When the eye’s clear gel which may become filled with blood, tugs on the retina, or which in some way is blocking access to damaged retinal tissue, a retinal surgeon may put forth that you have vitrectomy surgery. In that procedure we remove some or most of the vitreous gel which in turn gives the surgeon access to the retina in order to treat the base issue. Vitrectomy surgery may be used for retinal detachment, non healing vitreous hemorrhage, complications of diabetic retinopathy, macular holes, epiretinal membranes, certain eye injuries, and some infections.
What Is Vitrectomy Surgery?
Vitrectomy surgery process which takes place within the eye. In the common posterior approach which we also term as pars plana vitrectomy or ppv eye makes use of tiny instruments which enter through the pars plana a part of the eye wall behind the iris. Here the surgeon removes the vitreous gel and may also at the same time repair retinal tears, remove scar tissue, apply laser treatment, fill the eye with gas or silicone oil to support the retina.
The National Eye Institute says vitrectomy can treat problems involving the retina or vitreous. Depending on the condition, treatment may also include laser or freezing therapy, along with gas, air, or silicone oil. National Eye Institute Vitrectomy
Why Is Vitrectomy Surgery Performed?
The reason for performing vitrectomy surgery is based on the health of the eye which is in question. It may remove blood that is causing loss of vision, relieve traction which retinal detachment may cause, give access for retinal repair, or eliminate infected and inflammatory materials. In advanced diabetic retinopathy we may recommend vitrectomy surgery when there is persistent vitreous hemorrhage or the formation of scar tissue that causes traction on the retina.
| Condition | How the Procedure May Help |
| Retinal detachment | Gives access to repair retinal breaks and support the retina |
| Vitreous haemorrhage | Removes blood-filled or cloudy vitreous |
| Macular hole or epiretinal membrane | Allows treatment of tissue affecting the macula |
| Advanced diabetic retinopathy | Helps address bleeding and tractional retinal problems |
An anterior vitrectomy is different from the routine posterior one. Anterior vitrectomy which we see in the front of the eye, which may have moved there as a result of complex cataract, corneal, or glaucoma surgery is performed. The choice between the anterior vitrectomy and the posterior procedure depends on the location of the vitreous issue. Also Vasan Eye Care presents this distinction in their clinical info on vitreous surgery.
How Is Vitrectomy Surgery Done?
Before the retina is evaluated in the pre-procedure time frame we tailor the surgical plan according to that which is present. Anesthesia can be applied locally or totally depending on the patient and procedure. The surgeon makes small access points and uses specialized microsurgical tools. A vitrectomy cutter device is used to remove the vitreous which has been cut out in a controlled action at the same time we use an intraoperative infusion system to keep the eye’s structure stable.
In present day vitrectomy eye surgery vitreous removal is performed along with laser treatment, membrane peeling, retinal repair, or internal tamponade. We use the vitrectomy cutter and very fine instruments which are chosen based on the surgical system and case. For some retinal conditions ppv eye techniques provide access to areas that do not respond well to treatment from outside the eye.
The NCBI report on vitrectomy reports that pars plana vitrectomy is a well established surgical approach for treatment of the posterior segment and management of a variety of vitreoretinal disorders.
| Stage | What Usually Happens |
| Preparation | Eye examination, consent and anaesthesia planning |
| Vitreous removal | Vitreous is removed with microsurgical instruments |
| Retinal treatment | Laser, membrane removal or retinal repair may be performed |
| Internal support | Gas, air or silicone oil may be used when required |
| Follow-up | Eye drops, activity guidance and retinal reviews are scheduled |
Recovery After Vitrectomy Surgery
Recovery from vitrectomy surgery will vary depending on the cause of the procedure and what agent was used (gas or silicone oil). Early on in the recovery process patients may see mild redness, swelling and blurred vision. We recommend eye drops and also ask that patients do not rub the eye, lift heavy things, or engage in strenuous activity until cleared by their surgeon.
If at a vitrectomy eye surgery a gas bubble is put in, it may be that the patient will need to adopt very specific head positions. Air travel and high up travel must be avoided by you until the gas has fully gone which is at the risk of complications. Vision after vitrectomy surgery may improve over time, also the outcome is very much dependent on the base retinal health.
Risks of Vitrectomy Surgery
Like in other ophthalmic procedures, vitrectomy surgery has its risks which include infection, bleeding, eye pressure issues, cataract progression, retinal tears, re detachment, swelling, or the need for more surgery. Sudden vision loss, increase in pain, redness, new flashes, or a curtain like shadow after surgery are reasons to seek care right away.
At Vasan Eye Care we evaluate our patients who are candidates for this procedure with a retinal assessment which in turn goes over the cause for the surgery, what to expect post op, other options available and also we go over the individual risks. Related internal link topics include retina surgery, retinal detachment, diabetic retinopathy, and surgical retina care.
Frequently Asked Questions
1. Is vitrectomy surgery painful?
Vitrectomy surgery is performed under anaesthetic which means that pain is not an issue during the procedure. Discomfort may present itself during recovery.
2. How long does recovery take after vitrectomy surgery?
Recovery from vitrectomy surgery is variable. It may take some patients many weeks to get back to their routine activities especially when a gas bubble is used.
3. Is vitrectomy always done for retinal detachment?
No. Vitrectomy eye surgery is a treatment that may be used. What is used is based on the type, location and degree of the detachment.
4. Can vision improve after vitrectomy surgery?
Yes, with vitrectomy surgery, you may see vision improve but at the end what results in terms of vision is also a function of which disease process you have, how serious it is, that is what we are looking at also how long before treatment it went on.