Surgical Treatment for Diabetic Eye Disease
Vitrectomy Surgery for Diabetic Eye Disease
In some patients with proliferative diabetic retinopathy, bleeding from neovascularization can result in a vitreous hemorrhage, and blood may settle in the center of your eye, in the vitreous gel.
Vitreous Hemorrhage
When this happens, laser treatment is not possible, as the blood blocks the laser from reaching the damaged areas. In such cases, you may require surgical treatment to restore your vision. This procedure is called a vitrectomy. Vitrectomy is also required when the abnormal blood vessels grow into the vitreous gel and cause a retinal detachment.
You should not eat or drink anything after midnight the night before your surgery. On the day of treatment, you will be welcomed by a staff member who will help you prepare for your surgery by putting eye drops in your eye. You will be given a gown to wear over your street clothes during your actual surgery.
You will be given a local anesthetic in which the eye is numbed, along with a type of sedative. During the surgery, you will not feel any pain.
Your surgeon, Dr. Eddie Kadrmas, will look through a special microscope to have a clear view of the retina. He will use small instruments to remove the blood and some of the vitreous gel. Any vitreous gel which is removed will be replaced by a saline solution, and your eye will retain its normal appearance and shape. Overtime, the saline is replaced by your body's own natural fluids.
Since diabetics are also at higher risk for developing a detached retina, the surgeon may also remove some of the vitreous strands which are attached to the retina. This is to prevent them from pulling on the retina, since this pulling can lead to a tear or detachment.
Depending on the location and amount of leaky vessels in your eye, you may also require a laser treatment - either pan-retinal photocoagulation or focal laser treatment. This may be done at the same time as the vitrectomy. Again, if you require a vitrectomy in both eyes, the surgeries would be done several weeks apart.
After your surgery, you will rest in a comfortable reclining chair. Your family members may then join you in reviewing your follow-up care and schedule. Your surgeon will see you the next day after surgery to check how your eye is healing.
Some discomfort is to be expected following surgery. You will wear an eye patch for a short time afterwards. It will take about 10 weeks for your eye to fully heal. You may need to avoid strenuous activity during this period. It will be necessary for you to see your doctor at regular intervals during this time so that he can monitor your healing.
An untreated vitreous hemorrhage can lead to loss of vision in your eye. While there are some risks to a vitrectomy, they are less than the expected benefits to your vision. Some risks include infection, bleeding, retinal detachment, high intraocular pressure, and accelerated cataract formation.
Following the vitrectomy, it is likely that your eye will be red and sensitive. You will need to wear an eye patch for a few days. Your doctor will also give you medicated eye drops to prevent against infection and inflammation. While some discomfort and pain is normal for the first few days after surgery, you should immediately contact your doctor if you have severe pain that does not respond to over the counter medication.
Following surgery, your vision may be blurry but gradually improve. You will not be able to drive home following the treatment. Therefore, you should make transportation arrangements.
Remember that once you’ve been diagnosed with diabetic eye disease, you may require dilated eye exams more than once a year. By keeping your blood sugar levels and blood pressure as close to normal as possible, and by keeping to the schedule of eye examination your doctor recommends, you’ll be doing your part to protect your vision.