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Vitrectomy

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Vitrectomy surgery is the basis for many different types of retinal surgery, including repair of retinal detachment, repair of macular hole, removal of epiretinal membrane, and removal of vitreous hemorrhage.

The vitreous gel is a Jell-O like substance that fills the back of the eye.   Vitrectomy refers to removal of this gel.  The surgery is performed in an operating room and often takes around one to two hours.  It is often an outpatient procedure, meaning that overnight hospitalization is not required. The surgery if often performed under local anesthesia and most patients are not put fully to sleep (general anesthesia).  

 

At the end of surgery, the gel is not replaced. The eye produces its own fluid, and in some cases the surgeon may leave a bubble of air or gas inside the eye, which the body will absorb and replace with clear fluid. In some complex surgeries, the surgeon may leave the eye filled with silicone oil, which provides long term support to the retina but which requires an additional surgery to remove.

In most cases, vitrectomy refers to much more than just removal of the gel.  After the initial vitrectomy, additional steps are often performed.  For an epiretinal membrane, small forceps are used to peel scar tissue off of the retina.  For diabetic eye disease, a laser probe might be used to apply laser to the peripheral retina.  In a retinal detachment, a gas or silicone oil bubble might be injected into the vitreous cavity.

What are the risks of vitrectomy?

Vitrectomy surgery is often very safe but is not without risk.  Serious complications are rare but include infection, bleeding, changes in eye pressure, or retinal detachment.  ​For patients who have not previously had cataract surgery, vitrectomy surgery almost always accelerates the progression of cataract in the operated eye. Consequently, cataract surgery should be expected within 1-2 years after vitrectomy surgery.

What can I expect after surgery?

Redness and swelling usually decrease over 1-2 weeks following surgery. It is normal to experience a foreign body sensation after surgery (a sensation of sand or grit in the eye).  This sensation should decrease as the days and weeks go by after surgery.  Depending on if a gas bubble was placed in the eye, your vision might be severely decreased for several weeks and you might not be able to fly in an airplane or travel to high altitude during this time.

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