Vitrectomy or vitreous surgery can be used to address a variety of disorders. Surgery is recommended only when these four conditions are met:
- The findings have resulted in or are likely to result in vision loss.
- Because of the severity of the ailment or its natural history, non-surgical or spontaneous recovery is rare.
- The possible benefits of surgery exceed the dangers.
- The patient is aware of the treatment’s risks and advantages, as well as other options.
The following are the objectives of surgery:
- To cure the pathology (abnormal condition) that is causing the loss of vision.
- To lessen the chances of recurrence
- To reduce the possibility of further complications
A patient with long-term diabetes, for example, may experience a rapid, painless loss of vision that does not improve with observation alone. A vitreous hemorrhage is identified when there is bleeding in the vitreous. The hemorrhage is removed, and eyesight is restored via a pars plana vitrectomy.
Vitreous hemorrhage is likely to repeat if the cause of the bleeding is not addressed. When endolaser treatment is added to vitreous surgery, it addresses both the vitreous hemorrhage and areas of diabetic retinopathy, and the patient has a considerably better long-term outcome.
What to Expect Before Vitrectomy (Pre-Op)
Your doctor will inspect your eye and analyze your overall health prior to surgery. A detailed slit-lamp examination, dilated eye exam and in-office tests such as OCT (ocular coherence tomography), fluorescein angiography, retinal photography, and ultrasound are often used.
If the procedure is anticipated to include the anterior (front) segment, cornea, or lens, additional testing may be required. CT scanning, MRI, and other techniques may be necessary to completely determine the degree of the injury if the eye has been affected by traumatic injury. The goal is to stabilize any medical issues before surgery, if at all possible.
Other medical activities such as dialysis, home care, and transportation must be coordinated both before and after your surgery date. You should expect a follow-up visit the day after surgery to assess your recovery.
Patients are usually asked to be “NPO” (nothing by mouth) for 8 hours prior to surgery to avoid vomiting during the procedure, wherein the contents of the patients’ stomach will be less likely to enter the windpipe and lodge in their lungs.
On the Day of Vitrectomy
On the day of surgery, your physician and anesthesiology team will advise you whether or not to continue with your medications. Patients who are taking eye drops should continue to do so even on the day of surgery.
Pills and other oral medications, on the other hand, will require specific instructions. If you are taking medications for your heart, breathing, blood pressure, seizures, or anxiety, you will probably keep taking them with a teaspoon of water. Other medications, such as vitamins, cholesterol-lowering drugs, or birth control pills, can likely be resumed after surgery.
It is always preferable to arrive early rather than late for surgery. If other surgery cases take longer than expected, you may have to wait, but it is better to arrive early and relax than rush and be anxious. You will be given an identification (ID) band after you have been admitted in the hospital. It is the first step in ensuring you are the right patient, undergoing the correct surgery on the correct eye.
Typically, IV and EKG patches, as well as an oxygen monitor, will be placed to allow the team to administer pain medication and monitor your vital signs during surgery. Most adults are given only light sedation to avoid the adverse effects of general anesthesia and because they are more comfortable with it.
Children and severely injured, potentially unstable, or anxious people are typically given general anesthesia. To make the eye comfortable and the surgery painless, topical (eye drops) and periocular (around the eye) anesthesia are commonly used.