Vitrectomy: Vitreous Removal, Indications, and Vision Restoration
Vitrectomy helps the doctor work inside the eyeball when blood, scar tissue, or tears interfere with the normal functioning of the visual system. We consider surgery for conditions where delay could worsen the prognosis.
The decision is made after an in-person examination, as the outcome depends on the diagnosis, the duration of the complaints, and the condition of the internal structures.
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What is vitrectomy and what problems does it solve?
Vitrectomy is a surgical procedure in which the doctor removes the vitreous humor from the eye. When healthy, it remains transparent and transmits light to the retina. When blood, dense opacities, or scar tissue forms within, light passes less effectively, and the tissues may experience tension.
Removing the vitreous humor gives the surgeon access to the problem area. The doctor then:
- Removes blood
- Removes membranes
- Treats tears
- If necessary, fixes tissue from within
The goal of the procedure is to preserve the anatomy of the eye and maintain vision as much as possible given the diagnosis.
How does vitrectomy differ from other ophthalmological procedures?
Laser, injections, and observation are used according to their indications. For problems inside the eye, these methods are often insufficient. Endovitreal surgery provides access to the posterior segment through microincisions.
Vitreoretinal surgery is necessary for pathologies of the vitreous body, macula, and fundus. Accurate diagnosis is essential here, as similar complaints can have different causes. The method is chosen based on the actual picture inside the eye.
When does surgery help preserve vision?
Surgery is especially important in cases of rapid deterioration, the appearance of "curtains," flashes, dense floaters, or a sharp decrease in clarity. Such complaints may indicate:
- Hemorrhage
- Rupture
- Detachment
The patient should consult a retinal specialist without waiting for the planned improvement.
If there is blood in the eye, the doctor assesses its volume and the condition of the fundus. In cases of dense opacities, vitrectomy surgery helps remove the blood and identify the source of the problem. In cases of tractions and tears, the approach is aimed at realigning the retina.
Indications for vitrectomy
Indications are determined after an examination. We check visual acuity, intraocular pressure, media transparency, the condition of the macula, blood vessels, and the periphery of the fundus. If the view is obscured by blood or cloudiness, the doctor uses additional tests.
Hemophthalmos
This is a hemorrhage into the cavity containing the vitreous humor. The patient may see a dark curtain, a reddish haze, large spots, or almost complete opacity. The cause must be sought:
- Vascular disease
- Trauma
- Rupture
- Diabetic lesion
If the hemorrhage is small, the doctor may choose to observe and treat the underlying condition. However, when blood persists within the eye for a long time, interferes with examination, or there is a risk of retinal tear, vitreous removal is considered. Surgery helps remove the opacity, opens the doctor's view, and allows treatment of the underlying cause.
Retinal Detachment
A condition in which time is of the essence. The inner lining separates from the underlying layer, and visual cells quickly suffer without adequate nutrition. A person may notice lateral shadows, flashes, or loss of a portion of the visual field.
For complex tears, tractions, or hemorrhages, vitrectomy may be part of the surgical treatment plan. During the procedure, the doctor removes traction, treats the tears, and administers a supportive medium. Early treatment helps determine the most appropriate strategy.
Macular hole and epiretinal membrane
With a macular hole, the central area of the retina suffers. It helps to read, distinguish faces, see small text and details of objects. Most often, the patient complains of distorted lines, a spot in front of the eye, and difficulty working at close range. The doctor specifies the size of the defect, the time of onset of complaints and the condition of the tissues around the gap.
The epiretinal membrane is a thin scar film that forms on the surface of the macula. It can tighten the retina, causing images to become uneven and straight lines to appear crooked. If complaints are severe, the surgeon can remove the membrane and reduce tissue tension. The final restoration of vision depends on how much the macula was changed before surgery.
Complications of Diabetic Retinopathy and Other Conditions
Diabetic retinopathy damages the blood vessels in the fundus and can lead to hemorrhages, membranes, traction, and detachment. In complex cases, surgical treatment helps remove the blood and scar tissue that is pulling on the inner linings. Before surgery, we consider blood sugar control, vascular changes, and the risk of rebleeding.
Other indications include trauma, intraocular foreign bodies, inflammatory sequelae, and certain conditions following previous surgeries. Potential complications are assessed individually. The benefits of the procedure should outweigh the surgical risks.
Some symptoms require urgent evaluation. We ask that you do not wait for your scheduled appointment if you experience:
- A sharp deterioration in vision
- A "curtain" or shadow
- Blood in the vitreous
- Suspected detachment
- Rapid progression of diabetic changes
This list helps you assess the urgency of your visit. The final treatment decision will be made by your doctor after an examination.
General information
Types of Vitrectomy
There are several types of vitrectomy. They differ in the area of intervention, the access method, and what the surgeon fills the eye cavity with after removing the affected tissue.
Anterior and Posterior Vitrectomy
Anterior vitrectomy is used for problems in the anterior segment of the eye. The posterior technique is used for pathology in the posterior segment, where the retina, macula, and optic nerve are located. The purpose of the surgery, the extent of the intervention, and the follow-up plan are important to the patient.
| Type of vitrectomy | When it is used | What is important to the patient |
|---|---|---|
| Anterior | For problems in the anterior segment of the eye | Understand the purpose and extent of the intervention |
| Posterior | For pathologies of the retina and vitreous body | Accurate diagnosis and follow-up are needed |
| Microinvasive | When a gentle procedure is needed Access | Typically less traumatic to tissue and easier to recover from. |
The table shows the general differences between the options. The specific method is selected after an examination, taking into account the diagnosis, the transparency of the media, and the condition of the internal structures.
Microinvasive vitrectomy
Performed through thin incisions. An illuminator, vitreotome, and other instruments are inserted through them. Modern microinvasive surgery reduces the trauma of the approach, but the surgery remains an intraocular procedure.
The vitreoretinal surgeon explains the planned scope in advance. Sometimes the surgical approach is adjusted intraoperatively if the following are detected:
- Additional ruptures
- Dense membranes
- Unstable areas
This decision is based on tissue safety.
Tamponade with gas, air, or silicone oil
After the main part, the eye cavity is filled with a medium that helps maintain the internal tissues in the correct position. The surgeon may use air, gas, or silicone oil. In some cases, gas tamponade is used, and the patient receives special instructions on head positioning.
Frequently Asked Questions
What does the patient feel after surgery?
How long does recovery take?
Can vision be fully restored?
Is a repeat operation necessary?
What is a vitrectomy in simple terms?
When is vitrectomy prescribed?
Vitrectomy surgery requires a precise assessment and meticulous planning. We conduct a consultation, examination, select a surgical approach, and provide postoperative care.
If the doctor determines that vitreous removal can help preserve tissue and improve the prognosis, the treatment plan is discussed in detail without any guarantees.
At "K+31," an ophthalmic surgeon explains examination results in clear language and answers questions before surgery. If you experience a sudden deterioration, a shadow, flashes of light, blood in front of the eye, or suspected detachment, it's best to consult immediately.
Scheduling a consultation helps you quickly understand the cause of your complaints and choose a safe treatment plan.
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