What Is Vitrectomy?

Why would a surgeon deliberately remove the clear gel inside your eye? It sounds drastic, but that gel — the vitreous — sometimes becomes part of the problem: it can cloud, bleed, pull on the retina, or hold something that needs to come out. Vitrectomy is the operation that removes it so the surgeon can reach and treat the back of the eye. The short recording above, at just over a minute, shows a vitrectomy being used to remove a cyst from the eye, filmed from the surgeon's working view.

What exactly is taken out — and what replaces it?

The vitreous is the jelly-like substance that fills the main chamber of the eye and helps it keep its shape. During a vitrectomy, the surgeon works through tiny openings in the white of the eye with fine instruments, under an operating microscope, and removes the gel bit by bit. Your eye does not stay empty: the space is filled during surgery with a balanced salt solution, and afterwards the eye gradually produces its own clear fluid to take the gel's place. In some cases the surgeon leaves a temporary gas bubble or a clear oil inside to hold the retina gently in position while it heals; if that applies to you, your team will explain what it means for your posture and travel plans while it is there.

When is vitrectomy suggested?

The common thread is a problem at the back of the eye that drops, instruments or medicine from the front cannot fix. It is one of the operations used in repairing a detached retina — the subject of our guide to what a retinal detachment is — and for clearing blood or scar tissue out of the gel, treating advanced diabetic eye disease, removing a wrinkle of scar tissue over the macula, or dealing with a severe infection or injury inside the eye. Sometimes, as in the anchor video, it is simply the safest route to remove something from inside the eye. Whether it is the right step depends on your scans and examination, and many people are referred to a specialist retinal surgeon for that decision.

What happens on the day itself?

Most vitrectomy surgery is done as a day case. The eye is numbed, often with an injection around the eye, and many patients also have sedation; some have a general anaesthetic instead. You will not watch the procedure — the microscope sits over the eye being treated and the other is covered — and patients generally describe pressure or awareness of light rather than pain. Afterwards the eye is padded or shielded, drops are usually prescribed, and you go home with written instructions and a follow-up appointment. For a longer look at retinal surgery from the operating microscope, the site's "Macular Translocation" recording, at just under eighteen minutes, shows the scale and setting of this kind of work.

And once you are home?

Vision is often blurry at first and improves gradually over days to weeks, depending on what was treated. Mild grittiness or aching is common early on; worsening pain, increasing redness, a sudden drop in vision, or new flashes and floaters are not — contact your eye team the same day if any of those appear. If a gas bubble was left in the eye, you may be asked to hold a particular head position for part of the day, and you must not fly while the bubble is present. Keep your follow-up appointments even if the eye feels fine: some of what the surgeon needs to check can only be seen on examination.

Frequently Asked Questions

Is the vitreous gel missed once it is gone?
No — the eye works without it. The gel matters most while the eye is developing; in adult life the fluid that replaces it does the job of filling the eye, and most people notice no difference from its absence itself.

Will I be awake during a vitrectomy?
Often, yes — with the eye numbed and usually some sedation, though some people have a general anaesthetic. Your surgeon will discuss which is planned for you and why.

How soon can I drive afterwards?
Only once your vision in both eyes together meets the legal standard again and your team is satisfied — that timing varies with what was treated, so ask at your follow-up rather than guessing.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about vitrectomy, not medical advice and not a diagnosis. If you have been advised to have eye surgery, talk to your treating team, who know your situation.