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Sometimes You Just Need a Vitrectomy

A vitrectomy is an eye operation. It is performed by retina specialists for a variety of reasons. In patients with diabetic retinopathy, a vitrectomy may be useful to remove blood in the vitreous, aka a vitreous hemorrhage. There is no reason, to perform a vitrectomy in cases of macular degeneration.

Vitrectomy Surgery to Clear Hemorrhage
Vitrectomy Surgery to Clear Hemorrhage

In cases of vitreous hemorrhage, bleeding has and blood remains suspended in the vitreous. The vitreous is the gel-like substance that fills most of the eye. It is very similar to jellyfish, it has substance, but is mostly water.  It is optically clear.

A vitreous hemorrhage is benign, that is, the blood does not cause any damage to any portion of the eye, especially the retina. The vitreous hemorrhage physically blocks light and causes loss of vision. Sometimes the vitreous hemorrhage can absorb on its own, but if not, a vitrectomy is necessary to remove the non-clearing vitreous hemorrhage. At this point vision should be restored. It can take weeks or months to absorb. Many times we can’t wait that long.

Advanced diabetic retinopathy, or proliferative diabetic retinopathy, can have a retinal detachment associated with it. This type of retinal detachment is different. Most retinal detachments are caused by a retinal tear or retinal hole, called a “rhegmatogenous” retinal detachment.

Retinal detachments associated with diabetic retinopathy are called “traction” retinal detachments. The mechanism is different than rhegmatogenous retinal detachments in that the retina is pulled, like a tent, apart from the underlying layers. “Scar” tissue has formed on the surface of the retina, contracted and exerts this pulling.

A vitrectomy is necessary to correct/repair this type of retinal detachment. The vitreous is removed to allow access to the retinal surface. The abnormal scar tissue is cut away to relieve the “pulling.”

Vitrectomy surgery is also used for other retinal problems; rhegmatogenous retinal detachments, epiretinal membranes, macular holes, floaters, certain trauma, etc. Major risks of the surgery include blindness from infection and retinal detachment. The risks, however, are very, very uncommon.

Vitrectomy surgery has been around  for about 30 years.  It has allowed us to prevent potentially blinding retinal detachments in our diabetic retinopathy patients.  On the other hand, the whole focus of this site is to educate.  If you are seen early enough, you’ll never even need a vitrectomy.

“Randy”

Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax Virginia

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A detached retina is potentially blinding. The retina is the light sensitive tissue that lines the inside of the eye. A retinal tear or hole usually leads to a retinal detachment. Floaters can sometimes be the earliest, and only, symptom. Many times there is little warning and a retinal detachment usually occurs without trauma.

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Randall V. Wong, M.D.
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