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Vitrectomy

Surgery Overview

Vitrectomy is a surgery to remove the vitreous gel from the middle of the eye. It may be done when there is a retinal detachment or if blood in the vitreous gel (vitreous hemorrhage) does not clear on its own. Removing the vitreous gel gives your eye doctor better access to the back of the eye. Vitrectomy is done by an eye doctor (ophthalmologist) who has special training in treating problems of the retina.

During surgery, the doctor uses small tools to remove the vitreous gel. Then the doctor may treat other eye problems, such as a retinal detachment, vitreous hemorrhage, scar tissue on the retina, or tears or holes in the macula.

At the end of the surgery, the doctor may inject an oil or gas bubble into the eye. This lightly presses the retina against the wall of the eye. If an oil bubble is used, the doctor will need to remove the oil after the eye has healed.

What To Expect

The surgery lasts 2 to 3 hours. Your eye doctor will decide if only your eye will be numb or if you will also be asleep during surgery (local or general anesthesia).

Vitrectomy is usually done as outpatient surgery.

At home, you may need to keep your head in a certain position for a while. This helps the gas or oil bubble push against the detachment. Your doctor will tell you what position to lie in.

Call your doctor right away if you notice any problems after surgery, such as:

  • Decreasing vision.
  • Signs of infection. These include increasing pain, redness, or swelling around the eye.
  • Any discharge from the eye.
  • Any new floaters, flashes of light, or other changes in your field of vision.

Why It Is Done

Vitrectomy may be done along with other treatments to:

  • Repair or prevent traction retinal detachment.
  • Repair very large tears in the retina.
  • Reduce vision loss caused by bleeding in the vitreous gel (vitreous hemorrhage). Surgery may be needed if bleeding is severe or the blood does not clear on its own.
  • Treat severe proliferative retinopathy. This causes scar tissue to form or new blood vessels to grow on the retina. These new blood vessels can leak blood into the eye.

Your eye doctor may suggest this type of surgery for a retinal detachment because an oil bubble can be used. An oil bubble does not move around in the eye as much as a gas bubble does. This may make the surgery and recovery easier for people who have trouble keeping their head in the proper position.

How Well It Works

Vitrectomy can greatly improve vision in many people who have severe bleeding in the eye that has not cleared on its own.

This surgery may restore some vision in people who have traction retinal detachment. It may also help keep the detachment from getting worse. The results may be better if the detachment has not affected the macula or your central vision.

Risks

Possible serious problems after this surgery include:

  • Cataracts .
  • High pressure inside the eye. This happens most often in people who have glaucoma.
  • More bleeding into the middle of the eye.
  • Retinal detachment.
  • Infection inside the eye.

What To Think About

One of the main uses of vitrectomy is to treat vitreous hemorrhage. This surgery can have serious risks. So some doctors may want to wait up to a year before they do surgery. This delay lets them see if the vitreous gel will clear on its own.

Surgery may be done sooner if vitreous hemorrhage is causing severe vision loss or is preventing treatment of severe retinopathy. Long-term results may be better if surgery is done soon.

There are a few ways to repair a retinal detachment. Your eye doctor can help you understand which might be the best option for you.

Credits

ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine

Current as ofDecember 3, 2017


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