OHSU

Vitrectomy Surgery

What is a Vitrectomy?

Vitrectomy is a type of eye surgery that treats disorders of the retina and vitreous. The retina is the light-sensing tissue that lines the inside back surface of the eye. The vitreous is the clear, jelly-like fluid that fills the middle of the eye (vitreous cavity). The vitreous is removed during vitrectomy surgery and usually replaced by a saline solution. 

When do you need a vitrectomy?

Your retina specialist may recommend vitrectomy surgery to treat eye problems such as:

  • Diabetic retinopathy, if bleeding in the vitreous and/or and scar tissue is present
  • Some retinal detachments
  • Infection inside the eye
  • Severe eye injury
  • Macular pucker (epiretinal membrane or wrinkling of the retina)
  • Macular hole (full-thickness defect in the center of the retina that leads to partial loss of vision for fine details)
  • Certain problems after cataract surgery

How can a vitrectomy improve vision?

Vitrectomy surgery often improves or stabilizes vision. The operation removes any blood or debris (from infection or inflammation) that may be blocking or blurring light as it focuses on the retina. Vitrectomy surgery removes scar tissue that can displace, wrinkle, or tear the retina. Vision is poor if the retina is not in its normal position. This surgery can also remove a foreign object stuck inside the eye as the result of an injury. Most foreign objects will damage vision if they are not removed.

What happens if you decide to have a vitrectomy surgery?
Before surgery: Before surgery you will need to have a physical examination to alert your ophthalmologist to any special medical risks. In some instances, a painless ultrasound test may be performed before the surgery to view the inside of the eye. Your ophthalmologist will decide whether local or general anesthesia is best for you. Vitrectomy is completed as day surgery so you will not need to stay overnight in the hospital.  You will need to have an adult take you home after surgery.

Vitrectomy surgery: The length of the operation varies from one to several hours, depending on your condition. In certain situations, your ophthalmologist may do another surgical procedure at the same time, such as repairing a detached retina or removing a cataract. In order keep your eye comfortable, a numbing (anesthetic) injection is place around and behind your eye. Your retinal specialist performs the operation while looking into your eye with an operating microscope. Various miniature instruments are placed into the eye through tiny incisions in the sclera (white part of the eye).

In order to get the best possible vision for you, your ophthalmologist will do one or more of the following:

  • Remove the cloudy vitreous
  • Remove any scar tissue present, attempting to return the retina to its normal position
  • Remove any foreign object that might be in the eye
  • Treat the eye with a laser to reduce future bleeding or to fix a tear in the retina
  • Place an air or gas bubble in the eye to help the retina remain in the proper position (the bubble will slowly disappear on its own as the eye fills in with its own fluid)
  • Place silicone oil in the eye, which usually requires later surgical removal.
After surgery: An eye patch and eyeshield will be placed on your eye. This is to be kept on overnight until we remove it the next day in clinic. An adult will need to take you home after surgery. You may experience some discomfort after surgery. Usually the eyeshield is taped to the operated eye at bedtime for the first week after surgery. Your ophthalmologist will prescribe eye drops for you and advise you when to resume normal activity. If your surgery requires a gas bubble to be placed in your eye, your ophthalmologist may recommend that you keep your head in special positions until the gas bubble is gone.


ATTENTION: DO NOT FLY IN AN AIRPLANE OR TRAVEL TO ALTITUDES ABOVE 2000 FEET UNTIL THE GAS BUBBLE IS GONE! A RAPID INCREASE IN ALTITUDE CAN CAUSE A DANGEROUS RISE IN EYE PRESSURE AND IRREVERSIBLE VISION LOSS

What are the risks of vitrectomy surgery?

All types of surgery have certain risks, but the risks of vitrectomy are less than the expected benefits to your vision.
Some of the risks of vitrectomy include:

  • Infection
  • Bleeding, mild or severe
  • Retinal detachment
  • Excessive scar tissue formation
  • Poor vision
  • High or low pressure in the eye
Another risk of vitrectomy surgery is accelerated cataract formation. Although cataract rarely develops soon after surgery, elderly patients often develop cataract over many months.

How much will your vision improve?

Your vision after surgery will depend on many variables, especially if your eye disease caused permanent damage to your retina before vitrecomy. Your ophthalmologist will discuss your situation with you to explain how much improvement in your eyesight is possible.