Vitrectomy
Vitrectomy is a type of eye surgery that treats disorders of the retina and vitreous. The retina is the light-sensing tissue found lining the inside back part of the eye. The vitreous is the clear, jelly-like substance that fills the inside of the eye. The vitreous is removed during vitrectomy surgery and usually replaced by a saline-type solution.
What to Expect During a Vitrectomy
Most vitrectomies are performed on an outpatient basis using local anesthesia with sedation. Most patients are comfortable during the procedure and have little to no memory of the surgery. In some cases, your surgeon may determine that sedation is not necessary. If you remain awake, anesthetic eye drops and injections will be used to numb your eye, and medication may be given to help you relax.
During the procedure, your surgeon makes tiny incisions in the sclera (the white part of your eye) to remove the vitreous gel, along with any scar tissue, blood, or other material affecting your vision. If needed, your surgeon may also perform additional treatments, such as using a laser to repair a retinal tear or treating other retinal conditions.
Depending on your condition, a gas bubble or silicone oil may be placed inside the eye to help support the retina as it heals. The vitreous is replaced with a clear solution, gas, or silicone oil, depending on your specific needs. The tiny incisions often seal on their own, although stitches may occasionally be needed. At the end of the procedure, an antibiotic ointment is applied, and your eye is covered with a protective patch.
Post Vitrectomy
Your eye patch should remain in place until your post-op appointment the following day. If the patch is too irritating or uncomfortable, it can be removed 8 hours after surgery. With a numbing solution in place, it will be hard to blink. Ideally, the patch should remain intact until you are able to blink normally. Once the patch is removed, you may notice some redness, bruising, tearing, discharge, or foreign body sensation, this is common.
If a gas bubble was placed in your eye, your surgeon may recommend you keep your head in a special position for a specific amount of time. With a gas bubble or other substance in the eye, your vision will be blurry. Vision gradually improves in the weeks following resolution of the bubble.
Potential Risks
Most patients do very well with their vitrectomy, but complications do sometimes arise, as there are risks with any surgery. Your risks may depend on your age, your medical conditions, and the specifics of your eye problem. Note, there is also a risk that the surgery will not successfully repair your original problem. If this is the case, you might need a repeat surgery. Risks include:
- Infection
- Excess bleeding
- High pressure in the eye
- New retinal detachment caused by the surgery
- Lens damage
- Increased rate of cataract formation
- Problems with eye movement after surgery
- Change in refractive error
Common Questions
Your doctor may suggest a vitrectomy for the following medical conditions to avoid vision loss or potential blindness.
- Diabetic retinopathy
- Retinal detachment
- Vitreous hemorrhage
- Infection inside your eye
- Severe eye injury
- A hole in the central part of your retina (macula)
- A wrinkle in the central part of your retina
- Certain problems after cataract surgery
Vitrectomy surgery is not intended to improve vision for every patient. The operation removes any blood or debris (from infection or inflammation) that may be blocking or blurring light as it focuses on the retina. Removing the vitreous gives better access to your retina and decreases the tension on your retina.
Call our after-hours line ASAP at (615) 983-6000 and follow the prompts for “triage”.
A small amount of blood or discharge is completely normal and not a cause for concern. Simply use a sterile eye wash and rinse the blood/discharge out of the affected eye.
Most patients experience some bleeding and redness on the white of the eye and bruising around the eye after surgery. This usually clears up after 1-2 weeks.
Diminished vision or cloudy vision is very common after surgery as there is either silicone oil, gas bubble, or an air bubble where the vitreous used to be. With gas/ air bubble this will slowly improve as the bubble dissipates. With the silicone oil vision may remain cloudy or hazy until the oil is removed. You may also experience some double vision, distortions, and sunlight sensitivity for a few weeks after surgery.
You may shower the day after surgery but be overly cautious to not get water or soap into post-operative eye, and do not rub.
Generally, the return to light work time is about 1-2 weeks. This is usually determined at the 1-week post-operative appointment.
Immediately.
The first week one (1) drop should be administered into the effected eye FOUR (4) times every day. After one week the need for drops will be assessed by a Physician.
