What is a Vitrectomy for Diabetic Retinopathy?

Diabetes comes with a host of secondary complications that must be monitored throughout the course of diabetes and blood sugar management. Diabetic retinopathy is one frequent complication that develops as a result of diabetes, where all retinal blood vessels can leak blood into the retina and vitreous and new blood vessels can grow into the vitreous in the eye, which causes blurred and spotty vision, eventually potentially leading to partial or total vision loss in extreme cases.

Diabetic retinopathy is the leading cause of preventable blindness for adults in the US, which means there is a significant need for early detection, prevention, and treatment for this eye disease. 

This blog will explore the circumstances that require advanced treatment for diabetic retinopathy, particularly the decision to undergo a vitrectomy surgery for advanced cases. 

Diabetic Retinopathy Development 

Diabetic retinopathy can develop in any individual who is living with diabetes. The poorer the blood sugar control and the longer the duration of the disease increase the risk of developing progressive retinal damage. Diabetic retinopathy initially occurs when normal blood vessels leak, which causes abnormal blood vessel grow, leading to symptoms like blurred vision or “floaters” (dark spots). 

While the disease is often asymptomatic in its early stages (mild, moderate), its more advanced stages (moderate, severe, proliferative) can lead to visual impairment and permanent vision loss becomes a concern. 

The Path to Diabetic Eye Surgery 

Vitrectomy is typically used as a treatment option during the late stages of diabetic retinopathy when identification of retinopathy is delayed or diabetes is poorly controlled. 

The best option for preventive diabetic retinopathy care is retinal screenings through a licensed eyecare provider or through remote screening services such as IRIS, which can detect early-stage diabetic retinopathy and set patients on a path toward adequate blood sugar management, hopefully halting or slowing the progression of the disease. 

For patients who are suffering from progressive vision loss as a result of advanced stages of diabetic retinopathy, a vitrectomy may be a beneficial treatment solution. 

What is a Vitrectomy? 

A vitrectomy is an incisional eye surgery used to treat diabetic retinopathy, as well as other eye conditions that impact the retina and/or macula. 

This surgical procedure involves a delicate process of making tiny incisions into the eye to remove the vitreous and blood (if present) that cause substantial decreased vision, or to implement other necessary repairs to address retinal detachment and the traction that causes it. Laser can be performed if indicated as part of the procedure.

The objectives of this surgery are typically:

• Remove vitreous 
• Remove additional scar tissue distrorting or causing traction to the retina
• Make any necessary repairs to the retina 
• Inject temporary fluid or gas to keep the retina attached during recovery 

Preparation and Recovery 

Preparation for a vitrectomy includes the same requirements as preparation for any outpatient surgery, including limiting food and drink intake before the surgery, sharing important information with your doctor about medications or other health conditions, and having a plan in place for transportation home once the procedure is completed. 

While preparation is standard, the recovery from a vitrectomy can be a unique experience, especially for individuals who have never undergone eye surgery before. 

Most individuals in recovery from a vitrectomy are instructed to wear an eye patch for a certain period, as well as advised to take time off for rest and recovery. 

Depending on whether a gas bubble or a different substance was injected to hold the retina in the correct place, your doctor will likely require you to spend a number of hours, days, or even weeks (in rare cases) lying in a specific position, often facedown to keep the bubble in the correct location. The intensity of this recovery period and the doctors’ recommendations will be based on the treatment that was required during surgery, so the exact recovery timeline may vary depending on postoperative response.

Diabetic Retinopathy Operation Risks and Outcomes 

With all of this in mind, what are the benefits and risks of having a vitrectomy?

Risks: 

• Potential cataract development 
• Retinal detachment 
• Unresolved vision issues 
• Bleeding
• Infection 

Benefits: 

• Improved vision
• Prevention of further vision loss 
• Reduction of diabetic retinopathy symptoms
• Stabilization of diabetic retinopathy 

Preventative Measures for Diabetic Eye Disease

A vitrectomy can feel intimidating, but this procedure can be an effective treatment option for individuals who are at risk of partial or complete vision loss due to diabetic retinopathy. 

Overall, the best possible option for individuals living with or at risk of developing diabetic retinopathy is to ensure preventative measures before the disease progresses to the point that eye surgery is required. 

The very best way to prevent serious complications from diabetic retinopathy is to receive retinal screenings early and often. Every patient who has diabetes should receive annual eye screenings to detect early, mild diabetic retinopathy, when it is the least damaging and most treatable. 

That’s why a solution like IRIS is so crucial for healthcare providers and individuals living with diabetes.
IRIS offers a teleretinal screening solution that enables the detection and diagnosis of diabetic retinopathy before it progresses to a major vision risk, which means fewer surgery bills and more eyesight saved for diabetic patients. 

The IRIS solution is viable for use in primary care and at-home healthcare settings, which increases access for more patients who need these crucial early screenings. 

Learn more about how your healthcare organization can join the fight to end preventable blindness by contacting us or scheduling a demo today!

FAQs

What is a vitrectomy?

A vitrectomy is a surgical procedure used to remove cloudy substances, blood, or scar tissue from the vitreous of the eye. 

Is a vitrectomy a serious diabetic retinopathy operation?

Yes, a vitrectomy is an outpatient incisional eye procedure that requires anesthesia and a recovery period that can vary based on the individual patient’s situation.

Why poor vision after vitrectomy?

Poor vision is a common experience for individuals immediately following a vitrectomy, but your vision should begin to improve during recovery. If you are struggling with prolonged vision issues after a vitrectomy, consult with your provider. 

A vitrectomy removes the cloudy or bloody leakage that occurs as a result of diabetic retinopathy, and can stall or prevent the further progression of vision loss as a result.

 

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