Vitrectomy surgery is an outpatient surgery to correct problems with the retina and vitreous. A vitrectomy surgery removes the gel-like vitreous that fills the eye so that the surgeon can gain better access to the retina for repair. Once surgery is complete, the vitreous will be replaced with a saline solution, or a bubble made of gas or silicone oil to help hold the retina in position. If a gas bubble has been placed, the body slowly absorbs it as its own fluid is replaced within the eye over the course of several days to weeks. Vitrectomy surgery can often improve vision, or at least prevent the underlying cause from getting worse. It is only recommended when the eye will not heal on its own; a disease is vision threatening; the benefits outweigh the risks; and the patient understands the risks, benefits, and alternatives to surgery. Your doctor may suggest surgery to:
- Remove blood or other substance keeping light from focusing properly on the retina (vitreous hemorrhage, asteroid hyalosis, vitreous condensation, old inflammatory cells)
- Remove scar tissue that is wrinkling or pulling the retina and causing poor vision (epiretinal membrane, macular hole, vitreomacular traction)
- Help repair a retina that has detached from the eye wall (retinal detachment, proliferative vitreoretinopathy, tractional retinal detachment)
- Remove a foreign object stuck inside the eye (retained lens fragments following cataract surgery, dislocated intra-ocular lens, foreign body)
Surgery is usually done under local anesthesia, with mild sedation (the patient awake but very sleepy), or in rare cases general anesthesia. The procedure often takes less than an hour, although complicated cases can run longer. After the anesthetic is applied to numb the eye, the doctor will create a small incision in the white part of the eye behind the iris, but in front of the retina. These incisions are so small (about the width of an eyelash) that they usually do not require sutures to close. Tiny microsurgical tools are threaded through into the eye to assist the doctor in removing the gel and treating the retina problem. Following surgery, you will rest and be monitored as the anesthesia wears off before being released home.
An eye patch will be worn home and taken off by one of our staff at your one day post-operative appointment. You may have to wear the patch at night to protect the eye during sleep. If a gas bubble or silicone oil has been used to treat the eye, your surgeon will give you instructions on how to do any required positioning (such as face-down), and for how long. The success of your surgery highly depends on you following these instructions. Your doctor will let you know when it is safe to resume strenuous activities like running and lifting. After a procedure, you will be prescribed an antibiotic eye drop to use for the first week and anti-inflammatory eye drop to use for several weeks.
Complications to surgery are rare, but risks include cataract formation, increased eye pressure, bleeding, infection, and retinal detachment. Recovery takes 4-6 weeks, without complications, for the eye to heal during which time vision should improve. If you have any questions about an upcoming surgery, or instructions following a surgery, don’t hesitate to call us at (616) 954-2020.