What is Vitrectomy Surgery? How To?

Vitrectomy surgery aims to restore clear vision to the retina by removing the vitreous fluid that fills the posterior chamber of the eye. Vitrectomy surgery is considered the gold standard in cases such as diabetic bleeding, macular hole, retinal tear and intraocular foreign body. Vitrectomy surgery usually heals seamlessly and quickly, as the surgeon cleans the vitreous and repairs the retina through millimetric trocars placed near the cornea. Vitrectomy surgery requires preparations such as stopping aspirin and taking OCT before the operation; It takes about an hour with local or general anesthesia. Vitrectomy surgery is supported by antibiotic drops, positioning and physical restrictions in the postoperative period; vision improves as the gas dissolves or silicone oil is removed. Although vitrectomy surgery has an anatomical success rate of up to 90 percent, risks of complications such as infection, glaucoma and cataracts are managed with regular check-ups. While vitrectomy surgery is covered by SSI for medical indications, the price may vary in private hospitals depending on the buffer material and physician experience. Vitrectomy surgery is an advanced microsurgical method that prevents permanent vision loss and provides highly satisfactory results if applied on the appropriate patient in a timely manner.

What is Vitrectomy Surgery?

Vitrectomy surgery is the process of surgically removing the jelly-like vitreous fluid that fills the back of the eye and replacing it with a clear solution. The aim is to eliminate bleeding, inflammation, membranes, foreign bodies or fibers that cause shrinkage within the vitreous and to provide a transparent environment in which the retina can capture light again without any problems. Modern vitrectomy surgery is performed with pencil-thin instruments called 23–27 gauge; In this way, the need for stitches is less and the recovery time is short.

In Which Situations Is Vitrectomy Surgery Necessary?

Vitrectomy surgery is most commonly preferred to remove extensive intraocular bleeding in diabetic retinopathy. In addition, macular traction accompanying retinal tear, foreign body resulting from trauma, intraocular infection (endophthalmitis), macular hole, epiretinal membrane and some hereditary vitreoretinal diseases may also require surgery. Early intervention preserves the nutrition of the retina and reduces the risk of permanent vision loss.

Preparation Before Vitrectomy Surgery

After the surgical decision, fundus examination, optical coherence tomography (OCT) and ultrasound images clarify the operation plan. Aspirin or blood thinners that the patient uses regularly are temporarily discontinued, if necessary. Vitrectomy surgery can be performed under local or general anesthesia; Attention is paid to blood sugar regulation in diabetic patients and blood pressure control in hypertension patients. Arriving hungry and leaving the facial area without make-up on the morning of the surgery reduces the risk of infection.

How is Vitrectomy Surgery Performed?

During vitrectomy surgery, the surgeon inserts three millimetric tubes (trocars) through the junction of the cornea and sclera. One is for the door illumination probe, the other is for the micro vitrectome cutter, and the third is for the auxiliary instrument. While the vitreous fluid is fragmented with a microcutter and aspirated, the eye is simultaneously filled with sterile saline. If retina repair is needed, laser or freezing (cryoretinopexy) is applied; If necessary, gas (SF6, C3F8) or silicone oil is given as intraocular buffer. The choice of tampon is determined by the location and size of the tear.

Recovery Process After Vitrectomy Surgery

First Day — Slight stinging and watering can be expected on the first day; Artificial tear drops provide relief.
Drop Treatment — Antibiotic and steroid drops prescribed by the doctor prevent infection and edema.
Position — Patients with gas tamponade should maintain the prone or side-lying position for a few days, depending on the location of the gas.
Restrictions — Heavy lifting, bending forward for long periods and swimming in the pool are prohibited for the first three weeks.
Vision Improvement — Visual acuity gradually increases as the gas dissolves or after silicone oil is removed.

Vitrectomy Surgery Risks and Complications

Infection — Although the risk of infection (endophthalmitis) is low, immediate evaluation is required in case of redness and intense pain in the first week.
Intraocular Pressure — Increased intraocular pressure (secondary glaucoma) is observed especially in gas-buffered patients; Pressure regulating drops can be added.
Cataract — The likelihood of developing cataracts increases with age; If lens clouding occurs, cataract surgery is planned in the future.
Retinal Retear — The retina may tear again or develop detachment; If detected early, it is treated with revision vitrectomy.
Optic Nerve Damage — Although rare, optic nerve damage can lead to permanent vision loss; regular checking minimizes this.

Vitrectomy Surgery Success Rates

Vitrectomy surgery provides an anatomical success rate of 85-90 percent with modern techniques. Functional, that is, vision increase, depends on the type and duration of the underlying disease and how much the macular region of the retina is affected. Success in diabetic bleeding is directly related to blood sugar control; Early intervention in traumatic foreign body cases significantly protects vision.

Frequently Asked Questions

No. The gas expands at cabin pressure, increasing intraocular pressure to dangerous levels; The flight must be postponed before the gas is completely absorbed.

On average, it takes between forty-five minutes and an hour; In complex retinal repairs, the time may be longer.

Three to six months after the retina is stable, it is removed with a second minor surgery.

Since the cornea is not touched, no major change in refractive error is expected; However, if cataracts develop, the number is revised after surgery.