Contrary to what many eye floaters sufferers may think a vitrectomy is a very common procedure and in this post I will be explaining what a vitrectomy is and the difference between its normal use and also its use for floaters also referred to as a floater only vitrectomy or an FOV.
Vitrectomy is a type of eye surgery that involves the removal of part or all of the vitreous humour in the eyeball. The vitreous humour is the jelly-like fluid that fills the central space in the eye and is made up of 99% water. There are several reasons why an eye surgeon may wish to perform a vitrectomy and most of these reasons are for eye conditions.
Now, here are just some of the common eye conditions that may require a vitrectomy.
- Retinal detachment
- Epiretinal membrane
- Retinal bleeding
- Internal injury or infection
In these cases is the main reason for vitrectomy is really to clear the way so that the surgeon can see the retinal tear, the whole or the source of bleeding for treatment. The use of vitrectomy for the treatment of eye floaters is the same as it is for any other vitrectomy treatment except that it may not remove as much of the vitreous humour or even the posterior vitreous, also the surgery stops after the vitrectomy has been done, whereas, in the case of a standard vitrectomy, the retina treatment then starts once the vitrectomy has been completed. Now the term FOV is more of a modern term used to describe the use of vitrectomy for simply the removal of floaters only.
So what’s involved in this FOV vitrectomy?
Well, the individual will usually be awake for the procedure but the eye will be numbed with an anaesthetic that removes all pain but not the sensation of touch. The three probes will then be inserted into the eye through a specific region within the eye that we call the Pars Plana. The Pars Plana contains no retina, which is helpful for fast recovery and also to reduce any complications. So this is also why you commonly hear the procedure is described as a Floater Only Pars Plana vitrectomy and it’s important to make sure that’s actually what you’re getting if you are going to have this procedure done.
The first probe is inserted into the eye and allows a fibre optic light to be passed through to illuminate the inside of the eyeball and the second probe is an infusion probe which allows saline to be injected into the eyeball to replace any vitreous that is removed. The third probe is called a Vitrector and that’s there to help chop and cut up some of the vitreous and also to help suction out and remove the floater along with any vitreous fluid that is needed as well and your surgeon will of course assess your eyes before the procedure and plan out their intended approach to treat your floaters, including how much vitreous they feel is appropriate to remove to eliminate the floaters in your eyes.
So once they’ve removed all or as much of your floaters as possible, the procedure is finished even though it’s a floaters only vitrectomy and not a treatment for retinal detachment. For example, your surgeon will likely create a temporary gas bubble in the eye as a precautionary step to add extra pressure in the eye and to reduce the risk of retinal detachment so the bubble will disappear all by itself in about a week. After this, the probes are removed and the holes are created by the three probes into the eye they should seal all by themselves without leaking and they should completely heal in about 48 hours without any stitches being required and you’ll be given some combination if not all of the following medications to take home with you, so that includes a painkiller, antibiotic, eye drops to prevent infection, stroke, eye drops to combat inflammation in the eye and drops to dilate your pupils, as well as something to lubricate the eyes just to remove any soreness and gritty feeling that you may feel over the coming weeks.
So you’ll be given and advised to wear a patch over the eye for protection, particularly at night while you’re sleeping and you can expect some discomfort over the first few days in particular. After a week or so, things should settle down significantly and the improvements should continue to follow in the coming weeks. The gas bubble that I mentioned early on will usually be visible in your eye over the first few weeks and some of the drops that you’ll be taking will leave your eyes feeling less than clear, to begin with, you should find that quickly improves and settles down as well as the weeks follow.
Vitrectomy is certainly not a trivial procedure, It’s also one that is done very regularly by vitreo-retina surgeons to be able to make it possible for them to see clearly through the vitreous, for example, if the vitreous is full of blood or debris from inflammation so that they can then make repairs at the retinal level. The use of vitrectomy for eye floaters is traditionally considered too risky by many medical doctors and even eye care professionals as well. However, when you speak to vitreo-retina surgeons that do this procedure very regularly, they often tell a different story and many often consider it to be less of a risk than having a cataract operation.
I’ll be covering more on this next time so make sure you join me for the next post on vitrectomy where I’ll explain why vitrectomy is perhaps not the big risk that it often is claimed to be and why it should give all vitreous eye floaters sufferers hope for the future.
Let me know in the comments section if you’ve been put off in the past from having a vitrectomy for all eye floaters, I’d love to get your experiences on this, please let me know in the comments section.
Thank you and I look forward to catching you guys, until then take care.
