Patient Education
Vitrectomy
Outpatient surgery · about 30–90 minutes
Vitrectomy is the core operation of retinal surgery. Through three tiny openings in the white of the eye — small enough that they usually seal without stitches — the surgeon removes the vitreous gel that fills the eye, which clears the view and removes the gel's pull on the retina.
Vitrectomy is the core operation of retinal surgery. Through three tiny openings in the white of the eye — small enough that they usually seal without stitches — the surgeon removes the vitreous gel that fills the eye, which clears the view and removes the gel's pull on the retina. That access makes everything else possible: peeling scar tissue, flattening a detached retina, removing blood, and placing a gas or oil bubble to hold the retina in place while it heals.
What It Treats
- Retinal detachment
- Macular hole
- Macular pucker
- Vitreous hemorrhage from diabetic retinopathy
- Severe or disabling floaters
- Infection or retained material inside the eye
What to Expect
Before
Surgery is outpatient. Most vitrectomies are done under local anesthesia with sedation — you are relaxed and comfortable, and the eye is completely numb, but you are not under general anesthesia unless there is a reason. You will be asked not to eat beforehand and to arrange a ride home.
During
Three small ports are placed in the white of the eye. One maintains the eye's pressure with fluid, one carries a light, and one carries the instruments. The vitreous is removed, whatever brought you to surgery is addressed, and the eye is often filled with gas, silicone oil, or saline at the end. You will not see the instruments and you will not feel pain.
After
Your eye is patched and shielded for the first night. Expect it to be red, scratchy, and light-sensitive for a week or two. Vision is poor at first — especially if gas was placed, in which case you will be looking through a bubble. You will be seen the next morning.
Recovery & Restrictions
- You will need a driver on the day of surgery and someone with you that first evening.
- Use the prescribed antibiotic and anti-inflammatory drops exactly as scheduled; this matters more than how the eye feels.
- Wear the shield at night for as long as you are told, and do not rub the eye.
- If a gas bubble was placed, head positioning and the absolute ban on air travel apply — see the tamponade and positioning guide.
- Avoid swimming, hot tubs, and dusty or dirty work for at least two weeks. Heavy lifting is usually restricted for a similar period.
- Vision recovers gradually over weeks to months. If you had a macular problem, improvement can continue for six months to a year.
Risks & Side Effects
Cataract
The most predictable consequence. Most patients over about fifty who still have their natural lens will develop a significant cataract within a year or two of vitrectomy. Cataract surgery afterward is routine and usually restores the clarity.
Retinal tear or detachment
New tears can occur during or after surgery. The retina is examined carefully at the end of the operation and at follow-up visits for exactly this reason.
Raised eye pressure
Common in the early period, particularly with a gas or oil fill, and usually managed with drops.
Infection inside the eye
Rare but serious. Increasing pain and worsening vision in the days after surgery is the warning sign and warrants an immediate call, not a wait.
Bleeding
Blood in the eye after surgery can delay visual recovery and occasionally needs a further procedure to clear.
Incomplete visual recovery
Surgery fixes the structural problem. How much vision returns depends on how long the retina was affected and whether the central retina was involved before surgery.
Every procedure carries risk, and this list is not exhaustive. Your doctor will discuss the risks that apply to your eye and your circumstances before you decide.