Vitrectomy

Vitrectomy is where the jelly behind the pupil is removed and exchanged for clear fluid or gas.

The aim of the operation is to:

1. Clear away opaque vitreous jelly to allow light to easily pass through the eye so that the doctor can see in to assess and treat the eye and the patient hopefully can see out.
2. Vitrectomy is sometimes performed to create a space in the eye for surgical manoeuvres (such as membrane dissection or laser treatment).
3. Vitreous gel is sometimes removed because there are traction bands within this gel, which are pulling on the retina which may cause the retina to progressively detach.

The Operation

The operation takes between one and two hours. It can be performed under general anaesthetic or local anaesthetic. The head is restrained to avoid movement during surgery. It involves three tiny cuts on the white of the eye of less than 2 mm length. Once incision is used to illuminate inside the eye, the second incision is used for infusing fluid to keep the eye inflated and the third incision is used for cut and suction clearance of the jelly.

Other procedures that may be performed at the same time include cataract surgery, laser treatment, retinal detachment surgery, gas injection.

The problems of vitrectomy that occur commonly include:

1. Scratch on the cornea which takes a few days to heal.
2. Transient cataract which often clears within a few days with correct posturing of the head.
3. A small bleed in the eye which can cause hazy vision for a few days or weeks.
4. Sometimes patients complain of a gritty sensation. This is usually due to the dissolvable stitches used during the operation.

Less common problems include:

1. Cataract which would necessitate a cataract operation later.
2. Infection - this may be around the outside of the eye or within the eye. If it occurs within the eye then visual recovery is usually poor.
3. Retinal Detachment - Sometimes a retinal tear can occur; during surgery or alternatively be exposed, allowed the intra ocular fluids to pass through the retina and detach it from the inside wall of the eye. a little like wallpaper peeling off a wall. If this affects the peripheral part of the retina and if detected early it can usually be corrected surgically, sometimes by a gas injection. However, if it affects the central part of the retina it can reduce reading vision dramatically and permanently.
4. Sympathetic Ophthalmitis - This is an extremely rare condition. Essentially the unoperated eye can develop an inflammation so that the sight in both eyes is threatened. However, you will be receiving strong frequent steroid drops after the operation to reduce this risk further.

Essentially the decision to operate depends on balancing the known risks of the operation and anaesthetic, against the potential benefits of a successful outcome from the operation.

Warning Signs

1. Pain.
2. Deterioration of vision.
3. Curtain-like field defect from one corner of the eye.

If you have a gas bubble in the eye you will notice that there is a dark crescent or a silver crescent or poor vision at the bottom of the field of view.

You should not fly if you have an air bubble in your eye.

Your doctor will advise you how to posture your head and on what side to sleep

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This information site has been provided by varied UK and US eye doctors for patients with eye problems.

Once your eye doctor has made a diagnosis or recommended an investigation or treatment, then you will be able to find further explanation on this site.

It is not a self diagnosis centre. It should not be relied upon without taking professional advice.