What is a Vitrectomy?
Vitrectomy is a surgical procedure to remove the existing vitreous humor gel to allow for better access to the retina and macula. The surgery is performed by a retina specialist to address the harm caused when the vitreous pulls on the retina, creating a tear, hold, or detachment. It is also performed to address scar tissue, remove blood that is blocking vision, and repairing the eye from trauma. One of the underlying vision issues has been treated, the vitreous is replaced with a mixture of gas and air to hold the retina back in position.
What does a Vitrectomy help treat?
Vitrectomy surgery procedure may be performed to help treat the following conditions:
- Retinal Detachment
- Macular Pucker
- Retinal Tear
- Macular Hole
- Macular Edema
- Complications from cataract surgery
How do you prepare for a Vitrectomy?
Before surgery, your doctor will conduct a careful eye exam and assess your health. This typically involves a slit-lamp, dilated eye exam, and in-office testing such as OCT (ocular coherence tomography), fluorescein angiography, retinal photography, and/or ultrasound.
Beyond that, your ophthalmologist can tell you if there are specific things you need to do to prepare. You may ask one or more of the following questions:
- Will I need to stay overnight in a hospital, or will I go home the day of the surgery?
- Do I need to stop taking certain medications beforehand?
- Should I avoid food and drinks before surgery, and if so, how long before?
- What are my anesthesia options?
- How long do you expect the surgery to take?
Why is a Vitrectomy performed?
A vitrectomy is performed to allow access to the retina and macula to repair or fix any vision limiting or vision-threatening conditions. This access allows the ophthalmologist to fix the following conditions:
- Damaged blood vessels in your retina
- Infections inside your eye
- Serious eye injuries
- Wrinkles in your retina (macular pucker)
It is important to discuss the reasons and risks for the surgery with your doctor prior to the procedure.
What can you expect during a Vitrectomy?
During surgery, the ophthalmologist will make a small cut (incision) in the white of the eye (sclera) and remove the gel-like vitreous. Removal of the vitreous allows access to the area of the underlying condition. He or she will use a microscope to see inside your eye to treat the retina and/or macula.
Once the treatment has been completed, the vitreous is replaced with a mixture of gas and air to hold the retina back in position. This puts the necessary pressure on the retina and macula to allow them to heal correctly.
Depending on the condition being treated, a vitrectomy can take from one to several hours. It may be just one in a series of procedures to repair a problem.
What is the follow-up and recovery like for a Vitrectomy?
Ask your ophthalmologist about what you should expect after your surgery. Most patients will be able to go home the same day but plan to have someone drive you home after the procedure.
Be sure to follow your eye doctor’s instructions about post-surgery eye care. You may be prescribed antibiotic eye drops to help prevent infection. Because your eye may be a little sore after the procedure, over-the-counter pain relievers can be taken to relieve pain and soreness. Also, you may have to wear an eye patch for a day or so to protect your eye while it heals.
You will need to follow specific instructions about eye positioning after the surgery. You will also need to avoid air travel for a period (typically 4 weeks) after the procedure. If you plan on traveling by air soon after your surgery, be sure to ask your eye doctor when it will be safe for you to fly.
Close follow-up with your eye doctor is necessary to determine if the procedure was successful. In your follow up appointment after the procedure, be sure to immediately tell your eye doctor if you have a decreasing vision or increasing pain or swelling around your eye.
After a vitrectomy, your vision may not be completely normal, especially if your underlying condition caused damage to your retina. Be sure to ask your doctor about how much improvement you can expect.
A vitrectomy has little effect on the health of the eye. The gas bubble is gradually replaced by the eye’s own fluids.
Surgical complications are rare but include infection, bleeding, high or low eye pressure, cataract, retinal detachment, and loss of vision. There may be some temporary swelling of the eyelids, bruising around the eye, and redness following the surgery, but these improve relatively quickly. It is important to use prescribed medicated eye drops to help the eye heal.
A common experience of a mild sensation as if there is something in your eye is normal. Severe pain is uncommon unless there is inflammation or high eye pressure.
Some patients may experience a decrease in vision for a few days following the procedure while others may need longer. This could take weeks or even months for vision to improve.
Are there related procedures to a Vitrectomy?
Select Relevant Publications
Feistmann Jonathan, Prasad S, Gentile RC, Kasuga DT, Bhullar SS, Joshi DD. Bimanual Approach to Intraocular Lens Rescue Using Modified Transconjunctival Scleral Fixation. Retina Today. 2014;34(4):812-815. Link to Article.
Jonathan A. Feistmann, MD,PC, Reginald J. Sanders, MD. Transitioning to ICD-10: Will the Disruption Be Worth It?. Retina Times. Fall 2015; 61. Link to Article.