Vitreo-Retinal Surgery in Diabetes

Diabetic Retinopathy

Diabetic retinopathy is a condition that occurs when the vessels of the retina layer, a light-sensitive tissue in the back of the eye, are affected due to diabetes and causes blindness and is the only treatable complication of diabetes. When detected at an early stage, it is possible to treat in patients. For this reason, patients should have retinal examinations 1 or 2 times a year even if they have no complaints.

Stages of Diabetic Retinopathy

1- Background diabetic retinopathy: Small vasodilatation due to blockage of the retinal vessels and deterioration of their walls, small retinal hemorrhages due to leakage of blood elements into the retina, and yellow deposits called hard exudates are seen.

2-Maculopathy: Over time, as a result of damage to the vessels in the macular area, malnutrition, fluid leakage (edema) and bleeding and exudates that settle in this area affect vision. The patient begins to experience blurred and little vision.

3-Proliferative Diabetic Retinopathy: New vessels develop in unwanted places. These new vessels cause intense bleeding into the eye (vitreous hemorrhage), the retina to bulge out of its place (detachment) with the shrinkage caused by the bands that develop around them and extend towards the egg white gel (vitreous) filling the inside of the eye, and the eye pressure to rise (glaucoma). These conditions result in blindness.

How is laser light coagulation applied?

It is very important for a person with diabetes to consult an ophthalmologist before the onset of symptoms. It is possible to prevent recurrence in 80%-90% of patients treated with laser light coagulation in the early stages. Laser light is delivered to the areas to be treated through the lens and burns are applied.

What is Vitrectomy?

It is a type of surgery performed by entering into the eye with special instruments thinner than 1 mm in patients who are late for treatment and sometimes develop progression despite laser treatment. The aim is to remove hemorrhages and shrinking bands in the intraocular fluid (vitreous) and to restore the retina to its former anatomical structure. The removed intraocular fluid is replaced with physiological saline solution or other fluid and the eye is filled. Early surgery increases success.

What is the purpose of vitrectomy surgery in diabetes?

If blood glucose levels are not controlled in diabetes, usually about 5 years after the onset of the disease, retinal hemorrhages, leakage of fat and fluid into the retina and thickening of the retina, and in later stages, the hemorrhage may spread into the eye and separations and tears of the retina may develop. Vitrectomy techniques are used to treat these problems.

With this surgery, hemorrhages are cleaned, retinal tears are repaired, and the membranes on the retina are removed to reduce the accumulation of fat and fluid in the retina.

The point to remember is that diabetics should keep their blood sugar levels within normal limits regularly to avoid reaching this stage.