A.The estimated cost of vitreoretinal (Vitrectomy) surgery In India usually starts $1000 however, it may go up to as much as $2000. it depends on the hospital charges and the fee charged by the surgeon.
Vitreoretinal surgery is a new and evolving branch of eye surgery that involves microsurgical techniques. Surgery is performed inside the eye, allowing damage caused by an accident to be repaired, or a detached retina to be reattached.
This type of surgery requires a great deal of skill and often takes place in urgent or emergency cases. It is therefore restricted to specialist trauma centers and the larger private eye clinics.
Vitrectomy is suggested for individuals with eye diseases caused due to infection, inflammation, clouding of the vitreous fluid, filling with blood or debris, hardening, or scaring. These issues can keep light from venturing into the retina properly and lead to vision trouble. Once the fluid is removed and replaced, it might improve the eye condition and the vision.
Vitreoretinal surgery is used to treat a range of conditions that affect the retina and the vitreous humour of the eye, including:
Retinal detachment – a condition in which the retina begins to peel away from the back of the eye. If treated promptly, 90% of reattachment operations are successful. The eye is filled with gas to replace the vitreous fluid following surgery.
Macular hole – a condition in which a small hole appears in the center of the macula, disrupting vision. Following a vitrectomy, the internal covering film of the retina is expelled and a hole bubble is set up to press the sides of the hole together. This vitrectomy, peel and gas technique is successful in 90% of cases, giving that the macular hole is treated within twelve months of diagnosis.
Epiretinal membrane – this occurs when a thin layer of scar tissue forms over the macula. It is removed with delicate forceps following vitrectomy and the eye is then filled with gas.
Floaters – These are benign and will not cause any damage to the eye, however, in serious cases, they can significantly disrupt vision. A vitrectomy will remove both the vitreous fluid and the offending floaters.
Diabetic vitreous haemorrhage – this occurs when weakened blood vessels bleed into the vitreous causing hazing or floaters. A vitrectomy not only removes these obstructions but also stops the pulling effect of the vitreous on the retinal blood vessels.
Vitrectomy clears out the blood from vitreous humor that cannot be cleared out by the eye itself. The surgery prevents traction retinal detachment and helps in avoiding further or subsequent detachment. It also restores vision loss caused by the bleeding of the vitreous humor. It treats and repairs gigantic tears in the retina and stops scar tissues to form new blood vessels leading to the retina.
There are 2 types of vitrectomy, based on the approach used to remove the vitreous gel; namely anterior and posterior vitrectomy.
The most common approach is the posterior or pars plana vitrectomy performed as mentioned previously in order to enable certain procedures to be done at the back of the eye. Pars plana vitrectomy vitrectomy is performed by a vitreoretinal surgeon.
Sometimes vitreous gel comes out through the pupil in the anterior segment of the eye. This may occur due to eye trauma or injury, lens problems, or during cataract or glaucoma surgery. This vitreous is therefore removed via the anterior approach to prevent problems later on like retinal detachment and glaucoma and to promote recovery.
Vitreoretinal surgery is a complex procedure that is performed to treat various eye conditions affecting the vitreous humor and retina. The exact procedure can vary depending on the specific condition being treated. Here is a general overview of the steps involved in a vitreoretinal surgery procedure:
Preoperative Evaluation: Before the surgery, the patient undergoes a thorough preoperative evaluation, which includes a comprehensive eye examination and imaging tests (such as ultrasound or optical coherence tomography) to assess the condition of the retina and vitreous.
Anesthesia: The surgery is typically performed with the patient under local anesthesia to numb the eye and surrounding tissues. In some cases, general anesthesia or intravenous sedation may be used.
Incisions: Small incisions are made in the eye to access the vitreous humor and retina. The number and location of incisions depend on the specific procedure and the surgeon’s preferences.
Vitreous Removal (Vitrectomy): In most vitreoretinal surgeries, the vitreous humor is removed through one of the incisions using a specialized instrument called a vitrector. This instrument cuts and suctions the gel-like vitreous material from the eye.
Treatment of Retinal Condition: Once the vitreous is removed, the surgeon can directly access the retina. The specific treatment for the retinal condition is performed. This may involve repairing retinal detachments, removing scar tissue, treating diabetic retinopathy with laser therapy, or addressing other issues such as macular holes or epiretinal membranes.
Laser or Cryotherapy: Laser therapy or cryotherapy (freezing) may be used to seal or treat specific areas of the retina. This is often done to prevent further detachment or address abnormal blood vessel growth in conditions like diabetic retinopathy.
Fluid and Gas Injection: In some cases, a gas or silicone oil bubble is injected into the eye to help reattach the retina or stabilize it during the healing process. This bubble helps create a tamponade effect to keep the retina in place.
