Vitrectomy

What is Vitrectomy

Vitrectomy is a procedure to remove vitreous from the eye and replace it with a saltwater solution (saline). Vitreous is a sticky, gel-like substance that fills most of the inside of the eyeball.

The vitreous is clear, and it needs to stay clear for you to see properly. This procedure may be done to stabilize or improve your vision.

You may need this procedure if you have:

• Cloudy vitreous.
• Vitreous that pulls on the structures it touches and risks tearing them.
• A severe eye injury.
• Scar tissue on the light-sensitive layer of tissue in the back of your eye (retina).
• Retinal bleeding.
• A retina that is wrinkled (macular pucker) or detached.
• An infection inside your eye.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had, including refractive surgery such as LASIK.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs.
• Seeing small, drifting specks in your field of vision (floaters).
• Retinal tears or detachment.
• Increased eye pressure.
• Clouding of the lens in the eye (cataracts).
• Swelling of the front layer of the eye (cornea).

What happens before the procedure?

• You may have a physical exam. This may include an ultrasound to check the inside of your eye.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given eye drops. Use them as told by your health care provider.
• If you have bleeding in your eye or if you are at risk for retinal detachment, you may be told to limit your activity or stay in a certain position, such as sitting up. Do this as told by your health care provider.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your eye will be examined through a microscope.
• Small incisions will be made in the white part of your eye (sclera).
• Small tools will be inserted through the incisions, and vitreous and any scar tissue will be removed.
• Silicone oil or a bubble of air or gas may be used to reduce bleeding and hold your retina in place.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given eye drops. You may also be given pain medicine.
• You may need to stay in a certain position for a period of time, instead of being able to walk around. Your health care provider may ask you to sit up or remain on your back or your stomach.
• You may be given an eye patch or eye shield to wear.
• Do not drive for 24 hours if you received a sedative.

Vitrectomy, Care After

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• A “dancing bubble” blocking your field of vision. This goes away over time.
• Very blurry vision in the affected eye.
• A dilated pupil.
• Light sensitivity.
• Difficulty seeing things up close.

Follow these instructions at home:

Eye Care

• Keep the area around your eye clean and dry.
• Wear your eye patch or eye shield as told by your health care provider, if this applies.
• Wear sunglasses if your eyes are sensitive to light.

Activity

• You may be told to stay in a certain position for a period of time, such as sitting up or lying on your back. It is important that you do this as directed by your health care provider.
• Avoid strenuous physical activity for as long as told by your health care provider. This includes bending over, lifting anything that is heavier than 5 lb (2.3 kg), and straining.
• Ask your health care provider when you may have sex.
• Do not drive a car or use contact lenses until your health care provider approves.

General instructions

• Take or apply any over-the-counter and prescription medicines only as told by your health care provider. This includes any eye drops.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your eye becomes very red or painful.
• You develop any pus or discharge coming from your eye.
• You have chills.
• Your eyelid on either eye becomes swollen or stuck shut.

Get help right away if:

• You have a fever.
• You notice a vision change in either eye.
• You see more floaters or spots in front of your vision.
• Part of your vision is covered by what looks like a black curtain that you cannot see through.