performed to remove blood from the vitreous, as blood clouds the vitreous and can severely interfere with vision (think about looking through murky lake water instead of clear water).
What is a Vitrectomy?
A vitrectomy is a surgical procedure in which the vitreous humor is essentially sucked out of the eye and replaced with an artificial fluid such as silicone oil.
This is accomplished by making a small incision to the outer wall of the eye (the sclera).
Specialized imaging technology is used to allow the surgeon to visualize the posterior chamber of the eye so that he or she can see what they are doing.
A special tool is then be inserted into the eye to gently suck out the vitreous humor, leaving the retina and other eye structures untouched.
The outer eye wall is then sealed with either special glue or stitches.
You will be given an antibiotic eye drop to instill in the eye for a few days following surgery to prevent infection. You will likely also be given an eyepatch to wear for a day or two following surgery to ensure the eye is protected from outside forces.
Following the surgery you will be given special instructions on how to sleep/angles to hold your head at as it is crucial that the replacement vitreous (silicone oil) is given time to properly settle into the eye as to not affect vision down the road.
What Are Adverse Effects Post-Vitrectomy Surgery?
For the most part, vitrectomies are very safe and very rarely result in serious adverse effects.
The most common side effect of a vitrectomy is increased light sensitivity (photophobia). This occurs because the natural vitreous has some UV blocking properties that the artificial vitreous does not. Therefore, more light passes unaltered through the eye to reach the retina.
Other more serious adverse reactions include eye infection, retinal detachment, increased rate of cataract development, and secondary damage to other eye structures.
While safe, a vitrectomy is a surgery and should be saved as a more progressed treatment option to be explored after non-invasive treatment options have failed.
If you or someone you know is considering a vitrectomy, be sure to discuss it with your eye doctor. He or she would be happy to discuss the procedure further with you to help prepare for surgery.
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