Vitrectomy surgery aims to restore the retina’s ability to see clearly by removing the vitreous fluid that fills the back chamber of the eye. Vitrectomy surgery is considered the gold standard in cases such as diabetic hemorrhage, macular hole, retinal tear and intraocular foreign body. Vitrectomy surgery usually heals quickly and without stitches, as the surgeon cleans the vitreous and repairs the retina with millimetric trocars placed near the cornea. Vitrectomy surgery requires preparations such as stopping aspirin and taking an OCT scan before the operation; it takes about an hour with local or general anesthesia. Vitrectomy surgery is supported with antibiotic drops, positioning and physical restrictions in the post-operative 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, complications such as infection, glaucoma and cataract are managed with regular check-ups. While vitrectomy surgery is covered by the Social Security Institution for medical indications, the price in private hospitals may vary depending on the tamponade and physician experience. Vitrectomy surgery is an advanced microsurgical method that prevents permanent vision loss and provides highly satisfactory results if performed on the appropriate patient in a timely manner.
What is Vitrectomy Surgery?
Vitrectomy surgery is the surgical removal of 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 in the vitreous and provide a transparent environment where the retina can catch light again without any problems. Modern vitrectomy surgery is performed with pencil-thin instruments called 23–27 gauge; thus, the need for stitches is low and the recovery period is short.
In Which Cases Is Vitrectomy Surgery Necessary?
Vitrectomy surgery is most commonly preferred to clean intense intraocular bleeding in diabetic retinopathy. In addition, macular retraction accompanying retinal tears, foreign bodies developing as a result of trauma, intraocular infection (endophthalmitis), macular hole, epiretinal membrane and some hereditary vitreoretinal diseases may also require surgery. Early intervention protects 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. If necessary, the patient’s regular aspirin or blood thinners can be temporarily discontinued. 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 hypertensive patients. Coming home hungry on the morning of the surgery and leaving the face area without makeup reduces the risk of infection.
How is Vitrectomy Surgery Performed?
During vitrectomy surgery, the surgeon places three millimeter tubes (trocars) at the junction of the cornea and sclera. One door is for the illumination probe, the other for the microvitrectome cutter, and the third for the auxiliary instrument. The vitreous fluid is fragmented and aspirated with the microcutter, while the eye is simultaneously filled with sterile saline. If retinal repair is needed, laser or freezing (cryoretinopexy) is applied; if necessary, gas (SF6, C3F8) or silicone oil is administered as an intraocular buffer. The choice of tampon is determined by the location and size of the tear.
Recovery Process After Vitrectomy Surgery
• Mild stinging and watering can be expected on the first day; artificial tear drops provide relief.
Antibiotic and steroid drops prescribed by the doctor prevent infection and edema.
Patients who have had a gas tampon applied should maintain the prone or side-lying position for a few days, depending on the location of the gas.
Heavy lifting, prolonged bending forward and swimming in the pool are prohibited for the first three weeks.
Visual acuity gradually increases as the gas melts or after silicone oil is removed.
Vitrectomy Surgery Risks and Complications
• Although the risk of infection (endophthalmitis) is low, urgent evaluation is required in case of redness and intense pain in the first week.
Increased intraocular pressure (secondary glaucoma) is especially observed in patients with gas tampons; pressure-regulating drops can be added.
The possibility of developing cataracts increases with age; if lens clouding occurs, cataract surgery is planned in the future.
• The retina may tear again or detach; if detected early, it is treated with revision vitrectomy.
Although rare, optic nerve damage can lead to permanent vision loss; regular check-ups minimize this.
Vitrectomy Surgery Success Rates
Vitrectomy surgery provides 85–90 percent anatomical success with modern techniques. Functional, i.e. vision increase, depends on the type of underlying disease, its duration and how much the macula region of the retina is affected. Success in diabetic hemorrhages is directly related to the sugar control that feeds the vessel; in traumatic foreign body cases, early intervention significantly protects vision.
Frequently Asked Questions About Vitrectomy Surgery
Can I board a plane with a gas tampon?
No. The gas can expand in cabin pressure and increase intraocular pressure to dangerous levels; the flight should be postponed before the gas is completely absorbed.
How long does vitrectomy surgery take?
It takes between forty-five minutes and one hour on average; the time may be longer in complex retinal repairs.
When is silicone oil removed?
After the retina is stable, it is removed with a second minor surgery three to six months later.
Will my eye number change after vitrectomy surgery?
Since the cornea is not touched, no major change in refractive error is expected; however, if cataract develops, the number is revised after surgery.