Conclusion: Repeated pars plana vitrectomy with internal limiting membrane peeling and gas tamponade is a safe and effective treatment option for persistent MHs. Earlier reoperation is recommended for greater visual recovery.
There is also a risk that the surgery will not successfully repair your original problem. If this is the case, you might need a repeat surgery.
Management options after a failed primary vitrectomy for idiopathic MH include observation, tamponade exchange, and revision vitrectomy with different approaches to the internal limiting membrane (ILM).
People who have had vitrectomy surgery will experience temporary poor vision while the eye is filled with gas, but if the surgery is successful the vision will improve as the gas reabsorbs and is replaced with the eye's own clear fluid.
Patients may experience mild discomfort and redness for several days after this procedure. The vitreous that is removed does not grow back, but is replaced by fluid that is normally produced by the eye.
Although the several vitreous substitutes available include inert gas, silicone oil, heavy silicone oil, and hydrogels, to date, octafluoropropane (C3F8) and sulfur hexafluoride (SF6) are the most commonly used in clinics.
Recurrent detachment may occur more or less frequently after a variable lapse of time. Early recurrences occur within 6 weeks following the first surgery and late recurrences more than 6 weeks later. Insufficient treatment and proliferative vitreoretinopathy (PVR) are the main causes of early recurrence.
Raised Intraocular Pressure (IOP) IOP increase in eyes with intraocular tamponade is a common postoperative complication reported in up to 58.9% of eyes [26, 27]. Elevated IOP after vitrectomy may cause optic nerve damage, retinal ischemia, and subsequent visual loss.
Your surgery may not work if you do not recover in the recommended position. This is because lying in the wrong position puts pressure on other parts of your eye. That can lead to other eye problems. You cannot fly in an airplane, go to mountains/high altitudes or scuba dive until the gas bubble is gone.
The vitrectomy success rate depends on the reason for surgery. For example, the success rate is over 90% after surgery for retinal detachment and epiretinal membrane, and over 95% after surgery for eye floaters.
An ophthalmologist who is a specialist in retina and vitreous surgery removes the vitreous through a small incision (vitrectomy). The vitreous is replaced with a solution to help your eye maintain its shape. Surgery may not remove all the floaters, and new floaters can develop after surgery.
If you need vitrectomy in both eyes, you'll only get surgery on 1 eye at a time. Your doctor can schedule surgery on the second eye after the first eye has recovered.
Be sure to consume essential fatty acids, bioflavonoids, amino acids, hyaluronic acid, glucosamine sulfate, silica, vitamin C. Foods that support the vitreous humor include: broccoli. cucumber.
Many vitrectomy side effects improve within the first week of recovery. However, redness and inflammation may last for several weeks. Although vision should gradually improve in the days following surgery, it can take many weeks for it to be completely restored.
Your vision may not be completely normal immediately following your vitrectomy. This is , especially true if your condition caused permanent damage to your retina. Some patients seem to experience a decrease in vision for the first few days following the procedure.
Vitrectomy can lead to the formation and accelerated progression of cataracts, most commonly, the nuclear sclerotic (NS) type.
Don't do things that might cause you to move your head. This includes moving quickly, lifting anything heavy, or doing activities such as cleaning or gardening. If your doctor used an oil or gas bubble to hold the retina in place, keep your head in a certain position for a few days or longer after the surgery.
Some people will be required to lay face down for a period of time to help their eye heal properly. Often, eye drops will be prescribed to help prevent infection and to reduce inflammation. In general, the full recovery process for vitrectomy surgeries takes between 4 to 6 weeks.
Sulfur hexafluoride (SF6) dissipates in 10 to 14 days, and perfluoropropane (C3F8), in 55 to 65 days. The gas bubble blurs your vision while it is in place. As the bubble dissipates you will see a line across your vision where the gas meets the newly forming fluid which is gradually replacing the bubble.
Risks associated with vitrectomy include, but are not limited to, cataract formation, retinal tear and detachment, macular pucker, and macular edema (swelling). There is a small risk of vision loss. A laser is now available that can be used to try to break up large floaters into particles small enough to be ignored.
Rates of these complications in macular hole surgery vary from 0% to 14.6%, with retinal detachment occurring in 1.1% to 14% [1–3, 8, 9]. Reported rates for epiretinal membrane surgery range from 0.6% to 6.9% for peripheral retinal breaks and from 1.4% to 6% for retinal detachment [2–13, 15].
The fact that you already notice improvement in the blind spot and blurriness is remarkable and should be cause for great optimism. The fact that you still have wavy vision is typical. The epiretinal membrane caused distortion of the retina cells, which leads to waviness of vision.
Although about 90% of retinal detachments can be repaired in a single surgery, about 10% will need a second or even third surgery before successful reattachment is achieved.
Most of the time, the retina can be reattached with one operation. However, some people will need several surgeries. More than 9 out of 10 detachments can be repaired.
It's possible to get a detached retina more than once. You may need a second surgery if this happens. Talk to your provider about preventive steps you can take to protect your vision.