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Patient Guide to Vitrectomy Surgery

Apr 19 2019

Posted In:

20/20 Blog

Palo Alto, CA – Vinit Mahajan M.D., Ph.D., Associate Professor of Ophthalmology, is a vitreoretinal surgeon-scientist at Stanford’s Byers Eye Institute. He has performed vitreoretinal surgery for more than a decade and has published research papers on optimal surgical techniques. Mahajan is privileged to work with eleven other retina faculty at Stanford and help train retina surgery fellows who are in the process of mastering  important surgical procedures. 

Vitrectomy surgery, which involves the removal of the vitreous gel from the eye, is one of the most common surgeries performed by retina specialists. Over the years, Mahajan has seen instrumentation become more refined, improving patient outcomes and reducing healing times.

Mahajan explained, “The vitreous is normally a clear gel inside the eye overlying the retina. It is removed when there is blood or an opacity that blocks vision, when scar tissue is distorting the retina, when the retina is detached, or when injecting gene therapy beneath the retina, for example. The vitreous gel is needed for eye development, but it is no longer needed after birth. After vitrectomy surgery, the body replaces the missing eye fluid within a day." 

Frequently Asked Questions

Who performs vitrectomy surgery?

Vitreoretinal surgery faculty, including Dr. Mahajan and his colleagues, perform this outpatient procedure either at the Byers Eye Institute’s Ambulatory Surgery Center or at the Stanford Main Hospital.

How long does a vitrectomy take?

A vitrectomy surgery can take anywhere from thirty minutes to several hours depending on what kind of eye problem is being fixed. Occasionally, vitrectomy may be done in conjunction with another procedure such as cataract or glaucoma surgery.

What kind of anesthesia is needed?

Most patients undergo local anesthesia while an EKG, blood pressure, and oxygen sensor monitor vital signs and general health. Local anesthesia makes patients relaxed and sleepy, and it can be safer and more comfortable than general anesthesia.

Is a vitrectomy painful?

During the operation, anesthetic numbing medicine given around the eye makes patients pain-free. After the procedure, some patients may experience a Tylenol-level discomfort for a few days.

How successful is vitrectomy surgery?

This depends on the specific condition and disease stage of the eye. Most vitrectomy surgery is considered low risk with a very high success rate at treating a number of different eye diseases. 

What is the gas bubble for?

Gas bubbles are inserted during surgery and are used to hold the retina in place and allow for healing inside the eye - much like a cast holding a broken bone. Gas bubbles last for around a month. As they slowly disappear, the body fills the eye with its own fluid. During the first week, patients will keep their head in a certain position for most of the day and night. The surgeon will instruct patients on the optimal position, which may be looking down or laying on the right or left side. Laying on the back is avoided since this position may raise eye pressure and reduce retina stabilization.

Can I drive home from the procedure?

Because of the anesthesia, patients will need someone to drive them home after surgery and to the postoperative visit the next day. Most patients should not drive for several days. 

What medicines do I need to take?

Patients will be on several eye drops for at least a month. These prevent infection, control pain and inflammation, and maintain good eye pressure.

What do I need to do at home?

Even though most patients don’t feel much pain, it is important to rest and allow the eye to heal, especially the first night and first week. This means avoiding activities that cause the head to move quickly. Avoid bending over, heavy lifting, cleaning, and gardening.

Do I need to come back to get stitches removed or for any other reason?

Follow-up appointments are generally scheduled one day, one week, and one month after surgery. Most stitches dissolve on their own after a month. If an oil bubble was used, another surgery is needed to remove the oil after the eye has healed.

How long is the recovery time?

Most patients are back to their normal activity after a week. It may take two to 12 weeks for the vision to optimize.

Where can I find more information?

The Foundation of American Society of Retina Specialists vitrectomy fact sheet is an excellent resource. Click here.