Vitrectomy

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Vitrectomy Surgery

Vitrectomy surgery is a common surgery we use to treat a number of retinal health issues. The process involves removing part or all of the vitreous (the gel-like substance in the middle of your eye) and replacing it with a saline solution or bubble made of gas or oil.

When Is a Vitrectomy Recommended?

Your retina is a layer of tissue that receives light when it enters the eye. It then sends it to the brain through the optic nerve. When the vitreous is blocked by blood, debris, or scar tissue, it can impede vision and increase tension on the retina, which can lead to complications. Vitrectomy surgery is a safe and effective procedure that can help address this issue and preserve your retinal health.

There are many issues that can warrant a vitrectomy, all of which can contribute to vision loss and lead to blindness if not treated. These include:

• Detached retina
• Diabetic retinopathy
• Vitreous hemorrhage
• Severe floaters
• Macular hole or pucker
• Endophthalmitis (an infection inside your eye)
• Complications from cataract surgery
• Inflammatory or autoimmune diseases that affect the eye

Sometimes the vitreous itself can pull on the retina. In these cases, a vitrectomy can resolve that tension. A vitrectomy can also remove a foreign object stuck inside the eye from an injury.

The Vitrectomy Procedure, Step by Step

Vitrectomy surgery is a standard procedure that we typically conduct on an outpatient basis. It usually takes several hours. Here’s a step-by-step breakdown of what to expect:

Before Surgery

Before the surgery, one of our doctors will dilate your eyes and examine your retina. We may conduct an ultrasound of your eye to get a clearer understanding of your specific situation and create a plan for the surgery. You won’t be able to eat anything after midnight on the night before the surgery.

During Surgery

1. In most cases, you’ll receive a local anesthetic and sedation, though at times general anesthesia is used. Either way, you’ll be comfortable and this is no pain or discomfort.
2. Your eye will be cleaned and sterilized with antiseptics.
3. We place sterile coverings around your eye, also known as “draping.”
4. A speculum is used to delicately hold your eye open.
5. Your surgeon makes three small incisions through the white part of your eye, known as the sclera.
6. Using a vitrectomy probe, we gently cut away and suction out small pieces of the vitreous gel, along with any scar tissue, cataracts, or foreign objects.
7. If there are additional needs, such as laser surgery or repairing a retinal detachment, we’ll complete those procedures after the vitreous is removed.
8. Saline solution, gas, or oil is used to replace the removed vitreous.
9. The incisions are checked to ensure there is no leaking, and, in some cases, we apply any stitching needed to close the incisions.

After Surgery

Following the procedure, antibiotic ointment is applied, and a patch is used to cover your eye. After a brief observation, most patients are able to go home that same day. Plan to have someone take you home.

Recovery After Vitrectomy

After the vitrectomy, your eye may be a bit red or irritated – this is normal, only lasts a few days, and can be treated with over-the-counter pain relievers. Some patients report a sandy or gritty sensation which is also expected and temporary. We’ll send you home with antibiotic eye drops to address this issue and prevent infection.

For a period of time, you’ll need to avoid activities such as driving, exercise, heavy lifting, and air travel. If you start to notice decreasing vision or any increase in pain or swelling, reach out to us immediately. Some patients take time off of work, typically 2-4 weeks.

Complications and Risks of Vitrectomy Surgery

Vitrectomy surgery is generally a safe and effective procedure, but as with any surgery, there is always the risk of complications. Depending on your age, medical history, and the specific details of your situation, there is the possibility of:

• Infection
• Bleeding
• Increased pressure in the eye
• Retinal detachmentLens damage
• Increased rate of cataract formation
• Problems with eye movement
• Change in refractive error

In some cases, the surgery does not resolve the original issue. When this happens, we may recommend an additional follow-up surgery.