Having a Vitrectomy

A vitrectomy is a type of eye surgery to treat problems with the retina and vitreous. The retina is a layer of nerve cells that senses light and sends signals to the brain so you can see. The vitreous is a gel-like substance that fills your eye. During the surgery, your eye care provider removes the vitreous. It is replaced with another solution.

What to tell your eye care provider

Before your surgery, tell your eye care provider:

• What medicines you take. This includes prescription medicines, over-the-counter medicines, vitamins, herbs, and other supplements. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin.

• If you smoke. You may need to stop before your surgery. Smoking can delay healing. Talk with your eye care provider if you need help to stop smoking.

• If you have had any recent changes in your health. This includes an infection or fever.

• If you are sensitive or allergic to anything. This includes any medicines, latex, tape, and anesthetic medicines.

• If you are pregnant or think you may be pregnant.

Getting ready for your surgery

Make sure to:

• Ask a family member or friend to take you home from the hospital

• Make plans for some help at home while you recover

• Follow all directions from your eye care provider

• Read the consent form and ask questions if something is unclear

• Follow any directions you are given for not eating or drinking before surgery

Tests before your surgery

Before your surgery, your eye care provider will look at your retina. Special tools are used to shine a light in your eye and look at your retina. You may need to have your pupils widened (dilated) for this eye exam. If so, your provider will use eye drops to dilate your pupils. You also may need to have an ultrasound of your eye. This helps your provider view the retina if they can't see directly into your eye because of blood or some other reason. An ultrasound uses sound waves to create images on a computer screen.

On the day of your surgery

Talk with your eye care provider about what to expect during your surgery. The details of the surgery will depend on the problem being treated. An eye care provider specially trained in eye surgery (ophthalmologist) will do your surgery. In general, you can expect the following:

• You may have general anesthesia. This will put you into a deep sleep. Or you may be awake during the surgery. You will be given medicine to help you relax. You also may be given anesthetic eye drops and shots. This is to make sure you are relaxed and comfortable.

• Your eye care provider will make small cuts in the white part of the eye (sclera) to put tools inside the eye.

• Your eye care provider will remove the vitreous and any scar tissue or other material.

• Your eye care provider will do other repairs to your eye as needed. For example, they might use a laser to fix a tear in your retina. 

• Your eye care provider will replace the vitreous with another type of fluid, such as silicone oil or saltwater (saline) solution. In some cases, your eye care provider may place a gas bubble into your eye instead of fluid.

• Your eye care provider may close your incisions (cuts) with stitches.

• Your eye care provider will put an antibiotic ointment on your eye to help prevent infection.

• Your eye will be covered with a patch.

After your surgery

You’ll likely be able to go home the same day. Have someone drive you home. You are not allowed to drive for up to 24 hours after having anesthesia. Ask your eye care provider when you can go back to your normal activities.

Recovering at home

Follow all your eye care provider’s directions about eye care. Your eye may be sore after the surgery. You can take over-the-counter pain medicine as approved by your provider. You may need to use eye drops with antibiotics. This is to help prevent infection. You may need to wear an eye patch for a day or so.

If you had a gas bubble placed in your eye during your vitrectomy, you will need to follow specific directions, such as:

• Not flying on an airplane. Ask your eye care provider when it will be safe for you to fly again.

• Not using nitrous oxide gas anesthesia. Ask your eye care provider when it will be safe for you to use nitrous oxide gas anesthesia.

• Not traveling to higher altitudes. Doing so can raise your eye pressure. Ask your eye care provider when it will be safe for you to be at higher altitudes.

• Keep your head and eye positioned as directed by your eye care provider. Ask your provider for specific directions.

• Always wear a seat belt when traveling.

Follow-up care

You will need close follow-up with your eye care provider to see how well the surgery worked. You may have an appointment the day after the surgery. You may need more surgery in the future to remove silicone oil from your eye or to fix any new problems that arise.

Your vision may not be completely normal after your vitrectomy, especially if you had permanent damage to your retina. Ask your eye care provider how much improvement you can expect and the time frame. If a gas bubble or silicone oil is used, it may take weeks or months to see improvement in your vision. 

When to call your eye care provider

Call your eye care provider right away if any of the following occur:

• Vision that gets worse

• Pain, redness, bruising, or swelling around your eye that gets worse

• Fever of 100.4°F (38°C) or above, or as directed by your healthcare provider

• Drainage from your eye