Vitrectomy is a surgical procedure that removes the vitreous gel from inside the eye. This is necessary for performing certain procedures that cannot be completed while the gel is in place.

The vitreous is a clear, jelly-like substance that fills about two-thirds of the eye, located between the lens and the retina.

A vitrectomy is performed for various eye conditions, including:

• Vitreous Haemorrhage – Bleeding into the vitreous gel, causing blurred vision and floaters. This is most commonly due to proliferative diabetic retinopathy, but may also occur in retinal vein occlusions and age-related macular degeneration complications.
• Macular Hole – A hole in the center of the retina, leading to vision loss. Surgery involves removing the vitreous gel, peeling a fine membrane off the retina, and placing a gas bubble to aid healing.
• Epiretinal Membrane – Scar tissue on the retina that causes distortion, blurring, or double vision. Vitrectomy removes the vitreous gel and peels the scar tissue.
• Retinal Detachment Repair – When the retina detaches from the back of the eye, causing vision loss. The procedure involves removing the vitreous gel, draining fluid under the retina, and applying laser treatment to seal the retina.
• Eye Infection (Endophthalmitis) – A severe eye infection that can occur after surgery or injury. In these cases, vitrectomy is performed to clear the infection, followed by antibiotic injections.
• Dislocated Lens – In rare cases, during cataract surgery, the natural lens or lens fragments may fall into the vitreous cavity, causing inflammation and high eye pressure. Vitrectomy is used to remove the dislocated lens.
• Floaters – Vitrectomy may be considered in severe cases of debilitating floaters that significantly affect vision and daily activities.

Risks and Complications of Vitrectomy:

Vitrectomy has a high success rate, with over 90% anatomical success for many conditions. Advances in surgical techniques have greatly improved outcomes, even for diseases once considered untreatable, such as macular holes.

However, as with any surgery, complications can occasionally occur:

• Cataract formation – Accelerated in most cases within two years (if not already removed).
• Retinal detachment – Occurs in about 5% of cases.
• Infection (Endophthalmitis) – Rare, occurring in 0.1% of cases.
• Recurrence of the original problem – Approximately 8% risk.
• Severe complications (e.g., complete vision loss or eye loss) – Extremely rare (0.01%).

For more details on potential risks, consult Dr. Weaver.

Vitrectomy is performed as day surgery in a hospital. Most commonly, it is done under local anaesthesia, meaning you are awake, but your eye is numb, so you won’t feel pain or see what’s happening.

The steps of the procedure include:

1. Creating Tiny Openings – Three small incisions are made in the sclera (the white part of the eye).
2. Removing the Vitreous Gel – Specialized vitreous cutters extract the gel.
3. Treating the Retina – If needed, delicate forceps or scissors are used to remove membranes or scar tissue from the retina’s surface. A laser probe may be used to treat abnormal blood vessels or seal retinal tears.
4. Replacing the Vitreous – The vitreous gel is replaced with saline solution, air, or gas, which will naturally be replaced by your eye’s own fluid over time.
5. Additional Treatment (if required) – In some cases, silicone oil or heavy liquid is inserted instead of gas and may need removal in a later surgery. Occasionally, a scleral buckle (a plastic band around the eye) is added to help reattach the retina.

The vitreous does not grow back, but the eye can function normally without it.

Recovery

• Most patients go home the same day; in rare cases, an overnight stay may be needed.
• Visual recovery varies based on the condition treated and the type of material inserted into the vitreous cavity.
• Swelling, bruising, and redness around the eye are common but improve quickly.
• Mild discomfort is normal, but severe pain may indicate a complication.
• Eye drops are essential for healing and preventing infection.
• Vision improvement is gradual—some patients may experience reduced vision for a few days, while others (especially those with a gas bubble or silicone oil) may take weeks to months for significant improvement.
• Final visual recovery can take 6–12 months, particularly for retinal conditions.

Post-Operative Care following a Vitrectomy

• First Follow-Up Visit – You should have someone drive you to your appointment one day after surgery.
• Air Travel & Altitudes – If a gas bubble is placed in your eye, avoid:
  • Flying
  • Scuba diving
  • Using nitrous gas anaesthesia
  • High-altitude locations
    These restrictions help prevent dangerous increases in eye pressure. Dr. Weaver will advise when it is safe to resume these activities.
• Head & Eye Positioning – If a gas bubble or silicone oil is used, proper head positioning is crucial for a successful outcome.

Post-Operative Equipment Rental

For assistance with post-operative positioning, posturing equipment is available for hire.

The content provided on this website is for educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician.

All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions.

Neither Dr. Andrew nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content.

All surgical procedures carry risk. Before proceeding with any operation, always consider obtaining a second opinion from an appropriately qualified health practitioner.