originally published September 2000
The vitreous is a jelly-like fluid which fills the middle of the eye and helps it hold its shape. In order for repairs to be made to the retina, the vitreous must be removed and then replaced after surgery. The vitreous may also need to be replaced if it is inflamed or infected. The removal procedure is called a vitrectomy. It is also called trans pars plana vitrectomy (TTPV), named after the area of the eye through which the procedure is most often done.
The operation is usually performed on an out-patient basis or combined with a brief hospital stay of twenty-four hours or less. Intraocular gas mixtures will be put in the eye in order to hold the retina in place until they are replaced naturally by the body’s own fluids. Until this happens, it is frequently necessary for the patient to remain in a “face-down” position. In some cases where that kind of limitation is unfeasible (as with children), silicone oil or vitreous substitutions may be used. These, however, need to be removed later in a second operation.
Before the operation, drops will be put in the eye to dilate the pupil. In order to minimize the risk of infection, antibiotic drops will also be used following the surgery. Local anesthetic is the norm, but general anesthesia may be necessary in more complicated cases. Following the operation, the eye will be protected and bandaged, and follow-up examinations will be scheduled.
For most people undergoing a vitrectomy, activity is slowed down for a few days following surgery. Vision improvement could take several weeks to a few months, and it is important to not be alarmed by blurry vision. If a gas bubble has been injected into the eye, it will hinder normal focusing until it dissolves. This bubble will dissolve on its own accord within a few weeks. The majority of people return to their work and normal life style within 1-4 weeks following the operation.
Vitrectomy surgery is usually performed on patients who would experience serious visual loss without it.