Vitrectomy is an operation of the eye. It consists of removing the vitreous body, the transparent gel that keeps our eye in a round shape, often to remove floating bodies (the “black spots” on the vision), or to reach the back of the eye and treat d other disorders (retinal detachment, hemorrhages). It is a heavy operation with many possible complications, so it is not to be taken lightly.
What is a vitrectomy?
A vitrectomy surgery is an operation of removing the vitreous from the eye. The vitreous is what keeps our eye round and spherical, it consists of floating cells and transparent and gelatinous material.
It is removed either because it is failing (appearance of black spots in the vision), or as part of an operation of the larger eye (to reach the retina for example).
The vitreous can also come off, often with age. In this case, the patient sees blackheads or other forms that disturb his vision (like spider webs or flying insects).
It should be known that vitrectomy is a heavy operation, often followed by undesirable consequences such as a detachment of the retina. vitrectomy is often followed by cataract surgery as a precaution. It is reserved for the major disorders of the vision of the eye, in France, the ophthalmologists prefer to recommend to get used to living with small black dots, rather than to risk worsening the situation.
Preparing for a vitrectomy
Apart from good hydration, nothing special is recommended before a vitrectomy operation. To know all the same: after the operation, it will be impossible to drive or practice certain visual activities for a certain period. Better not to come alone by car!
The period of hospitalization will vary, it varies from a few hours to a few days. This will be defined with your ophthalmologist.
The operation in several stages
- The patient is stretched out on the back, the eye aligned with an operating microscope.
- The surgeon will insert several metal tubes into the eye, cannulas. With one of them, he sucks the vitreous body (in order to remove dead cells or blood). In parallel, a liquid is injected into the eye using a second tube. This liquid is a gel similar to the vitreous body and serves to compensate for the loss of volume. Indeed by removing the vitreous, the pressure in the eye decreases. It is to avoid any complication that we add this liquid (sometimes replaced by gas or silicone oil).
- The operation continues, according to different protocols. Vitrectomy is often used only as an intermediate step for other operations such as retinal detachment, retinopathy, eye hemorrhage, laser surgery or macular disorders (the macula is the central area of the eye). the retina).
Why practice a vitrectomy?
Vitrectomy is an intermediate operation in most cases. Indeed, the vitreous being in the eye, it must often be removed to reach the bottom of the wall (retina, macula, optic nerve). Vitrectomy can, therefore, accompany different diseases or infections.
After the operation
If the vitreous body has been replaced by gas, the patient will be required to maintain a specific position of the head. Air travel will be discouraged during this period: the strong pressure variation between the ground and the altitude would change the volume of gas in the eye and therefore lead to complications.
If silicone oil has been added to the eye, it will take a second operation to remove it.
After a vitrectomy, it takes several days or even weeks for the patient to fully recover the sight, depending on the nature of the operation.
Some activities are discouraged: operations with dangerous machines or instruments (because of the risk of loss of vision, see the “complications” part), as well as the driving of a motor vehicle.
Vitrectomy is a very heavy operation, and complications are numerous
The lens of the eye, becomes opaque after removal of the vitreous body, especially if the age of the patient exceeds 50 years. Cataract surgery is very often required after vitrectomy.
- The detachment of the retina
This will require a new patching operation.
- Macula disorders
- Loss of vision of the eye or loss of the eye (in the rarest cases)
We see that the operation is not to be taken lightly. The ophthalmologist must, therefore, discuss with his patient the need or not to perform the operation.