Vitrectomy: Procedure, complications, and recovery
Depending on the additional procedures involved, most people start to recover from vitrectomy surgeries after a few days, but a full recovery often takes several weeks.
- Vitreous humor is a gel-like substance made of at least 98 percent water.
- Vitrectomy is an outpatient surgery, performed in hospital or dedicated ambulatory surgery center.
- The vitreous cavity gives the eye its round shape and makes up at least two-thirds of the volume of the eye
- After vitrectomy surgeries, most people can go home following a short monitoring period.
What is vitrectomy surgery?
A vitrectomy surgery is when the vitreous humor or fluid surrounding the eye is surgically removed and replaced.
It is important for people to arrange to take a few days off work and to arrange for a ride home after the surgery.
Before the day of their surgery, an appointment will be scheduled to examine the eye that will be operated on.
Usually, people will have to avoid all food and water for at least 8 hours before the surgery is done.
An individual should discuss any current medications they are taking and medical conditions they have with the surgeon, ahead of time. Some medicines may need to be avoided on the day of surgery.
Common steps in vitrectomy surgery include:
1. The eye is anesthetized or numbed and dilated.
2. The eye is cleaned with an antiseptic solution and draped with a sterile covering.
3. An eyelid speculum is used to keep the eye open, and a protective covering is placed over the eye not being operated on.
4. The surgeon makes a small incision or cut, usually about the width of an eyelash or 0.5 millimeters, in the outer membrane of the eye.
5. The surgeon accesses the eye through the pars plana, a structure in the sclera or white part of the eye.
6. The surgeon uses forceps to open the cut.
7. The surgeon inserts a microscope, as well as a fiber-optic light to be able to see the eye.
8. The surgeon uses a vitrector or vitrectomy probe to cut the vitreous gel, and a suction tool to remove broken down fluid.
9. Depending on the individual case the surgeon will then:
- use forceps, scissors, and cutters to peel back scar tissue from the retina
- insert a silicone-tipped needle to drain infected, cloudy, or bloody fluid
- use a laser probe, to treat abnormal blood vessels, clots, and seal off retinal injuries, such as tears or holes
10. The surgeon fills the eye with a vitreous substitute similar to saline solution, silicon oil, or a gas or air bubble.
11. An antibiotic ointment will be applied to the eye to prevent infection and the eye will be covered.
12. The individual may need to lay face down for a while to be monitored, and instructions will be given, depending on what other procedures are done on the eye.
Why would you need a vitrectomy?
Virectomy surgery may be performed to treat a range of eye problems, from eye injuries to cataracts.
Vitrectomy procedures are often done to allow surgeons access to the back of the eye, during operations for retinal conditions.
It is also commonly done to drain vitreous fluid that has become cloudy or bloody, or filled with floaters or clumps of tissue.
Common reasons for a vitrectomy surgery, and other surgeries associated with it include:
- bleeding inside of the eye
- eye infections
- major eye trauma or injury
- problems after cataract (cloudy lens) surgery
- vitreous floaters or tiny bits of tissue in the vitreous fluid
- damaged retinal tissue or scar tissue on the retina
- injury from a dislodged, misplaced, or infected intraocular lens (IOL)
- detached retina where the retina becomes loose and moves around the eye
- trauma or injury that occurs during cornea, cataract, or glaucoma surgery
- diabetic retinopathy when the retina has been damaged by long periods of uncontrolled diabetes
- macular degeneration or a macular hole where there is a small hole, tear, or defect in the macula or central tissue of the retina
- swelling of the central retinal tissue
- swelling of the eye
Complications and risks
Complications are rare for virectomy procedures, and the surgeons should explain the potential risks to the patient before performing the surgery.
Vitrectomy procedures are an effective surgery and severe complications are rare. According to the American Society of Retina Specialists, most surgeries have a 90 percent success rate.
In rare cases, however, complications can occur, especially in immune-compromised individuals and those with a history of eye conditions or surgery.
Possible side effects of vitrectomy procedures include:
- inflammation or redness, swelling, and pain
- bleeding inside the eye
- increased pressure (glaucoma) or reduced pressure in the eye
- cataract formation or progression of existing cataracts
- surgical injury, such as a wrong cut or tear, resulting in the need for further corrective surgery
- swelling of the central part of the retina
- change in vision, requiring the need for new eyeglasses
- loss of night vision, blurriness, or depth perception
- double vision
- retinal detachment
- dislocation or discoloration of the intraocular lens
- macular pucker or a wrinkle in the retina
- loss of vision
- allergic reaction or over-reaction to anesthesia, which may risk stroke, heart attack, or pneumonia
What is the recovery process?
Vitrectomy procedures are often done alongside other eye surgeries, so individual recovery time and recommendations vary.
In general, activities like driving, reading, and exercise will need to be avoided for a few days after the procedure.
Some people will be required to lay face down for a period of time to help their eye heal properly. Often, eye drops will be prescribed to help prevent infection and to reduce inflammation.
In general, the full recovery process for vitrectomy surgeries takes between 4 to 6 weeks.