Understanding Vitrectomy: Recovery at Home

What is Vitrectomy?

Vitrectomy is an eye surgery that is performed to treat problems of the eye’s retina and vitreous gel. The retina is the layer of nerve tissue at the back of the eye that senses light and signals to the brain for you to see. The vitreous gel (also called vitreous humour) is the jelly-like substance in the middle of the eye that helps the eyeball maintain its shape.

In this surgery, the vitreous gel is removed to provide better access to the retina. This is usually an outpatient surgery where local anaesthesia is administered to the patient to numb the eye.

An ophthalmologist will then create an incision to the affected area of the eye and may do the following:

• Remove blood or other substance keeping light from focusing properly on the retina
• Remove wrinkling scar tissue
• Remove any cataracts
• Repair of retinal detachments
• Remove a foreign object stuck inside the eye from an injury

When surgery is finished, a silicone oil or gas bubble is injected. This helps hold the retina in position against the wall of the eye.

When is vitrectomy needed?

An ophthalmologist may suggest a patient undergo a vitrectomy if he/she has one of these conditions:

• Diabetic retinopathy
• Retinal detachments
• Macular hole or macular pucker
• Endophthalmitis (eye infection)
• Severe eye injury
• Cataracts

How to prepare for a Vitrectomy?

A series of eye examination to identify the overall condition of the retina and vitreous gel will be done to the patient before proceeding to the surgery. All the benefits and risks will be discussed also. Thus, it is very important that a patient discloses any medical information needed by the ophthalmologist.

Here is a simple checklist of what needs to be done before the surgery takes place:

• Discuss in details with the ophthalmologist the risks and expected results of the surgery
• Sign informed consent
• Disclose any medical information needed to take into consideration
• Do not eat eight (8) hours before surgery
• Take prescription medicines for surgery purposes (as prescribed)

How is recovery after Vitrectomy?

A vitrectomy is an outpatient surgery, recovery of the patient is primarily done at home.  There will also be a series of post-care steps that should be carefully followed by the patient to recover well.

Right after surgery, the eye will be patched and shielded to protect it from injury. If a silicone oil or gas bubble is injected, the patient will be given instructions to keep their head in a certain position for most of the day and night while the eye is healing. At the same time, having been injected with silicone oil or gas bubble means another surgery will be scheduled to remove them when the eye has healed.

The patient’s eyes will get swollen, red, and bruised with a little bit of pain felt a few days after surgery but will get better relatively quickly. It is also expected that vision will be slightly blurry. It will take around two (2) to four (4) weeks for the vision to go back to normal. That is why most ophthalmologist will suggest that someone will accompany the patient or at least someone could fetch and take them home. It will not be safe for them to travel or drive alone.

The recovery period is relative as every patient adapt or recover indifferently from each other. Though naturally, those with healthier eyes before surgery are expected to heal quicker compared to others.

Below is a list of self-help tips on how to take care of oneself on the way to proper and faster recovery:

• Limit Everyday Activities
  1. Rest when necessary. It is important to take time out and relax especially when feeling tired.
  2. Don’t overwork the eye area and give it time to heal. Avoid moving the head too much, lifting heavy objects, or strenuous activities.
  3. Follow the doctor’s advice on how to position the head while waiting for the eye to heal. If the surgery included injection of bubble gas or silicone oil, it is recommended to keep the head face down for around 1-3 weeks post-surgery as doing otherwise (like lying on your back) will make the bubble move to the front of the eye and press against the lens instead of the retina.
  4. Another thing to take note when the gas bubble has been injected is to avoid aeroplane as ascending to higher altitudes so that to reduce the risk of elevated eye pressure. This will affect the size of the bubble.
  5. Take a leave from work. The period in which you will have to refrain from work’s activities is dependent on the patient’s type of work. It may be as short as one (1) week to as long as four (4) weeks.
  6. Wait for normal vision to come back before driving. While travelling as a passenger, remember to keep head in the recommended position. Also, don’t forget to always use the seat belt.
  7. Don’t get soap in the eyes. Use a washcloth to wash your face or wear goggles to protect the eye from getting contact with soap.
  8. Wear sunglasses during the day. The ophthalmologist may also require the wearing of an eye patch or shield up to a few weeks after surgery.

• Take Medicines/Relievers as Prescribed
  1. Medicated eye drops are very important to aid in the healing process.
  2. In most cases, the ophthalmologist may have required some medications to be taken or not taken (e.g. pills, vitamins) before the surgery. Instructions will also be given as to whether to continue or discontinue taking these medicines.
  3. If taking insulin, blood thinners, or in pacemakers and other critical devices, the doctors in charge will have recommendations. Be sure to follow their instructions properly.
  4. Keep it cool and elevated by placing ice or cold pack on the eyes 10-20 minutes at a time. This will help reduce the swelling. Do this every two (2) to three (3) hours. Do this every day for three (3) days post-surgery.

• Eat a Balanced Diet
  1. After surgery, a patient can return to his/her normal diet. It is recommended to eat bland, low-fat food.

How effective is Vitrectomy?

Over the years, the success rate of this surgery has been constantly high (over 90%) for many conditions. Severe complications are rare. However, in case of healing does not come as expected, it is important to call the ophthalmologist or surgeon that did the surgery for any further instructions.

Some cases that may need urgent attention are the following:

• Sudden loss of vision or vision gets worse
• Increasing eye pain
• Symptoms of eye infection (e.g. eye discharge, redness in the eye area, fever_
• Vision changes

Vitrectomy has been one of the answers in battling serious eye problems and its technologies continue to evolve to provide excellent eye care for all.