Vitrectomy

A vitrectomy is a surgery to remove the vitreous humor (vitreous) in your eye. That’s the gel-like substance that fills the center of your eyeball. Some eye doctors call it a pars plana vitrectomy (PPV).

During a vitrectomy, your surgeon removes the vitreous. This will give them access to repair your retina, if needed.

Your surgeon might replace the vitreous humor with sterile salt water, silicone oil or a gas bubble.

Eye doctors use vitrectomy to treat lots of eye issues and conditions, including:

• Retinal detachment
• Vitreous hemorrhage
• Posterior vitreous detachment
• Diabetes-related retinopathy
• Macular hole
• Macular pucker
• Retinopathy of prematurity
• Eye injuries
• Endophthalmitis
• Tumors
• Lens issues

Your eye doctor can also use this surgery to put medicine into your eye.

Benefits/risks

The biggest benefit of vitrectomy is managing serious conditions that can cause permanent damage or vision loss if they’re not treated.

Vitrectomy is safe. But, like all surgeries, there’s a small risk of complications, like:

• Cataracts
• Infections
• Bleeding
• Damage inside your eye
• High or low eye pressure
• Vision damage or loss (this is very rare)

What happens before this procedure?

You’ll need to fast before surgery. Your eye doctor will let you know when to stop eating and drinking before your appointment.

Make sure you tell your surgery care team about all the prescriptions and over-the-counter medications you take, including supplements. They’ll tell you if you should stop taking anything before surgery.

Arrange for transportation to and from your vitrectomy. You won’t be able to drive yourself home. You’ll also need a driver for your follow-up appointment, which is usually the next day after your surgery.

What happens during vitrectomy?

Your care team will give you anesthesia to numb your eye so you don’t feel anything during surgery. They might also give you general anesthesia to put you to sleep.

During vitrectomy, your surgeon will:

1. Dilate your eye.
2. Hold your eye open with a tool called an eye speculum.
3. Make a cut in your eye.
4. Use very small tools to remove the vitreous.
5. Repair your retina or other tissue (if needed).
6. Use a laser to repair or safely destroy blood vessels that are leaking or growing out of control (if needed).
7. Replace the vitreous humor with sterile salt water, a gas bubble or silicone oil (if needed).

Vitrectomy usually takes around 90 minutes. The time can vary. More complicated procedures will take longer.

After surgery, your care team will move you to a recovery room to make sure it’s safe for you to go home. You should be able to go home the same day.

If you have a gas bubble or silicone oil, your care team may tell you to spend lots of time in specific positions. During the day, you may need to sit up, like you would to read. At night, you may have to sleep on your stomach. Your care team will give you detailed instructions.

You’ll need to wear a patch after surgery. You’ll need to visit your surgeon the next day for a follow-up exam. They’ll remove the patch and give you exact recovery instructions.

Vitrectomy recovery

It usually takes a few weeks to recover completely after a vitrectomy. Your vision may be blurry or worse than usual for a few days. But it’ll get better over time.

Your surgery care team will tell you how to hold your head when you’re awake and how to sleep correctly. You might want to use a neck pillow to help you keep your head in the correct position.

You may have some side effects after surgery, including:

• Puffiness
• A feeling of irritation
• Redness in your eye
• Bruising

Use your medicated eye drops as often as your surgery team suggests to help manage any side effects like these.

You may need another operation to remove silicone oil. Your body will naturally absorb saline or gas bubbles and replace them with new vitreous humor over time.

Don’t start driving again until your eye doctor says it’s safe. This can be anywhere from a few days to a few weeks.

Call your eye doctor if you have severe pain or worsening vision.