Vitreous Traction and Surgery for High Myopia

Q: Vitreous Traction and Surgery for High Myopia

Dear Ms. W： 1. Whether additional steps need to be taken during the surgery is something you should discuss with your attending physician, as I cannot provide an answer to that. Generally, the likelihood of developing cataracts after surgery is high. 2. The

Traction issues

Hello, I would like to ask about a case of myopia over 600 degrees, where the left eye has a visual acuity of 0.5, and there is vitreous traction on the macula.
The imaging shows significant traction (with folds, and no tears or splitting in the macula).
There is a concern about a black spot in the image, which could be a tear or edema.

1.
In this situation, will the vitrectomy involve the removal of the entire vitreous body? If the doctor did not mention the use of gas or silicone oil, does that mean it is not necessary, or will this be determined on the day of the surgery? If gas is used, and if proper care is taken while lying face down afterward, will the risk of developing cataracts still be high?
2.
Does frequently bending, lowering the head, or lifting heavy objects contribute to or worsen vitreous traction? Or can being cautious and moving slowly mitigate the risk? How long after surgery should these activities be avoided?
3.
Are there potential postoperative complications or increased risks associated with the surgery?
4.
With vitrectomy and the presence of folds, is there a chance for visual acuity to recover to 0.8 or higher postoperatively? Thank you!

w, 30~39 year old female. Ask Date: 2023/10/01

Dr. He Jianxian reply Ophthalmology

Dear Ms.
W:
1.
Whether additional steps need to be taken during the surgery is something you should discuss with your attending physician, as I cannot provide an answer to that.
Generally, the likelihood of developing cataracts after surgery is high.
2.
The posture or movements have minimal impact on macular traction.
As for post-operative activities, there are no significant restrictions unless gas is injected.
3.
Surgery carries various risks, which should be detailed in your surgical consent form.
Please refer to it for more information.
4.
It is possible, but this varies greatly from person to person.
Dr.
He Jianxian, Ophthalmology Department, Nantou Hospital

Reply Date: 2023/10/01

More Info

Understanding vitreous traction and the surgical options available for high myopia is crucial, especially when dealing with complications such as macular traction. High myopia, defined as a refractive error greater than -6.00 diopters, can lead to various ocular complications, including vitreous traction on the macula, which can result in vision impairment.

1. Vitreous Surgery and Removal: In cases of significant vitreous traction, a vitrectomy may be performed. This procedure involves the removal of the vitreous gel from the eye. Depending on the severity of the traction and the presence of any associated complications, such as macular folds or holes, the surgeon may remove the entire vitreous or just the portion that is causing the traction. The decision regarding whether to use gas or silicone oil during the surgery often depends on the specific circumstances of the case. If the surgeon has not mentioned the use of gas or silicone oil, it may be determined intraoperatively based on the condition of the retina and the vitreous. The use of gas can help maintain the shape of the eye and support the retina during healing, but it also requires specific post-operative positioning to avoid complications.

2. Impact of Physical Activity: Activities that involve bending, lifting, or straining can potentially exacerbate vitreous traction. While gentle movements are generally acceptable, it is advisable to avoid heavy lifting or straining, especially in the weeks following surgery. Post-operative instructions will typically include guidelines on physical activity to minimize the risk of complications. It is essential to follow your surgeon's advice regarding activity restrictions to ensure proper healing.

3. Post-Surgical Risks and Complications: As with any surgical procedure, vitrectomy carries risks, including bleeding, infection, retinal detachment, and cataract formation. The likelihood of developing cataracts can increase after vitrectomy, particularly if gas is used during the procedure. However, the risk varies among individuals and can be influenced by factors such as age and pre-existing conditions.

4. Visual Prognosis: The potential for visual recovery after vitrectomy largely depends on the extent of the damage caused by vitreous traction and the overall health of the retina. In cases where the macula is not severely compromised, patients may experience significant improvement in vision post-surgery. Achieving a visual acuity of 0.8 or better is possible, but it is not guaranteed. Factors such as the duration of traction, the presence of any retinal damage, and the patient's overall ocular health will play a significant role in the final visual outcome.

In summary, if you are experiencing vitreous traction due to high myopia, it is essential to have a thorough discussion with your ophthalmologist regarding the specifics of your condition and the surgical options available. Understanding the risks, benefits, and expected outcomes of vitrectomy can help you make an informed decision about your treatment. Always adhere to your surgeon's post-operative care instructions to optimize your recovery and visual outcomes.

Similar Q&A

Understanding Cataract Surgery Options After Vitrectomy: What You Need to Know

Hello, I would like to ask: 1. With a myopia of 600 degrees and having undergone vitrectomy due to vitreomacular traction, if cataracts develop afterward, can I choose femtosecond laser surgery? Or is only conventional cataract surgery an option? Is it true that after having vitr...

Dr. He Jianxian reply Ophthalmology
Hello, Miss: 1. The choice of cataract surgery technique is not significantly related to the vitreous surgery performed previously, and there are no specific restrictions on the selection of the intraocular lens. 2. Vision loss caused by macular traction may not show significa...

Understanding Vitreomacular Traction and Alternative Treatment Options

Hello, doctor. I saw online that vitreous traction on the macula can be treated not only with vitrectomy but also by injecting a certain gas to separate the areas where the vitreous is adherent, as an alternative to vitrectomy. I also came across research reports from China indic...

Dr. Gao Pilin reply Ophthalmology
Hello: The success rate may vary depending on the patient's condition and the timing of treatment. For certain diseases, vitreous detachment treatment may be an effective option to avoid more invasive procedures, such as vitrectomy. However, the choice of treatment should be...

Understanding Vitreomacular Traction: Vision Loss and Treatment Options

Hello Doctor: I have a follow-up question and would appreciate your clarification. I have been diagnosed with vitreomacular traction, and my vision is 0.5, with distorted letters. Given the vitreous pulling and my vision being 0.5, is it correct to say that glasses would not be e...

Dr. Gao Pilin reply Ophthalmology
Hello: Regarding the issue of vitreomacular traction and vision decline, corrective lenses may provide some benefit, but the outcome depends on the severity and nature of the condition. 1. Vitreomacular traction: This condition typically involves issues with the retina, where t...

Understanding Macular Holes: Risks, Surgery, and Vision Recovery

Hello Doctor, I would like to follow up on the issue mentioned in article #207477: Last September, vitreous degeneration caused traction on the macula, resulting in a hole (which is currently likely a macular lamellar hole). In November, the vitreous spontaneously detached in the...

Dr. Gao Pilin reply Ophthalmology
Hello: 1. For macular hole, continued enlargement may lead to further loss of retinal tissue. The success of surgery and the degree of visual recovery depend on multiple factors, including the size, location, and morphology of the hole, as well as the postoperative recovery. Ge...