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Vitrectomy

A vitrectomy is a surgical procedure that removes the vitreous in the central cavity of the eye so that vision can be corrected. It is beneficial in many disease states including diabetic eye disease (diabetic retinopathy), retinal detachments, macular holes, macular pucker, and vitreous hemorrhage.


The vitreous is normally a clear, jelly-like fluid that fills the inside of the eye. Various disease states can cause the vitreous to cloud, fill with blood, or even harden so that light entering the eye will be misdirected and not reach the retina properly.


The vitrectomy procedure is usually performed as an outpatient procedure. Rarely, an overnight stay in the hospital is required. Local or general anesthesia may be used. The eye will be held opened using a special speculum, and the eye that is not being operated on will be covered with a patch.


The procedure begins with the surgeon making a small (less than 2 mm) slit in the side of the eye and inserting an infusion line to maintain constant eye pressure. Next, a microscopic cutting device is inserted which will aspirate (suck out) the vitreous fluid.


A microscopic light source is also inserted to illuminate the inside of the eye through the procedure. Additional instruments may also be used to perform additional maneuvers such as cauterizing blood vessel leaks or removing scar tissue.


The surgeon will look through a microscope while performing the procedure. The surgeon may also use special lenses to help see the anatomy of the eye. After the vitreous is removed, the surgeon will refill the eye with a special saline (salt) solution that closely resembles the natural vitreous fluid in your eye. Tiny absorbable stitches are used to close the three small openings and antibiotic injections to prevent infection will be instilled at the end of the procedure.


Vitrectomy has been commonly performed and perfected for over 30 years. However, certain risks do exist. They include:



Retinal detachment during or after the procedure is the most common risk. The surgeon is prepared for this to happen and can repair the detachment by inserting gas that applies pressure on the retina before completing the case.


The retinal detachment will heal during the normal vitrectomy healing time, which is between 4 to 6 weeks. Normal restoration of vision can take several weeks. Physical activity will be restricted during this time to prevent complications.

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