Vitrectomy – retinal surgery
This is a surgical procedure performed in the posterior segment of the eyeball. It offers the possibility of treating disorders of the retina and the vitreous body, the part located behind the lens of the eye.
What is vitrectomy?
Vitrectomy consists of access to the intraocular space, removal of the vitreous body and additional procedures in diseases of the retina and the border between the vitreous body and the retina. Diseases of the retina, uvea and vitreous body are treated in this way. Vitrectomy surgery is performed under local anaesthesia – with peribulbar injection.
Thanks to the development of innovative technology and the introduction of new surgical methods, modern equipment and diagnostic tests, the number of diseases that can be treated using vitrectomy has increased significantly. Vitrectomy is a chance to regain or maintain vision for eye conditions that were until recently considered incurable.
Vitrectomy in brief:
- Microsurgical procedure.
- Surgery performed in the eyeball.
- Removal of the vitreous body.
- Surgical procedure performed under local (peribulbar) anaesthesia.
- Surgery carried out by a specialist in ophthalmic surgery.
- Treats diseases of the vitreous body of the retina and uvea.
- Offers the chance to maintain vision and sometimes improve it.
What does vitrectomy surgery involve?
- Vitrectomy surgery is performed under local anaesthesia, following the injection of an anaesthetic into the eyeball area. The surgeon uses an operating microscope, and precise surgical instruments are inserted into the eyeball through millimetre-long incisions in the walls of the eyeball, using them to remove the vitreous body, together with the opacities and diseased tissues contained therein. Adequate fluids are introduced in place of the removed vitreous body, allowing the desired tension of the eyeball to be achieved.
- For some conditions, a bubble of gas or silicone oil is injected into the vitreous chamber. This keeps the head in a fixed position for several days after the surgery in order for these substances to arrange themselves in the right place in the eye, pressing the retina from the inside against the walls of the eye until its full post-operative stabilisation is achieved. If silicone oil has been injected into the vitreous chamber during surgery, it is usually removed surgically after a period determined by the operator.
- Our equipment enables most sutureless surgeries to be performed. Depending on the intraoperative conditions, the surgeon decides whether to place sutures, making the procedure safer.
Step-by-step vitrectomy:
- Make an appointment in person at the registration desk or by telephone by calling the telephone number 71 701 10 10.
- Medical consultation and preliminary examination (qualification for vitrectomy surgery).
- Coming for surgery to a specialist surgeon.
- Preparation of modern and proven equipment by the doctor to enable the surgery to be performed accurately.
- Administration of local anaesthesia.
- Insertion of precision instruments through a small incision.
- Removal of the vitreous body together with the opacities within it.
- The introduction of appropriate fluids into the area of the removed vitreous body to achieve the desired eyeball tension.
- Post-operative follow-up.
What are the indications for vitrectomy?
The following lesions should send you immediately for medical consultation. The specialist will determine whether and when to carry out surgery. Upon successful qualification, an appointment for a vitrectomy will become available.
- endophthalmitis that does not improve despite treatment and post-inflammatory dense vitreous floaters
- haemorrhages into the eyeball that do not absorb on their own (in diabetes, after trauma, in retinal vein occlusion)
- foreign bodies penetrating the eyeball as a result of trauma – indication for urgent surgery
- folding of the natural or artificial lens into the vitreous body
- retinal diseases, i.e. retinal detachments, abnormal connections between the retina and the vitreous body, epiretinal membranes deforming the retinal surface, macular holes
In the above-mentioned lesions, no improvement in vision can be expected without surgery. In some cases (e.g. endophthalmitis or retinal detachment), complete and irreversible blindness may rapidly develop.
What are the chances of improved vision after vitrectomy?
The surgical procedure aims to restore the highest possible level of normal condition of the eyeball. However, the return of vision takes a longer time, and the improvement depends on the extent of the retinal damage. Of course, specialists in the field of ophthalmic surgery precisely and accurately perform the entire procedure to save the patient’s vision as much as possible.
The retina is a nervous tissue that has 10 layers of different cells, but only one layer of photoreceptors are very sensitive to damage. They are not capable of regeneration or restoration. The longer the disease lasts, the more retinal cells die irreversibly. Even a good surgical result of restoring normal anatomical conditions does not restore good vision if the retina has been destroyed by a foreign body, infection or the long-term hypoxia that occurs in the ocular complications of diabetes. Each case is individual and depends on many factors. However, it is important to bear in mind that our specialists have already carried out such procedures and treat each patient in a bespoke manner.
For uncomplicated vitreous haemorrhages, most patients achieve improved vision. However, if the haemorrhage was due to severe diabetes, it cannot be ruled out that a repeat haemorrhage will occur despite successful surgery. Surgery is necessary, as it allows the retinal condition to be monitored and further treatment to be undertaken. In the case of vitrectomy to remove a foreign body, the further fate of the eye and the ability to see depend on the mechanical, chemical or infectious damage caused by its penetration into the eye.
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