A vitrectomy is an operation to remove the vitreous gel from the inside of the eye. This is necessary in order to carry out procedures that cannot be performed with the fluid in its place.
The vitreous is a clear jelly-like substance which occupies about two-thirds of the eye, lying between the lens and the retina. Composed of over 99% water, it also contains collagen fibres, proteins and hyaluronan.
When is vitrectomy needed?
A vitrectomy is required for a variety of eye conditions, the most common are;
Vitreous haemorrhage: occurs when there is a bleed into the vitreous gel, usually resulting in blurred vision. It is most common in proliferative diabetic retinopathy, though may also occur with other diseases of the retinal blood vessels such as vein occlusions and complications with age-related macular degeneration. Serious injury to the eye may also result in a vitreous haemorrhage.
Primary retinal detachment repair: to learn about why a vitrectomy is required for a retinal detachment click here (link).
Diabetic retinopathy: to learn about why a vitrectomy is required for diabetic retinopathy click here (link).
Retinal detachment with proliferative vitreoretinopathy (PVR): a condition in which excessive scar tissue grows on the surface of the retina and in the vitreous. Scar tissue pulls on the retina, lifting it up like a tent and puckering it into stiff folds. This usually occurs as a consequence of severe eye injuries or as a rare complication of retinal detachment.
Preretinal membrane: the name given to scar tissue that has formed on the retina. Scarring can cause distortion, blurring or double vision. A vitrectomy involves the removal of the vitreous gel and the peeling of scar tissue off the retinal surface.
Infection of the eye: aninfection called endophthalmitiscan develop within the eye, after eye surgery or injury. Avitrectomy is performed in severe cases followed by an injection of antibiotics.
Trauma to the eye: traumatic injury to the eye may cause vitreous haemorrhage or retinal detachment.
A dislocated lens: occasionally during cataract surgery the natural lens of the eye (or part of) falls into the vitreous cavity causing inflammation and high eye pressure. The dislocated lens can be removed by a vitrectomy.
Macular hole: a hole in the centre of the retina, which causes loss of reading and detailed vision. Vitreous surgery can be considered as an option to improve vision.
A consultation with an ophthalmologist will assess your need for a vitrectomy by looking carefully into your condition.
A vitrectomy is performed in hospital using either a local or general anaesthetic. Three tiny openings are made in the sclera and delicate instruments are inserted into the eye. Vitreous cutters, forceps and scissors remove the vitreous gel and scar tissue that’s growing on the surface of the retina. A fibreoptic illuminator is used to light the inside of the eye during the operation.
The vitreous gel is replaced by either saline solution, air, or gas, all of which are replaced by the eyes own fluid over time. The vitreous does not grow back and the eye is able to function well without it. Sometimes, silicone oil or heavy liquid is inserted into the vitreous cavity at the end of the procedure and this will require another operation for its removal at a later date. Occasionally, a silicone band is encircled around the eyeball to assist with reattachment of the retina.
Most patients go home on the day of the surgery, though some may require an overnight stay.
Visual recovery after surgery varies greatly from patient to patient, depending on the underlying condition for requiring a vitrectomy in the first place and the type of substance inserted into the vitreous cavity at the end of the operation. Your ophthalmologist will explain your expected recovery time, implication in air travel and long term vision quality in detail.
Risks & Complications
When using modern surgical techniques, the risks of vitreous surgery are small, however, as with any operative procedures, occasional complications can occur. For more information on the possible risks and complications, talk to an ophthalmologist.
Further Information and Support
For further information on vitrectomy surgery, including the associated risks, implications and recovery, please discuss these with an ophthalmologist.
Please contact The Lions Eye Institute to make an appointment with the appropriate ophthalmologist. A current referral from either a GP, or an optometrist, is required for all appointments.
The Lions Eye Institute also conducts an array of Clinical Trials. You can view these on our Clinical Trials page.