Vitrectomy: Uses, Procedure, Recovery, and More

Vitrectomy is an oft-successful eye surgery to restore full vision by correcting issues with the retina and vitreous. 

The retina collects and organizes information and sends it to the brain. The vitreous is the transparent, gel-like substance between the lens of the eye and the retina.

Doctors perform the procedure to repair retinal detachments, retinal tears, holes in the macula, vitreous leaks, penetrating eye traumas, among other conditions.

Intro

Vitrectomy ranks among the most challenging surgical procedures of the eye. Surgeons who perform vitrectomies are among the most qualified in their profession, and they undertake this surgery to prevent vision loss.

During this surgery, the ophthalmologist removes the vitreous humor gel in the eye cavity to access the retina.

From there the surgeon carries any corrective procedures needed to restore your vision and replaces the old vitreous with a substitute of air, saline or, in complex cases, with hexafluoride gas or one of two longer-lasting gasses (perfluoropropane or perfluorohexane).

There are two types of vitrectomies:

• Anterior vitrectomy: This surgery addresses issues in the front of the eye, typically because of an eye injury.
• Posterior vitrectomy: The more common of the two procedures, this is also known as pars plana vitrectomy. The name refers to repairs needed in the back of the eye.

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What Does Vitrectomy Treat?

Many eye complications arise as we grow old. Some people discover their vision turning blurred and cloudy, while others can see floaters in their field of sight. Not all procedures will remove floaters, but vitrectomy is among them.

Aging causes the vitreous to become more liquid, making collagen fibers within the eye to clump together. When this happens, bits of debris cast shadows onto the retina, which appear as floaters in the eyes.

Standard eye surgery does not remove all the floaters, and new ones may form later. Only vitrectomy fully restores the vision. 

Who Needs a Vitrectomy?

Some severe eye conditions may mean that vitrectomy is your only treatment option. You will need this procedure if you’re having any of the below eye complications: 

• Severe eye injuries from an accident
• A hole or wrinkle in the central part of the retina
• Diabetic retinopathy
• Vitreous hemorrhage
• Retinal detachment
• Infections or wounds inside the eye
• Eye problem after a cataract surgery

All of these medical eye problems can result in partial blindness. In worst-case scenarios and when left untreated, the conditions may lead to vision loss or complete blindness.

When eye doctors notice the likelihood of vision loss, they may recommend a vitrectomy to restore your sight. Although the success rate is high, it is not 100-percent guaranteed that the procedure will fully restore your vision.

A five-year study of vitrectomy repairs for retinal detachment released in 2021 showed single-surgery a success rate of 89.6 percent.

How to Prepare for the Procedure

Only your doctor can recommend a vitrectomy after diagnosing the condition of your eyes. Once they have confirmed, the preparation can begin;

Prep 1: Ask your doctor what you will need for the surgery. The doctor will inquire if you are on any medications and advise whether or not to continue with them before the surgery. The doctor will also write down specific instructions that you should know before the surgery. 

Prep 2: Depending on your doctor’s advice, you may need an eye ultrasound to help your doctor analyze and understand your retina. The doctor may also dilate your eyes for an eye exam. They may also use an instrument to shine light in the eye during the retina examination.  

Prep 3: You’ll be informed not to consume any solid food for six hours before the surgery. The food classification here also includes thick liquids like mango or prune juice, cream, or milk. 2 hours before the surgery, the doctor may recommend you drink lighter liquids like water, tea, or apple juice. 

The Vitrectomy Procedure

The time the procedure takes will depend on the complication of your eye condition. A more severe eye problem may take more hours than a less painful eye condition. Before the procedure, you can choose whether to remain awake or use anesthesia during the entire surgery. 

During a vitrectomy, the ophthalmologist will cut the eye’s outer layer then cut through the sclera. They will remove the fluid in the vitreous then bring out any debris or scar tissue from the eye. This procedure is done using a microscopic cutting tool. 

After removing the fluid, the doctor will correct any other notable conditions and fill the eyes with saline. Notably, if your doctor fills your eyes with oil, you’ll need another surgery sooner to remove the oil. Once filled with the fluid, your eye will be stitched up to close the cuts, and an antibiotic ointment placed to cover the patch.

Recovery Timeline

As with many eye treatment procedures, the recovery timeline of a vitrectomy varies from person to person and depends on the type of surgery and the intensity of it. The average recovery time is two to four weeks before you can fully resume your normal activities.

You may also experience a swollen or tender eye immediately after the procedure. Other people feel some pain in the operated eye and have blurred vision a few days after the process. 

Risks

Thanks in large part to the high success rate of vitrectomies, the rate of surgical complications is low. Again, the outcome depends on the intensity of the surgery. Possible risks that come with the procedure include:

• Eye infections
• Bleeding in the vitreous
• Retinal detachment
• Macular pucker
• Cataracts
• Pressure (swelling) in the diseased eye 
• Pain moving your eyes

Be sure to call the doctor if you begin seeing light flashes or floater, experience severe pain in the eye, stary losing vision, or have discharge from the operated eye. 

Costs

Your out-of-pocket costs for a vitrectomy can range from $6,000 to nearly $10,000. If you have health insurance or Medicare coverage, the final amount can range from $6,000 to $8,500.

Without insurance covers, your out-of-pocket cost will end up on the high end of the range.

The amount may also vary depending on the surgeon and hospital of your choice. 

FAQs

How long does it take to heal from a vitrectomy? 

In most cases, the average recovery time is two to four weeks before you can fully resume your normal activities. After four weeks, you may have a clear vision if you do not experience any complications or risk factors. Doctors say that the clarity extent after surgery varies from person to person. 

What is the success rate of a vitrectomy?

Unlike many eye surgeries, vitrectomy enjoys a high success rate. Medical specialists confirm that the surgery’s success rate approaches 90 percent, even for patients aged 60 years old and above.

References

1. Vitrectomy. (2016). The Foundation of American Retina Specialists.

2. What Is Vitrectomy? (April 2021). American Academy of Ophthalmology.

3. Faster visual recovery after 23-gauge vitrectomy compared with 20-gauge vitrectomy. (October 2010). Retina.

4. Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment. (December 2016). BMC Ophthalmology.

5. Three techniques have similar success rates to treat rhegmatogenous retinal detachment. (December 2021). Ocular Surgery News.