What Should I Expect from Vitreous Surgery?

Vitreous surgery is a type of operation which allows eye surgeons to treat patients with diseases of the retina. Also called vitrectomy, it is the surgical removal of the vitreous gel from the middle of the eye. Such surgery may be performed if this gel is pulling the retina from its normal position, or if blood and scar tissue are obscuring light passing through to the retina, causing blurred vision.

Normally, the vitreous is a clear, gel-like fluid that fills the center of the eye. Some conditions, such as diabetes, can cause bleeding into the vitreous, which decreases visibility. When an abnormal blood vessel develops on the surface of the retina — which is a layer of nerve tissue that sends signals or images to the brain — it may break and bleed into the vitreous gel. In addition to this abnormality, scar tissue may form around the damaged vessel. Traction retinal detachment occurs when such scar tissue contracts and pulls the retina loose, causing distortion and vision loss.

Before vitreous surgery, most patients are usually given sedatives and a local anesthetic that numbs the area around the eye. The surgeon then uses microscopic instruments to cut the eye and remove the vitreous gel. A small light source may also be used to illuminate the inside of the eye. Typically, a laser is needed to cut any scar tissue from the retina, smooth areas where it has become detached and repair tears. After the procedure, the surgeon often injects a silicone gas or oil to replace the vitreous gel and restore normal pressure to the eye.

There are a number of possible risks associated with vitreous surgery. These can include swelling under the retina, a red or scratchy eye, further retinal detachment, infection or a change in focus that may require new eyeglass lenses. Such conditions often necessitate additional surgery or treatment.

A vitrectomy typically lasts two to three hours and is usually performed as an outpatient procedure, although some patients may need to stay for several days at the clinic or hospital. Most people claim to experience little or no pain after the surgery, but medication may be prescribed for pain if necessary. The affected eye is normally patched up for a few days and antibiotic eye-drops may be used to aid the healing process.

Doctors typically recommend that patients who have had silicone gas injected into the eye maintain a fixed head position for a number of days, to allow the substance to be absorbed. Airplane travel is discouraged during this time. It is also common for a patient to experience blurred vision for weeks or months after vitreous surgery, and the affected eye may tire easily during the rehabilitation period.