Vitrectomy Surgery: What is it and Does it Work for Repairing Macular Holes?

Vitrectomy surgery is currently the only treatment for a macular hole. What is a macular hole? What is involved in a Vitrectomy, and does it work to repair macular holes? These are the questions addressed in this article.

What is a macular hole?

A macular hole is defined as a small tear in the macula which is located in the light-sensing tissue of the retina. When nerve cells of the macula become separated from each other and start to pull away from the eye, a hole can result, requiring Vitrectomy surgery to repair it. Macular holes may also form as a result of injury to the eye or even a medical condition that affects the eye. It is rare that someone would develop a macular hole in both eyes, and generally they occur in people after the age of 60. A person with a macular hole will eventually lose their central vision close- up and at a distance. Their peripheral vision remains intact, but their central vision often just reveals darkness across the middle of the field of view. This was my Mom’ problem and she just had Vitrectomy Surgery to repair a macular hole and removal of a cataract at the same time, which is fairly common. She is currently in the recovery process and is doing well.

What happens during Vitrectomy surgery?

A Vitrectomy can take from an hour to several, depending on the patient’s condition. In certain situations it takes longer than an hour because the ophthalmologist may perform another surgical procedure at the same time such as repairing a detached retina or removing a cataract. The Vitrectomy is done under local or general anesthesia which is determined by the ophthalmologist before the surgery. The Vitrectomy is performed to remove the vitreous, which is the clear, jelly-like substance that fills the middle of the eye. Small incisions are made in the sclera (the white part of the eye) so that special instruments can remove the vitreous. While looking into the eye with a microscope, the ophthalmologist then removes the fluid, as well as any small membranes near the macula to prevent anything from pulling on the macula that would prevent the hole from closing after surgery. The gel-like fluid is replaced with a gas that forms a bubble which helps hold the retina (macula) in its proper position while the macular hole closes during the recovery process. To maintain proper positioning of the gas bubble, patients are instructed to maintain a face-down position for varying time periods following surgery as determined by the ophthalmologist. Recovery from Vitrectomy surgery varies but generally takes 6 to 8 weeks at least.

Does Vitrectomy surgery work?

In my Mom’s personal experience it has! Just 4 weeks following surgery, she has regained partial vision in the operative eye, and it is improving daily. The goal of a Vitrectomy is to improve or at least stabilize vision in worse cases. According to the Digital Journal of Ophthalmology , the macular hole closes following the Vitrectomy in 80-90% of patients, and most see a 2 or more line on the eye chart improvement in vision. However, in rare instances a patient may experience complications following surgery such as, retinal detachment, bleeding, or infection in the eye. There is also a chance that a cataract may form in the operative eye and may require surgery at some point in the future.

Despite the complications that can result from Vitrectomy, as well as any surgery, this procedure has proved successful in my mother’s experience. Make sure before deciding whether or not to have this procedure that you consult with a reputable and licensed ophthalmologist who has specialized training and experience in retinal surgeries.

Note: The information and personal recommendations in this article are for informational purposes and should in no way be used to make a diagnosis, determine treatment, or in place of consultation with a qualified physician. For any medical condition, always consult your physician.

References:

John I. Lowenstein, M.D.
Massachusetts Eye and Ear Infirmary, Harvard Medical School Digital Journal of Ophthalmology: treatment#a1128.djo.harvard.edu/site.php?url=/patients/pi/532:

http://wwwhttp://emedicine.medscape.com/article/1224320-

http://www.webmd.com/eye-health/vitrectomy


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