Vitrectomy

The vitreous is the clear, gel-like substance that makes up the center of the eye. The vitreous makes up approximately 2/3 of the eye's volume and provides the form and shape prior to birth. Eye problems affecting the back of the eye may require a vitrectomy, or removal of the vitreous. The vitreous is replaced as the eye secretes aqueous and nutritive fluids following surgery.

A vitrectomy may be performed for many reasons, clear blood and debris for the eye, removal of scar tissue, or to alleviate traction on the retina. The removal of blood, debris, and scar tissue will allow light to properly pass through the eye and reach the retina. The vitreous can also be removed if it is pulling or tugging on the retina.

Conditions requiring vitrectomy:

• Complications with diabetic retinopathy
• Macular Hole
• Retinal Detachment
• Pre-retinal membrane fibrosis
• Vitreous Hemorrhage (Bleeding inside the eye)
• Injury or infection

Our retinal surgeon performs the procedure through a microscope and special lenses that have been designed to provide a clear image to the back of the eye. Multiple small incisions, a few millimeters in length, will be made on the sclera. Our surgeon will then insert microsurgical instrument through the incisions such as:

• Fiber optic light source to illuminate inside the eye
• Infusion line to maintain the eye's shape during surgery
• Instrument to cut and remove the vitreous

A vitrectomy is often done in combination with other procedures such as macular hole surgery, retinal detachment, and macular membrane peels. The length of the surgery depends on whether additional procedures are necessary and the eye's overall health.

Special Techniques may be used with you vitrectomy depending on the circumstances. Our surgeon will decide if a special technique is appropriate for your eyes.

• Sealing Blood Vessels - a laser is used to stop tiny retinal vessels from bleeding inside of the eye
• Gas Bubble - a small gas bubble may be used inside of the eye to help seal a macular hole
• Silicone Oil - the eye may be filled with silicone oil after a reattachment surgery to keep the retina in place

A patch will be placed on your eye after your first postoperative checkup. The patch can often be removed in the evening before bed. Since the anesthesia numbs the lids to temporarily prevent blinking, it is important to keep the eye patch on until the blinking returns to normal. Eye drops should begin to be administered after the patch has been removed.

How will the eye feel after vitrectomy?

Discomfort is common immediately after surgery and several days following. This is primarily related to swelling on the outside of the eye and around the eyelids. A scratchy feeling or occasional sharp pain is normal following a vitrectomy.

Icing the swollen areas will help to reduce the soreness and aching. Tylenol will help with the minor aching. If you experience extensive pain that is not resolved by Tylenol or other over the counter medication, please contact Greater Maryland Eye Physicians and Surgeons.

A redness around the eye is very common after surgery but will diminish over time. Some patients may notice a patch of blood on the outside of the eye. A similar situation will occur with the bruising on the skin and will resolve on its own.

When will vision improve?

Vision will improve are different stages for each person. Depending on the problem that the vitrectomy is trying to resolve or the other surgery that it may be in conjuction with, the recovery period will be different. The surgeon will discuss the recovery time with you and during regular check-up will determine is the vision is improving at the appropriate pace.