Vitrectomy

WHAT YOU SHOULD KNOW:

Vitrectomy (Inpatient Care) Care Guide

  • Vitrectomy is surgery to remove all or part of the vitreous in your eye. Your vitreous is a gel-like substance inside your eyeball. Your lens is clear and is located on the front part of your eye. Your lens directs light onto your retina at the back of your eyeball. Your retina sends the images that you see to your brain. You may need a vitrectomy if your lens is not in its right place. You may also need a vitrectomy if your retina breaks away from the back part of your eyeball. This is called a retinal detachment.

  • You may also need a vitrectomy if your macula is swollen or damaged. Your macula is a small part of your retina that helps you see in front of you. It also helps you see when you read and write. If you are diabetic, your caregiver may have told you that you have diabetic retinopathy. Diabetic retinopathy may cause blood vessels to break and blood to build up in your vitreous. Vitrectomy will help clear the blood from your eyeball. Vitrectomy is also done to treat endophthalmitis. Endophthalmitis is a serious eye infection that can occur after having eye surgery.

  • With a vitrectomy, your caregiver cuts through an area of your eye called the pars plana. The pars plana is found near the iris and sclera during surgery. The iris is the colored part of your eye, and the sclera is the white part of your eye. Vitrectomy helps your caregiver look at and repair your retina and other parts of your eye. A vitrectomy may remove scar tissue or objects from your eye, such as slivers of wood or glass. Having a vitrectomy may improve your eyesight and prevent blindness.
Lateral cut-away of the Right Eye

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • After your surgery, you may have pain. Your sight may not improve for up to one year. Your eyesight and eye pressure may not get better and could become worse. A vitrectomy may cause a cataract (clouding over your eye) or glaucoma (increased eye pressure). Your retina may break away from the back part of your eyeball during your surgery. The hole in your macula could reopen. Some problems may happen months after your surgery.

  • You may also have endophthalmitis which is inflammation (redness and swelling) inside your eye. Endophthalmitis may also be an infection. Your eye may also start bleeding. You may need to have eye surgery again to fix these problems. If you do not have vitrectomy, your eyesight problems may get worse. This may lead to blindness. Ask your caregiver if you have any questions or concerns about your treatment.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

    • Before you are given anesthesia: An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

    • Local or monitored anesthesia: This is a shot of numbing medicine put into your eye. You may still feel pressure or pushing during surgery but you should not have pain. With local anesthesia, you will be fully awake during your surgery. With monitored anesthesia care, you will be given medicine through a tube placed in your vein. This medicine keeps you comfortable, relaxed, and drowsy during the surgery.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Pre-op care: A caregiver may put eye drops in your eyes. These eye drops may decrease the chance of having inflammation (redness, swelling, and pain) in your eye. Inflammation is the eye's normal reaction to a surgery cut.

During your surgery:

  • Your caregiver uses tools so that he can see clearly inside your eye. One tool makes the parts of your eye appear bigger. The other tool has a light on its end to shine on the inside of your eye. Your caregiver makes small cuts on your sclera. These cuts are made in the pars plana area of your eye. Your caregiver will place a tiny tube into your eye to put saline (salt water) in it. Saline helps the keep your eye pressure the same as before your surgery. Your caregiver uses a special machine to remove the vitreous.

  • Saline (salt water) is put into your eye to replace the vitreous. Your caregiver may also fix other problems you may have with your eye. He uses laser to stop tiny blood vessels from bleeding. A small gas bubble may be put inside the eye to repair a hole in your macula. This bubble will act as a bandage by pressing the macula to the back of the eye. After your retina is attached, your eye is filled with silicone oil to keep your retina in place. Your caregiver closes the tiny cuts using very tiny sutures (thread) or a special glue.

After your surgery:

Your caregiver will then tape an eye patch (bandage) is over your eye. This bandage keeps the area clean and dry to prevent infection and helps keep your eyelid closed. Your caregiver may then place a metal or plastic shield on top of the bandage. You may be taken to a room where you will be watched closely by a caregiver. Do not try to get out of bed until your caregiver says it is OK. Your caregiver will let you know when you are well enough to go home.

  • Medicines:

    • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.

    • Antibiotics: Your caregiver may put antibiotic ointment on your eye. Antibiotic medicine kills germs in your eyes and helps keep your eye from getting an infection.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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