Vitrectomy

What you should know

  • Vitrectomy is surgery to remove all or part of the vitreous in your eye. Your vitreous is a gel-like substance inside your eyeball. Your lens is clear and is located on the front part of your eye. Your lens directs light onto your retina at the back of your eyeball. Your retina sends the images that you see to your brain. You may need a vitrectomy if your lens is not in its right place. You may also need a vitrectomy if your retina breaks away from the back part of your eyeball. This is called a retinal detachment.

  • You may also need a vitrectomy if your macula is swollen or damaged. Your macula is a small part of your retina that helps you see in front of you. It also helps you see when you read and write. If you are diabetic, your caregiver may have told you that you have diabetic retinopathy. Diabetic retinopathy may cause blood vessels to break and blood to build up in your vitreous. Vitrectomy will help clear the blood from your eyeball. Vitrectomy is also done to treat endophthalmitis. Endophthalmitis is a serious eye infection that can occur after having eye surgery.

  • With a vitrectomy, your caregiver cuts through an area of your eye called the pars plana. The pars plana is found near the iris and sclera during surgery. The iris is the colored part of your eye, and the sclera is the white part of your eye. Vitrectomy helps your caregiver look at and repair your retina and other parts of your eye. A vitrectomy may remove scar tissue or objects from your eye, such as slivers of wood or glass. Having a vitrectomy may improve your eyesight and prevent blindness.
Lateral cut-away of the Right Eye

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • After your surgery, you may have pain. Your sight may not improve for up to one year. Your eyesight and eye pressure may not get better and could become worse. A vitrectomy may cause a cataract (clouding over your eye) or glaucoma (increased eye pressure). Your retina may break away from the back part of your eyeball during your surgery. The hole in your macula could reopen. Some problems may happen months after your surgery.

  • You may also have endophthalmitis which is inflammation (redness and swelling) inside your eye. Endophthalmitis may also be an infection. Your eye may also start bleeding. You may need to have eye surgery again to fix these problems. If you do not have vitrectomy, your eyesight problems may get worse. This may lead to blindness. Ask your caregiver if you have any questions or concerns about your treatment.

Getting Ready

The week before your surgery:

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • You may need to see your eye doctor 1 to 4 days before the surgery for an eye exam. You may also need to have a blood test. Tests to look at the inside of your eyes using special tools may also be needed. These tests may include a slitlamp exam, retinoscopy, and an ultrasound scan. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

  • Ask someone to drive you to and from your surgery.

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • Eye drops: Your caregiver may put several eye drops in your eye an hour before your surgery. This may be an antibiotic eye drop. It will help prevent infections during your surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

  • You may be given medicine in a vein (blood vessel) to help you relax or make you drowsy. You may get medicine called local anesthesia that will numb your eye. You may also get general anesthesia to keep you completely asleep during your surgery. During surgery your caregiver will use tools to see the parts of your eye more clearly. One tool makes the parts of your eye appear bigger. The other tool has a light on its end to shine on the inside of your eye.

  • Your caregiver will make one or more small cuts on your sclera. Your caregiver will place a tiny tube into your eye to put saline (salt water) in it. Saline helps the keep your eye pressure the same as before your surgery. Your caregiver will then remove your vitreous. Your caregiver may place a gas bubble or oil into your eye to help you heal. During your vitrectomy, your caregiver may also repair other problems with your eye. Your caregiver will close the small cuts he made using very small sutures (thread) or a special glue.

After your surgery:

Your caregiver may put antibiotic ointment on your eye. Your caregiver will then tape an eye patch (bandage) is over your eye. This bandage keeps the area clean and dry to prevent infection and helps keep your eyelid closed. A metal or plastic shield may be put on top of the bandage. You may be taken to a room where you will be watched closely by a caregiver. Do not try to get out of bed until your caregiver says it is OK. Your caregiver will let you know when you are well enough to go home.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You get sick (a cold or flu) or have a fever. Your surgery may need to be done later when you are well.

Seek Care Immediately if

  • You have sudden, severe eye pain.

  • Your eyesight suddenly changes for the worse.

  • You see floaters (spots or lines) in your vision.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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