Vitreoretinal Eye Surgery - An Overview

What Are Vitreoretinal Surgeries?

Vitreoretinal surgery is a surgical specialization performed in the deeper parts of the eyes in which the eye's vitreous, the retina, and other back parts are affected. As the name suggests, this surgery has two parts: vitreous and retina. Read further to know what these surgeries entail.

What Is Vitreous?

The vitreous is a jelly-like substance that fills the cavity between the eye's lens and the retina. It is present in the middle part of the eyes. Normally, the vitreous is clear, so light can pass through the eyes and reach the retina.

What Is Retina?

The retina is a layer of cells that is light-sensitive that is present in the backside of the eyes. The cells present in this part use light to send visual information to the brain. As these parts are deeply situated, these surgeries tend to be delicate.

The intent behind performing these procedures is to:

• Restore.

• Preserve.

• Improve the overall vision.

Which Vision Problems Require Vitreoretinal Surgeries?

In certain conditions, there may be an accumulation of blood and debris in the eyes. This leads to the blockage of the light. Sometimes, scar tissue may be present in the eyes' vitreous part. This may lead to a tear or displacement of the retina. Interference of the blood or tissue in these parts leads to impairment in vision.

The common medical conditions in which these surgeries are required are listed below:

• Diabetic Retinopathy: There is damage to the vasculature in the eyes because of diabetic complications.

• Macular Holes: This is an age-related condition in which there is shrinkage of the vitreous, because of which there is a pull in the retina. Now, this pull can lead to a tear in the center part of the retinal area where most of the focus is there. This central part is called the macula. The shrinkage and pull will lead to macular holes.

• Macular Pucker: A wrinkle in the retina's small area responsible for focus, leading to vision distortion.

• Retinal Detachments or Tears: In this condition, there are tears in the retina, or the retina separates from the back of the eye. Patients in such conditions experience a sensation of curtains closing on the peripheral vision.

• Retinopathy of Prematurity: An eye disorder of the retina primarily affects premature babies. Since the retina is not fully developed, there is the growth of abnormal blood vasculature, which further leads to distortion and detachment of the retina.

• Retinoblastoma: It is a form of eye cancer that is usually diagnosed during infancy or early childhood.

How Is the Surgery Performed?

• The surgery typically involves making a small incision in the eye and using a microscopic instrument to access the back of the eye.

• The operating surgeon may then remove the vitreous, repair the retinal part, or perform other procedures to treat the condition.

• Vitreoretinal surgery is usually performed under local anesthesia.

• The debris or blood clots are removed.

• The vitreous part which is removed will be replaced with saline. Sometimes the doctor may put in silicone oil. In that case, the surgeon will remove it later and put it in saline.

• Depending on the situation, doctors may or may not give stitches.

• In the end, doctors may put antibiotic drops or ointment and cover the eyes with a patch.

• It is considered a highly specialized and complex procedure to manage the anatomy and physiology of the back of the eye, which is a delicate strategy.

What to Ask the Doctor Before Surgery?

Before the procedure, patients can ask the operating doctor the following questions:

• If a patient takes any medications for systemic conditions such as diabetes mellitus, is on blood thinners, or has high blood pressure, do they have to be stopped or continued before the surgery?

• What diet should be consumed, and at what time before the surgery?

• What are the anesthesia options?

• If any pre-medications are to be administered before the procedure?

What Could Be the Possible Complications?

Despite the advancements in surgeries, complications are likely to occur. Here are a few of them:

• Infection: There is a risk of infection after any surgical procedure after vitreoretinal surgery. This can lead to increased pain, redness, and vision loss. Thus, ensuring that the operated part does not get infected becomes essential.

• Bleeding: Bleeding inside the eye may occur after vitreoretinal surgery. This may cause loss of vision or require additional surgery to correct it.

• Retinal Detachment: The retina may become detached from the back part of the eye post-vitreoretinal surgery, leading to vision loss. This can occur due to scarring or pulling on the retina during surgery.

• Cataract Formation: Cataracts are the formation of clouds like the structure of the eye's lens. This can develop after vitreoretinal surgery. This can cause blurring of vision. This does require additional surgery to correct.

• Macular Edema: In this, swelling of the macula can occur, a small but crucial part of the retina, can occur after vitreoretinal surgery. This can cause vision loss or distorted vision.

• Glaucoma: When the pressure inside the eye increases can occur after vitreoretinal surgery, which leads to glaucoma. This can cause vision loss and may require additional treatment.

These are just a few possible complications that can occur after vitreoretinal surgery. Therefore, discussing the risks and benefits of any surgical procedure with your doctor and closely following all postoperative instructions to minimize the risk of complications is important.

Conclusion:

Vitreoretinal procedures are becoming more advanced with advanced technology. Talk in depth regarding the details of the procedure with the operating doctor. Post-surgery care must be taken, and proper follow-ups should be done as the surgeon advises. With efficient technology, one should proceed to get the procedure without any hesitation with the advice of the operating surgeon.