Sometimes, a vitreous hemorrhage can clear up on its own. If vision does not improve, vitrectomy surgery may be necessary. A vitrectomy is a surgical procedure that is performed to remove the clouded vitreous gel in the center of the eye. The gel is replaced with a solution that is similar to the makeup of healthy, clear vitreous matter. This diabetic retinopathy treatment has a very high success rate for improving vision.
Vitrectomy surgery may also be used to remove scar tissue remaining as a result of retinal detachment. Once the scar tissue is no longer pulling on the retina, the retina will usually settle back into place and flatten out, which will improve vision.
The Vitrectomy Procedure
Vitrectomies can be performed under local or general anesthesia. During vitrectomy surgery, your surgeon will first remove the blood-clouded vitreous gel from your eye. The vitreous tissue is then cut and removed one piece at a time and replaced with a special salt solution in order to maintain the eye's proper shape and pressure. The inside of the eye is illuminated, and the surgeon views the eye through a microscope.
In the case of a severely detached retina, it may be necessary to inject expandable gas into the eye during vitrectomy surgery. The expanding gas bubble pushes against the retina, helping it reattach. Patients must often lie face-down for two to four days until the gas bubble dissipates.
During vitrectomy surgery, a laser may be used to perform photocoagulation across the surface of the retina. This photocoagulation helps to prevent the formation of scar tissue and bleeding, and may also prevent the future growth of abnormal blood vessels.
During your vitrectomy recovery, your eye will be covered with a patch, which you can remove at bedtime. You will also be given eye drops to help speed your recovery after vitrectomy surgery.
Your eye may be swollen and uncomfortable for several days during your vitrectomy recovery period. The discomfort you will feel is generally caused by the swelling outside of the eye. An ice compress and over-the-counter medication should help relieve the swelling and pain. If you experience a deep or throbbing pain which is not relieved by over-the-counter medication, call your doctor right away.
If you are treated for retinal detachment with an expandable gas bubble, you will have to lie face-down for several days as part of your vitrectomy recovery. This is necessary to keep the bubble in the proper position. After excess scar tissue and blood vessels have been removed, the gas bubble will push your retina back into place.
Vitrectomy complications range from having no improvement in your vision to permanent vision loss, though the majority of vitrectomy surgeries are successful. Vitrectomy-related complications are on the decline as a result of improved surgical techniques.
About 82 percent of vitrectomy patients experience significant improvements in vision after the surgery. Of the 18 percent of patients who experience vitrectomy complications, 9 percent have no improvement in their vision, and 9 percent experience permanent vision loss.
Neovascular glaucoma, one of the vitrectomy complications that can occur, causes permanent blindness in about 3 percent of vitrectomy patients. Neovascular glaucoma occurs when new blood vessels grow in the eye, blocking the drainage ducts. This blockage prevents fluid from draining properly and causes a build-up of pressure in the eye.
The risk for developing vitrectomy complications varies, depending on whether or not other procedures are performed in conjunction with your vitrectomy.
If you are required to lie face-down during your vitrectomy recovery, it is important that you follow your doctor's orders very carefully in order to avoid unnecessary vitrectomy complications.
Vitrectomy results vary because other procedures are often performed in conjunction with the surgery. Your vitrectomy results depend largely on the reason you are having the surgery-whether to remove clouded vitreous gel, scar tissue, or excess blood vessels.
Unlike laser photocoagulation, a vitrectomy usually results in improved vision and fewer diabetic retinopathy symptoms. The replacement of blood-clouded vitreous gel with a clear solution (a basic vitrectomy) results in marked vision improvement. Along with a vitrectomy, your surgeon may remove scar tissue or excess retinal blood vessels. If the removed scar tissue or blood vessels were causing the retina to detach, their removal will result in improved vision as the retina moves back into position. Scar tissue and blood vessels may also be removed if they are blocking drainage ducts.
Although your vitrectomy results depend on many factors, your vision should begin to improve in about a week.
In order to maintain favorable vitrectomy results and slow the progression of diabetic retinopathy, it's important that you control your blood sugar by checking it frequently, keeping all follow-up appointments with your surgeon, and having your eyes examined by an ophthalmologist at least once a year.
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