by Woods M

Definition

A vitrectomy is surgery to remove a gel-like fluid from the center of the eye. The fluid is called the vitreous humor. This fluid gives the eyeball its shape and plays a key role in vision.

Normal Anatomy of the Eye
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Reasons for Procedure

This surgery may be done to:

  • Remove blood or things that are making the vitreous humor cloudy and blurring vision
  • Access the back of the eye during surgery
  • Improve healing of other damaged areas of the eye

Vitrectomy may also be done to treat:

  • Certain problems in the retina of the eye, such asdetachment
  • Eye trauma or infection

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, like:

  • Vision problems
  • Bleeding
  • Cataracts
  • Infection
  • The retina tears or comes off the eye wall
  • Damage to other parts of the eye
  • Scar tissue
  • Increased eye pressure

Things that may raise the risk of problems are:

  • Smoking
  • Drinking excess alcohol
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Curent medicines, herbs, and supplements you take and whether you need to stop taking them before the surgery
  • Fasting before the surgery—not eating or drinking anything after midnight the night before the surgery
  • Whether you need a ride from the surgery
  • Specialists you may need to see
  • Tests that will be done before the surgery

Anesthesia

The doctor may give:

  • Local anesthesia: the area around the eye will be numbed
  • General anesthesia: you will be asleep

    • Description of the Procedure

    Tiny incisions are made in the whites of the eyes. A small instrument is put into the incisions to remove the vitreous humor and any debris. The doctor can then reach other areas of the eye to fix any problems.

    Next, a gas bubble, saline solution, or silicone oil will be put in the eye. This will help the eye keep its shape.

    How Long Will It Take?

    The length of the procedure depends on other work that needs to be done. A vitrectomy itself takes about an hour.

    Will It Hurt?

    Anesthesia will block pain during the procedure. After the procedure there may be some discomfort. Medicine and home care can help.

    Post-procedure Care

    At the Care Center

    After the procedure, the staff may:

    After the procedure, the staff may:

    • Place an eye patch or shield over the affected eye
    • Give medications or eye drops to reduce discomfort

    During your stay, the staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

    • There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

    • You will be able to leave when you are alert and well enough to travel home. Some people may stay overnight in a hospital.

    At Home

    Eyesight may be affected for a time as your eye heals. It could take 2 to 4 weeks to return to work. If a gas or air bubble was used, you may need to lay down for days or weeks to keep the bubble in the right place. Air travel may also be limited if gas was used. Physical activity may need to be limited during to avoid straining the eye.

    The eye will refill the eye with vitreous humor over time. If gas was used, the gas bubble will go away on its own as the vitreous humor moves in. If oil was used, it will need to be removed with another procedure.

    Eyesight may be affected for a time as your eye heals. It could take 2 to 4 weeks to return to work. If a gas or air bubble was used, you may need to lay down for days or weeks to keep the bubble in the right place. Air travel may also be limited if gas was used. Physical activity may need to be limited during to avoid straining the eye.

    The eye will refill the eye with vitreous humor over time. If gas was used, the gas bubble will go away on its own as the vitreous humor moves in. If oil was used, it will need to be removed with another procedure.

    Problems to Look Out For

    Call the doctor if you are not getting better or have:

    • Signs of infection, including fever and chills
    • Worsening vision problems
    • Pain that you cannot control with the medicines given
    • New or worsening symptoms

    If you think you have an emergency, call for medical help right way.

    RESOURCES

    Eye Smart—American Academy of Ophthalmology  http://www.geteyesmart.org 

    National Eye Institute (NEI)  https://nei.nih.gov 

    CANADIAN RESOURCES

    Canadian Association of Optometrists  https://opto.ca 

    Canadian Ophthalmological Society  http://www.cos-sco.ca 

    References

    Cataracts in Adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cataracts-in-adults. Accessed February 14, 2022.

    Management of diabetic retinopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-diabetic-retinopathy. Accessed February 14, 2022.

    Vitrectomy. National Eye Institute website. Available at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/vitrectomy. Accessed February 14, 2022.

    What is vitrectomy? American Academy of Ophthalmology. Available at: https://www.aao.org/eye-health/treatments/what-is-vitrectomy. Accessed February 11, 2022.

    Yamada H, Imai H, et al. The contribution of the proximity of the retinal detachment to the fovea for postoperative metamorphopsia after 27-gauge pars plana vitrectomy for the primary rhegmatogenous retinal detachment. PLoS ONE, 2021 16(10): e0258775.

    Revision Information