Vitrectomy

What is a Vitrectomy?

A Vitrectomy is an operation to remove the vitreous humour, the transparent jelly, from inside your eye. The vitreous is behind the iris (the coloured part of your eye) and the lens, and it sits in the middle of the eyeball, in front of the retina.

Why is a Vitrectomy necessary?

You may need a Vitrectomy if you have one or more of the following:

  • Retinal Detachment
  • Macular Hole
  • Diabetic Vitreous Haemorrhage (bleeding)
  • Removal of intraocular foreign body
  • Removal of membranes (scar tissue) from the retina
  • Endophthalmitis (a serious eye infection)
  • Complicated Cataract Surgery where there are residual lens fragments that need retrieving

How is the vitreous jelly removed?

Prof. Stanga will discuss with you whether you will have the operation under local anaesthetic (while you are awake), or general anaesthetic (while you are asleep).

Three micro-cannulas will be inserted into the sclera (the white part of the eye) and instruments will be passed through each. These include a tiny light source, a vitrector device which cuts or liquefies the vitreous depending on your needs, and an infusion port which replaces the fluid in the eye to maintain the pressure in the eye during the procedure.

Once the jelly is removed, necessary repairs are carried out, such as peeling membranes, applying laser or removing foreign bodies. The procedure normally takes 1-2 hours.

Does the vitreous jelly get replaced naturally?

Once the vitreous jelly is removed the eye is filled with one of the following:

  • An artificial fluid that is in time replaced by a fluid produced by the eye itself
  • A gas bubble which reabsorbs within 4-8 weeks, dependent on the type of gas used.
  • Transparent oil which is usually removed through a second surgery at a later date.
  • Air which reabsorbs within 10 days.

What are the risks of vitrectomy surgery?

Although serious complications are unusual, there is always the risk of infection and possible blindness in the operated eye.

Other complications that may occur and require further surgery in theatre:

  • Leakage from micro-cannula incisions requiring stitches. These usually self-seal.
  • Cataract formation requiring cataract surgery
  • Retinal detachment
  • Bleeding inside the eye

Patients who have a vitrectomy surgery are more likely to develop a cataract (cloudiness of the lens of the eye) earlier than they would otherwise. This can also be the result of the gas or silicon oil used. If there is already a cataract present, cataract surgery may be performed at the same time as the vitrectomy. If not, the cataract surgery can be performed at a later stage when it has become more significant.

What to expect after your Vitrectomy

Your rate of recovery and final outcome are dependent on your pre-operative condition which required a vitrectomy and how well you adhere to the postoperative instructions, such as needing to posture. Prof. Stanga will advise you of your likely outcome and post-operative management.

You should expect:

  • Blurry vision for several weeks after surgery.
  • Swollen, sensitive and red eyes due to the nature of the surgery.
  • To regularly administer your own eye drops once at home, this will help to reduce inflammation and prevent infection.
  • If a gas or oil bubble has been inserted into your eye, you will be advised to adopt a certain posture in order for this to encourage healing. This will be explained in greater detail by Prof. Stanga, and what is needed for your recovery.

Prof. Stanga will need to see the day after the surgery and usually again at 1-2 weeks for a check-up to examine your eyes and discuss your progress. Should further appointments be required depending on your individual response to surgery, these will be organised as necessary.

Vitrectomy