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.
Talk with your eye doctor about what to expect during your surgery. The details of the surgery may differ somewhat. A doctor specially trained in eye surgery will do your operation. In general, you can expect the following:
You may be awake during the surgery. You will receive a medicine to help you relax. In this case, your eye doctor may use anesthetic eye drops and injections to make sure you don’t feel anything.
In other cases, you may have anesthesia to put you to sleep. If this is the case, you will sleep deeply through the surgery and won’t remember it afterwards.
Your eye doctor will expose your eye, making an incision in the outer layer of your eye.
Your eye doctor will make a small cut in the sclera, the white part of your eye.
Your eye doctor will remove the vitreous and any scar tissue or foreign material.
Your eye doctor will do other repairs to your eye as needed. For example, he or she might use a laser to fix a tear in your retina. In some cases, your eye doctor may inject a gas bubble into your eye to help keep your retina in place.
Your eye doctor will replace the vitreous with some other sort of fluid, like silicone oil or saline.
Your eye doctor may close your surgical incisions with stitches, but stitches are often unnecessary.
An antibiotic ointment will be placed on your eye to help prevent infection.
Your eye will be covered with a patch.
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
You may be asked to return for a check-up on the day after surgery and to renew instructions about routine activities, use of the eye patch, medications, and eye position and to schedule the next visit.
Eye drops to reduce infection and inflammation are routinely prescribed. If you need to put more than one type of eye drop at the same time of the day, wait at least 5 minutes between successive drops. Painkillers such as Ibuprofen and Paracetamol may be prescribed.
Instructions on maintaining the head position have to be followed as indicated. The head position has to be maintained for at least 45 minutes out of every 60 minutes. Those 15 minutes are for activities such as eating, visiting the restroom and stretching your feet.
There may be an itchy sensation due to the use of sutures but these will be absorbed in 2-3 weeks. A lubricating eye ointment may be used as needed.
You may experience floaters or light flashes for a few days after surgery. Vision will be blurry because of the gas and will improve once the gas disappears.(about 3-8 weeks).
Straining and lifting heavy weights should be avoided for at least a week after surgery.
Regular medications and activities may be resumed as per the doctor’s advice.
Vitrectomy is a simple, effective procedure with few risks and complications. Your risk for complications may be higher if the procedure was done to repair extensive damage to your eye or retina.
Possible complications of vitrectomy include:
Q. What is the success rate of vitrectomy surgery?
A. The success rate for vitrectomy is around 90 percent, even if you’re over 60.
Q. Is vitrectomy major surgery?
A. Vitrectomy surgeries involve the removal and replacement of some or all of the vitreous humor or fluid from the eye. The procedure is considered very successful and is often done as part of other eye surgeries
Q. What is Macular Hole Surgery And Repair?
A. A vitrectomy is the most common treatment for macular holes. In this surgery, a retinal specialist removes the vitreous gel to stop it from pulling on the retina. Then the specialist inserts a mixture of air and gas into the space once occupied by the vitreous.
Q. How long does it take to recover from macular hole surgery?
A. The total recovery time is several months. Patients will be asked to maintain face down positioning after surgery, from one to seven days, depending on a variety of patient-specific factors. Patients are on post-operative eye drops for a few weeks.