The vitreous is normally a clear, jelly-like fluid that fills the
inside of the eye. Various disease states can cause the vitreous
to cloud, fill with blood or even harden so that light entering
the eye will be misdirected and not reach the retina properly.
A vitrectomy is a surgical procedure that removes the vitreous
in the central cavity of the eye so the retina can be operated
on and vision can be corrected. It is beneficial in many disease
states including diabetic eye disease, vitreous haemorrhage,
retinal detachments, macular holes, epiretinal membrane and
following complications of cataract surgery.
The vitrectomy procedure is normally performed as an
outpatient procedure. Rarely, an overnight stay in the hospital
Local or general (while you are asleep) anaesthesia may be
used. The eyelid will be held opened using a special speculum
and the eye that is not being operated on will be covered.
You will not be able to see any of the procedure.
The procedure begins by making 3 tiny incisions in the white
part of the eye and connecting an infusion line to maintain
constant eye pressure. Next, a light source and microscopic
cutting device and are inserted which will gently remove the
The surgeon will use a microscope to view the eye whilst
performing the procedure.
After the vitreous is removed the surgeon will perform any
retinal surgery that is required and then refill the eye with
one of the following substitutes depending on your condition:
- Saline solution that closely resembles the natural vitreous
fluid in your eye
- Gas to keep the retina flat (this will absorb over 2-4 weeks)
- Silicone oil (this usually requires removal with surgery
3 months later)
An antibiotic to prevent infection will be given at the end of
Your procedure may take between 30 - 60 minutes,
depending on its complexity.
Vitrectomies have been commonly performed and perfected
for over 30 years. However, certain risks do exist. They include:
• cataract formation or progression
• retinal detachment
• raised pressure in the eye
• bleeding inside the eye
• Loss of vision (extremely rare)
• need for additional treatment and/or surgery
What to expect after vitrectomy
Expect your eye to be sensitive, red and swollen due to the
nature of the surgery.
If gas has been inserted into the vitreous chamber, your vision
will be poor until the bubble gradually absorbs.
The most important factor determining your rate of recovery
and final outcome is the pre-operative condition for which
the vitrectomy was performed. Your surgeon can advise you
what to expect.
You will be prescribed a combination of drops to administer
on your discharge home.
Since vitrectomy is often performed along with other
procedures, postoperative instructions may vary.
Some general guidelines are provided however, please consult
with your surgeon for specific instructions.
If gas or oil has been inserted into the eye, you will be
advised how to position your head. This helps ensure that
the gas or oil is in contact with the affected retina, in order
to encourage healing. You may be advised to maintain this
position for up to 45 minutes of every hour for 3-7 days
- No flying with gas in the eye (2-6 weeks). The reduced
atmospheric pressure causes the gas bubble to expand,
which can raise the pressure in the eye to dangerous levels
Begin using any anti-inflammatory and antibiotic drops
prescribed by your physician immediately after your eye
patch has been removed
Take simple analgesia to relieve mild discomfort
Wear the plastic eye shield when sleeping for the first 7
days following surgery
Avoid strenuous activity for one week (unless directed
otherwise by your physician)
If you develop a deep headache or throbbing pain that does
not respond to over-the-counter painkillers, you should
contact the Ophthalmology Department immediately.