Closure of Incisions: Once the necessary procedures are completed, the surgeon closes the incisions using sutures or a self-sealing technique.
Postoperative Care: After the surgery, the patient is monitored in a recovery area. Eye drops and medications may be prescribed to manage pain, reduce inflammation, and prevent infection. Patients may also be advised to maintain specific head positions to facilitate proper healing, depending on the surgery.
Follow-Up: Patients will have follow-up appointments with their vitreoretinal surgeon to assess the progress of healing and monitor vision. Multiple follow-up visits may be necessary to ensure the success of the procedure.
It’s important to note that the specific steps and techniques used in vitreoretinal surgery can vary based on the individual case and the surgeon’s approach. Patients should discuss their procedure in detail with their surgeon to understand what to expect and any specific postoperative care instructions.
Because so many variables are involved, only your eye surgeon familiar with your condition can give you a realistic idea of what to expect following a vitrectomy.
But the underlying reason for the procedure usually is a major factor in determining how fast you will recover as well as the ultimate outcome.
After a procedure, you likely will use antibiotic eye drops for about the first week and anti-inflammatory eye drop medications for several weeks.
Follow your surgeon’s advice carefully. In general, don’t expect to know your final visual outcome for at least a few weeks. Again, your surgeon or attending ophthalmologist will be the best judge of your individual recovery.
Vitrectomies have a very high success rate. Bleeding, infection, a progression of cataract, and retinal detachment are potential problems, but these complications are relatively unusual.
For most patients who undergo a vitrectomy, sight is restored or significantly improved. The procedure is a marvel of modern medicine for people with conditions that might be blinding otherwise.
After surgery, the eye is patched and a shield placed to protect the eye from injury. This shield should be used at night for a week after surgery.
After ensuring the vital signs are stable, you will be shifted to your room.
If a gas bubble or silicone bubble has been injected into the eye, you will be required to adopt a particular head position depending on the position of the break. Since the bubble floats up, you will be asked to adopt a posture such that the bubble lies against the break. (this is so that the break is tamponaded to enable permanent sealing of the break.)
Since the surgery is performed under local anesthesia, you can return home on the same day. However, if there are concerns about a raised intraocular pressure, you may be asked to stay one or two nights in the hospital.
If the surgery is performed under general anesthesia, recovery takes longer and you may have to stay overnight at least in the hospital.
It is advisable to arrange in advance your transport back home after surgery and the visit to the surgeon on the day after surgery
Q. What is vitreoretinal surgery?
A. Vitreoretinal surgery is a subspecialty of ophthalmology that involves surgical procedures to treat conditions affecting the vitreous humor (gel-like substance in the eye) and retina (the light-sensitive tissue at the back of the eye).
Q. What conditions can be treated with vitreoretinal surgery?
A. Vitreoretinal surgery is used to treat various eye conditions, including retinal detachment, diabetic retinopathy, macular holes, epiretinal membranes, vitreous hemorrhage, and complications from eye trauma.
Q. How is vitreoretinal surgery performed?
A. The surgery is typically performed using microsurgical instruments through small incisions in the eye. Techniques may include vitrectomy (removing the vitreous gel), retinal detachment repair, laser therapy, and the injection of medications into the eye.
Q. Is vitreoretinal surgery performed under general anesthesia?
A. In many cases, vitreoretinal surgery is performed under local anesthesia with sedation. General anesthesia may be considered for patients who cannot tolerate local anesthesia or for specific surgical procedures.
Q. What is the recovery time for vitreoretinal surgery?
A. Recovery time varies depending on the specific procedure and the individual patient. Patients may need to avoid strenuous activities, keep their head in a specific position, and use eye drops as prescribed by the surgeon. Full recovery can take several weeks to months.
Q. Are there any risks associated with vitreoretinal surgery?
A. Like any surgical procedure, vitreoretinal surgery carries some risks, including infection, bleeding, retinal detachment, and changes in vision. The specific risks depend on the nature of the surgery and the patient’s overall health.
Q. Is vitreoretinal surgery painful?
A. During the surgery, patients are typically under anesthesia, so they do not experience pain. After the surgery, there may be some discomfort, but pain is usually managed with medications.
Q. How long does it take to see improvements in vision after vitreoretinal surgery?
A. Vision improvements vary depending on the underlying condition and the success of the surgery. Some patients may experience immediate improvement, while others may see gradual improvements over time.
Q. Can vitreoretinal surgery restore lost vision?
A. The goal of vitreoretinal surgery is to prevent further vision loss and, in some cases, to improve vision. However, the extent of vision improvement depends on the specific condition and the stage at which it is treated. Some patients may experience significant vision improvement, while others may have limited gains.