A vitrectomy is an operation to remove the vitreous jelly, a fluid-like substance the fills the cavity of the eye. The vitreous is something that is left over following the development of the eye and does not serve any known useful purpose in the adult. Once removed, it does not grow back, instead the eye gets filled by the clear fluid called aqueous, produced at the front of the eye. This does not affect the vision and carries other side benefits, such as the removal of the majority of floaters (which are constituents of the vitreous).
In order to perform the operation, you will be asked to lie down comfortably on your back on a bed. An anaesthetic will be administered to ensure that the eye is comfortable throughout the procedure. This will usually be drops, followed by an injection next to the eye in order to numb it. After this, the area around your eye will be cleaned with antiseptic and a plastic or paper cover be placed over that side of the face to help keep the area clean and sterile.
The operation will involve using keyhole surgical techniques to allow very thin instruments to pass through the white of the eye to remove the jelly from the inside. Any other steps of the surgery will then be carried out as necessary.
It is important to stay still for the procedure, especially for certain parts of the operation. The vast majority of patient have no problems with staying still enough. We ask you to let the surgeon know of you need to cough, sneeze or adjust your position for comfort – this can be accommodated, provided that the surgeon has sufficient warning.
You may feel touch and pressure during the operation, however you should not feel any pain or sharpness. Please let the surgeon know if there is any discomfort.
You will not be able to see the surgeon or the steps of the operation, although sometimes patients can see lights and colours, a bit like a firework display.
Your eye will be covered by a pad and plastic shield. This should stay on for at least a few hours, or the next day. This is to protect the eye from accidental damage while the numbing effect of the anaesthetic continues to work.
After this, the eye may become a bit gritty and irritated, which is normal. You should not be in severe pain and should report this if it happens. You should be given post-op instructions for the care of your eye by the nursing staff. There will frequently be drops to take, you may be asked to posture (maintain a particular head position) and there may be special considerations if you have had a bubble of gas placed inside the eye. You will receive instructions on all these if they are relevant. You should receive a post-op follow up appointment, usually within 2 weeks of surgery.