A Vitrectomy is a procedure to remove the vitreous gel from the posterior chamber of the eye. Using specially designed instruments the vitreous is removed via 3 small keyhole incisions that are made through the sclera far enough back to avoid the lens, but not too far back as to damage the anterior retina. One key hole allows an illuminating light to be introduced into the vitreous chamber so that the surgeon can visuallise the retina and vitreous gel. The second key hole is to allow for the insertion of the ocutome which is long thin instrument with a guillotine like mechanism at the end which cuts and aspirates small pockets of vitreous gel. The vitreous gel which is being removed needs to be replaced with a saline like solution at the time of vitrectomy surgery in order to maintain the inflation of the eye and this occurs via the infusion line which enters the eye via the third key hole.

A Vitrectomy is used in the treatment of several retinal disorders including, retinal detachments, vitreous haemorrhage due to any cause, epiretinal membranes and macular holes.

Once the vitreous has been removed via a vitectomy procedure, the saline solution which has been infused into the eye during the operation may be replaced with a gas bubble. This gas bubble splints the retina into place and allows any laser or cryotherapy treatment to heal and will resorb spontaneously over 3-8 weeks depending on which gas bubble is being used. In Most cases the gas bubble lasts for a period of 2.5 – 3 weeks only. Whilst there is a gas bubble in the eye, one is not allowed to fly, as this will result in severe elevation of intraocular pressure causing permanent blindness. Often, a bubble of air is left in the eye as this will help in the self sealing of the vitrectomy key holes once the instrument ports have been removed. Whilst there is air in the eye, the patient is also not allowed to fly. With both gas and air being left in the vitreous cavity, a meniscus that represents a gas/fluid level will be observed by the patient especially after the first few days. This results in a sensation as if walking around with a spirit level in the eye.

In the case of more complex retinal cases whereby a longer lasting agent to hold the retina in place is required, options include silicone oil, heavy silicone oil or heavy liquids.

Risks of a vitectomy include, loss of vision, bleeding, infection, elevated intraocular pressure, retinal detachment and cataract if the patient has not previously had cataract surgery.