Skip to content

Magdalena G. Krzystolik, M.D. - Paul B. Greenberg, M.D.

Expert retinal care for Rhode Island and Southern Massachusetts

Vitreoretinal Surgery - Retinal diseases and treatments

Vitreoretinal Surgery

Vitrectomy is a type of eye surgery used to treat disorders of the retina (the light-sensing cells at the back of the eye) and vitreous (the clear gel-like substance inside the eye). It may be used to treat a severe eye injury, diabetic retinopathy, retinal detachments, epiretinal membrane (macular pucker), and macular holes . This proceure is performed in the operating room.

During a vitrectomy operation, the surgeon makes tiny incisions in the sclera (the white part of the eye). Using a microscope to look inside the eye and microsurgical instruments, the surgeon removes the vitreous and repairs the retina through these tiny incisions. Repairs include removing scar tissue or a foreign object if present.

Gas bubble face downDuring the procedure, the retina may be treated with a laser to reduce future bleeding or to fix a tear in the retina. An air or gas bubble that slowly disappears on its own may be placed in the eye. This bubble holds the retina in place as it re-attaches to the back of your eye. With time, the bubble disappears and is replaced with your normal eye fluid.

You must keep your head facing downward or turned to a particular side for up to several weeks after surgery so that the bubble will remain in the right position. In some cases the positioning requirements are full-time, and in others it may be part-time. If you lie in the wrong position, such as face-up, pressure may be applied to other parts of the eye, causing further problems like cataract or glaucoma. When the gas bubble is in the eye the vision may be poor but as the gas bubble dissolves, the vision should improve. The final vision after surgery depends on how damaged the retina was before surgery.

Scleral buckle surgery is sometimes used alone or in combination with vitrectomy to treat retinal detachment. In this procedure, a flexible band (sclera buckle) is placed around the eye to counteract the force pulling the retina out of place. The surgeon often drains the fluid under the detached retina allowing the retina to settle in its proper position against the wall of the eye. This procedure is performed in the operating room.

Pneumatic retinopexy is a procedure that sometimes can be performed in the office to treat retinal detachment. A gas bubble is injected into the vitreous cavity inside the eye to push the retina against the wall of the eye. This is usually done in combination with laser surgery or cryopexy (freezing treatment).