Vitrectomy

Vitrectomy is a surgery to remove the vitreous gel from the middle of the eye. It may be done when there is a retinal detachment or if blood in the vitreous gel (vitreous hemorrhage) does not clear on its own. Removing the vitreous gel gives your eye doctor better access to the back of the eye. This surgery is done by an eye doctor (ophthalmologist) who has special training in treating problems of the retina.

During surgery, the doctor uses small tools to remove the vitreous gel. Then the doctor may treat other eye problems, such as a retinal detachment, vitreous hemorrhage, scar tissue on the retina, or tears or holes in the macula.

At the end of the surgery, the doctor may inject an oil or gas bubble into the eye. This lightly presses the retina against the wall of the eye. If an oil bubble is used, the doctor will need to remove the oil after the eye has healed.

The surgery lasts 30 minutes to 3 hours, depending on why you're having surgery. Your eye doctor will decide if only your eye will be numb or if you will also be asleep during surgery (local or general anesthesia).

Vitrectomy is usually done as outpatient surgery.

Vitrectomy may be done along with other treatments to:

• Repair or prevent traction retinal detachment.
• Repair very large tears in the retina.
• Reduce vision loss caused by bleeding in the vitreous gel (vitreous hemorrhage). Surgery may be needed if bleeding is severe or the blood does not clear on its own.
• Treat severe proliferative retinopathy. This causes scar tissue to form or new blood vessels to grow on the retina. These new blood vessels can leak blood into the eye.

Your eye doctor may suggest this type of surgery for a retinal detachment because an oil bubble can be used. An oil bubble does not move around in the eye as much as a gas bubble does. This may make the surgery and recovery easier for people who have trouble keeping their head in the proper position.

Vitrectomy can greatly improve vision in many people who have severe bleeding in the eye that has not cleared on its own.

This surgery may restore some vision in people who have traction retinal detachment. It may also help keep the detachment from getting worse. The results may be better if the detachment has not affected the macula or your central vision.

Activity

• Rest when you feel tired.
• Allow the eye to heal. Don't do things that might cause you to move your head. This includes moving quickly, lifting anything heavy, or doing activities such as cleaning or gardening.
• If your doctor used an oil or gas bubble to hold the retina in place, keep your head in a certain position for a few days or longer after the surgery. Make a plan for this part of your recovery, because it will be hard to do some daily activities. Your doctor will give you specific instructions.
  • Do not lie on your back, or the bubble will move to the front of the eye and press against the lens instead of the retina.
• If your doctor used a gas bubble, avoid airplane travel until your doctor tells you it is safe. This is because the change in altitude may cause the gas bubble to expand and increase the pressure inside the eye.
• You will probably need to take 2 to 4 weeks off from work. It depends on the type of work you do and how you feel.
• You may drive when your vision allows it. If you are not sure, ask your doctor.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you take aspirin or some other blood thinner, be sure to talk to your doctor. Your doctor will tell you if and when to start taking this medicine again. Make sure that you understand exactly what your doctor wants you to do.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• You will need to use eyedrops for up to 6 weeks.

Ice and elevation

• Close your eye and put ice or a cold pack on it for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.

Other instructions

• Ask your doctor when you can wash your hair and face. You will need to be careful not to get any soap or water in your eye. You may want to use a washcloth to gently wash your face.
• Wear sunglasses during the day. You may have to wear an eye patch or shield for a few days.