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What Is A Vitrectomy? | American Eye Associates | San Diego, CA

What Is A Vitrectomy?

January 12, 2019

What Is A Vitrectomy?

Vitrectomy, or removal of the vitreous body, is a procedure we perform here at American Eye Associates. It can be very helpful in certain cases, sometimes allowing us to save a person's vision. What is this procedure? How is it useful? What is the recovery like?

What Is The Vitreous Body?

The vitreous body (also known as the vitreous humor, or simply as the vitreous) is the substance that fills most of the eye, from the retina at the back to the lens at the front. It helps the eyeball to hold its shape, and it exerts a little pressure on the retina to help it stay attached to the back of the eye. Although it's made up of 99% water, the vitreous is not a liquid, but rather has a gel-like consistency. Because of this, it can get in the way of doing surgery on the retina.

It's very important that the vitreous remains clear. Because it's a gel rather than a liquid, any object that enters the vitreous will tend to remain there, and will not be naturally cleared by the body. It's not possible for a surgeon to remove an object from within the vitreous while leaving the vitreous intact. However, it is possible for a surgeon to remove the vitreous entirely, without damaging the eye's ability to function. Removal of the vitreous is called a vitrectomy.

What Is It Like To Have A Vitrectomy?

During a vitrectomy, the patient's eye is anesthetized. Additionally, the patient is often under either general anesthesia or heavy sedation, for comfort.

In most cases, the surgeon enters the eye through a small incision in the sclera, the white part of the eye. The vitreous is removed in pieces, through this tiny incision. If any retinal surgery is needed, such as a repair, the surgeon will perform it at this time.

Next, the space left by the vitreous will be filled with another substance. In many cases, this is sterile saline (saltwater). If more pressure is needed to help hold the retina in place (such as in a retinal detachment), then the surgeon may place a gas bubble or silicone oil into the space left by the vitreous. In this case, your surgeon may advise you to lay face-down for a period of time after your procedure, to help the gas or oil apply enough pressure to the retina to be effective.

Does The Vitreous Return?

The body doesn't repair or replace a damaged vitreous, so after the vitreous is removed, it will not return. Instead, the sterile saline infused into the eye will be replenished by the body with its own fluid, the aqueous humor. This normally fills a chamber at the front of the eye, but once the vitreous is removed, it will also fill the space left behind by the vitreous. This fluid will help the eye hold its shape. If a gas bubble is used during the vitrectomy, the gas will gradually be absorbed by the body and replaced with aqueous humor.

Removing the vitreous removes floaters or other debris in the vitreous, and having a vitrectomy means that these will be gone for good. If the body created a new vitreous after vitrectomy, then some patients might need more than one vitrectomy in their lives. This doesn't happen. Once you've had a vitrectomy, you'll never need a second vitrectomy.

What Conditions May Be Treated With A Vitrectomy?

There are several different conditions of the eye for which a vitrectomy may be useful, including:

  • Retinal detachment
  • Macular pucker
  • Macular hole
  • Vitreous hemorrhage
  • Diabetic retinopathy (if it has caused hemorrhage)
  • Foreign bodies in the eye after an eye injury

In some cases, the vitreous is removed because of problems with the vitreous itself. For example, blood from a vitreous hemorrhage may interfere with vision, resulting in a dramatic increase in "floaters" in the patient's vision. Removing the vitreous can restore clear vision.

In other cases, removal of the vitreous is performed to allow surgeons access to the retina itself, in order to repair it. For example, vitrectomy for retinal detachment allows an eye surgeon to access the retina to repair it, and to place a gas bubble or oil into the eye to help hold the retina in place while it heals.

Vitrectomy San Diego

Because this is a highly technical and specialized procedure, it should be performed by a specialist. At American Eye Associates, our surgeons are specialists in performing procedures on the retina, with many years of training and experience. We receive many referrals from other doctors for patients needing a vitrectomy San Diego area. If you or a loved one may need a vitrectomy San Diego, we encourage you to schedule an appointment to discuss the procedure with us. We will advise you on whether vitrectomy might be right for you, and what the risks and benefits of the procedure would be in your case. Please contact our office to schedule your appointment.

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