Vitrectomy involves the removal of the vitreous and can improve visual function in people with visually debilitating vitreous opacities (floaters).
Everyone has vitreous floaters. Sometimes vitreous floaters are a sign of a serious eye disease. For example, a diabetic patient with new vitreous floaters may be on the verge of serious permenant vision loss. An adult with new onset floaters could have a retinal tear, retinal detachment, eye infection, auto-immune disease (uveitis), or even a cancer inside the eye. Therefore, anyone with new onset floaters or a big change in floaters should be evaluated urgently by an eye doctor. When you are young your vitreous is transparent. As you get older, it sometimes developes optical irregularities which are visible as floaters. Rarely, these floaters are visually significant and impair visual function. In those cases, it is sometimes appropriate to consider surgery for floaters. Most of the time, floaters clear with time. So, if someone has new onset floaters and they do not have a serious eye condition, it is appropriate to wait at least 6-12 months to see if they will clear without intervention. After waiting a reasonable amount of time, if the floaters are visually significant and do not clear, surgery can be very helpful. Because vitrectomy surgery always causes an accelerated cataract, vitrectomy for floaters is safer in someone who has already had catarct surgery. As long as a person considering vitrectomy for floaters understands the risks and benefits of surgery, it is reasonable to consider surgery.
Vitrectomy Surgery allows the Retina Surgeon to work inside of the eye and repair damage caused by a variety of diseases. The vitreous is the jelly inside the eye and is removed during the vitrectomy. YOU DO NOT NEED YOUR VITREOUS. The vitreous is important when the eye forms as a fetus grows into a baby. There is theoretical evidence that the vitreous absorbs oxygen and protects the natural lens. That may be why most pateints who have not yet had cataract surgery develop cataracts after vitrectomy surgery. The vitreous is replaced with a salt solution or gas or oil and your body replaces the salt solution or gas in the vitreous cavity over a week or two.
Some vitrectomies can be performed using very small instruments.
Vitrectomy surgery in our practice is usually done with local anesthesia and sedation. Since you will be sedated, YOU CANNOT EAT the morning of surgery. You will be sedated and your eye will be anesthetized. You will be monitored by an anesthesiologist or nurse anesthetist. After surgery you will have to wear a patch and shield over the eye until your appointment the following day.
After your patch is removed during your post-operative visit, you will need to take eye drops. If during the week after surgery, your eye starts to hurt more or vision starts to decline, you should call our office since that can indicate a problem with infection or elevated intraocular pressure. If you see a new shadow after surgery you need to call so we can check to make sure you do not have a retinal detachment.
Using modern microsurgical techniques, your retinal surgeon is able to remove the vitreous with an instrument that is like a vacuum cleaner.
After any eye surgery there is a risk of infection, bleeding, and retinal detachment. Also, the intraocular pressure in the eye can sometimes rise necessitating extra post-operative eye drops. Make sure to call our office if you are having any problems.
65 year old woman with 7 years of poor visual function from vitreous opacities (floaters). She had a clump of material behind her intraocular lens. The video show this material being removed with a 25 gauge vitrectomy. She was better the day after the surgery. Her other eye had vitrectomy for floaters 7 years ago for a dense posterior floater.