In brief: Vitrectomy is surgery in which the surgeon removes the gel inside the eye (the vitreous) to reach and repair the retina. It is performed for retinal detachment, macular disease, blood inside the eye, complications of diabetes, injuries or infection. At the end, the eye is filled with saline, gas or silicone oil. The eye usually heals within a few weeks, while vision may continue to improve for months. You must not fly with gas in your eye.
What is vitrectomy?
The middle part of the eye, behind the lens, is filled with a clear gel called the vitreous. It makes up about two-thirds of the eye's volume. As we age, the gel can separate from the retina and sometimes tear it as it pulls away.
During vitrectomy, the surgeon removes this gel to reach the retina with very fine instruments. They then seal tears, remove blood or membranes, or put the retina back in place. Removing the gel has little effect on the health of the eye. The space is temporarily filled with saline, gas or silicone oil.
Why is vitrectomy performed?
Vitrectomy is recommended when a problem threatens vision and is not expected to heal without surgery:
- retinal detachment: some detachments are repaired with vitrectomy, others with a band around the eye, or with both (see retinal detachment surgery in Tirana);
- macular holes and epiretinal membranes, which blur and distort central vision (macular surgery);
- blood inside the eye (vitreous hemorrhage) that does not clear on its own;
- diabetic retinopathy with bleeding or scar tissue that pulls on the retina;
- severe injuries and a foreign body inside the eye (eye trauma);
- infection inside the eye (endophthalmitis);
- a piece of the lens or an artificial lens that falls to the back of the eye during cataract surgery.
When blood collects beneath the macula, a clot-dissolving medication (tPA) may be injected under the retina after vitrectomy, as described on the clinic's page about macular surgery. Signs that should prompt you to see an ophthalmologist are covered under retinal diseases.
How is vitrectomy performed, step by step?
Vitrectomy is usually performed as day surgery. The eye is numbed with drops and an injection around the eye, often with a sedative given through a vein. General anesthesia is rarely used, for example in children. The operation takes one to several hours.
- The surgeon makes three openings, each smaller than 1 mm, in the white of the eye. They often close on their own, without stitches.
- Using a microscope and light inside the eye, a fine probe cuts and suctions out the vitreous along with blood or cloudiness.
- Depending on the case, the surgeon removes membranes or scar tissue with very fine forceps, or removes the foreign body.
- Retinal tears are sealed with a laser inside the eye or by freezing (cryotherapy).
- The eye is filled with saline, gas or silicone oil to hold the retina in place.
Most patients go home the same day; after some procedures, such as macular surgery, patients stay overnight at our clinic.
At Indian Eye Institute & Laser Center, vitrectomy is performed by Dr. Nishant Taneja, a vitreoretinal surgeon, using the Stellaris Elite 27-gauge system, installed at the clinic in October 2025.
Gas bubble or silicone oil: what's the difference?
Both push the retina against the back wall of the eye, like an internal bandage, until the tear seals (according to Moorfields, usually in about ten days). Long-acting gas or silicone oil is often used for complex detachments.
| Gas bubble | Silicone oil | |
|---|---|---|
| How it is removed | Absorbed naturally; the eye replaces it with its own fluid | Not absorbed; removed in a second procedure, usually after a few months |
| How long it stays in the eye | Air: up to 2 weeks; SF6: up to 4, C2F6: up to 8, C3F8: up to 12 weeks | Until it is removed |
| Vision | Very blurry; then a line like the waterline, which moves down as the bubble shrinks | Blurry at first; improves over weeks or months |
| Head position | Often, for days to weeks | Sometimes; decided by the surgeon |
| Flying, mountains, diving | No, until the gas has completely gone | Ask your surgeon (Moorfields: no flying for 2 weeks) |
| Nitrous oxide anesthesia | No, until the gas has gone | Ask your surgeon |
Ask which gas was used: the restrictions depend on this.
What happens after retinal surgery?
- The eye is covered with a patch for one or several days.
- Use the drops as directed to prevent inflammation and infection. Do not rub the eye.
- A gritty feeling in the eye is common; severe pain is rare.
- The eye may remain red and swollen for several weeks. Moving black spots are common, especially with gas.
The first follow-up is usually the next day, so bring someone with you. Do not drive without your doctor’s approval; this also depends on the vision in your other eye. Avoid strenuous sports and heavy lifting; light walking is allowed. Reading and watching TV will not harm the eye. Time off work usually lasts 2–4 weeks.
Face-down positioning
The gas bubble rises. To make it press against the repaired area, your surgeon may ask you to keep your face down or your head turned to the side, for several days to several weeks. Maintain this position at all times, even when eating, walking or sleeping. Without it, the operation may not be successful. It can help to rest your forehead on your folded arms on a table; special pillows and chairs are also available. Not every patient needs to maintain this position; your surgeon will decide.
Flying and anesthesia when there is gas in the eye
With gas in your eye, you must not fly, climb mountains or scuba dive. Changes in altitude cause the bubble to expand and increase pressure in the eye, which can damage your vision. The same applies to nitrous oxide, a gas sometimes used for pain relief, for example during childbirth or in an emergency. Tell every doctor that you have gas in your eye. If you are visiting from abroad, plan your return after your surgeon confirms that the gas has cleared (see international patients).
How long does recovery from vitrectomy take?
The eye usually heals within 2–6 weeks. Vision takes longer to recover: with gas or silicone oil, it may take weeks or months, and it clears gradually over several months. You may need new glasses afterward. The result depends on the condition of the retina before surgery, especially whether the macula was affected. Vitrectomy often improves vision or prevents it from getting worse, but it cannot reverse damage the retina had already sustained.
What are the risks of vitrectomy?
Serious complications are rare, but risks include:
- infection inside the eye;
- bleeding;
- a new retinal tear or detachment;
- increased eye pressure, which can lead to glaucoma;
- vision that does not improve.
Cataracts can also develop, particularly in people over 50. They are treated with cataract surgery if they develop. If you already have an artificial lens, vitrectomy will not damage it.
When should you contact the clinic immediately?
Call the clinic immediately if, after vitrectomy, you have:
- severe or worsening pain;
- sudden loss of vision;
- increasing redness or discharge from the eye;
- flashes of light, many new floaters, or a curtain-like shadow. The retina may have detached again.
Frequently asked questions
Can I see the gas bubble in my eye? Yes. At first, your vision will be very blurred. As the bubble gets smaller, it looks like a moving line; you can see more clearly above it. Eventually, the bubble disappears.
Does silicone oil need to be removed from the eye? Usually, yes. It is removed in a second procedure after a few months. Your surgeon will decide when.
Can both eyes be operated on at the same time? No. If both eyes need vitrectomy, the second eye is operated on after the first has healed.
Sources
- American Academy of Ophthalmology (AAO) — What Is Vitrectomy?
- AAO — Positioning After Retinal Surgery
- American Society of Retina Specialists (ASRS) — Vitrectomy
- ASRS — Retinal Detachment
- ASRS — Complex Retinal Detachment
- National Eye Institute (NEI) — Vitrectomy
- NEI — Retinal Detachment
- NHS — Detached retina (retinal detachment)
- Moorfields Eye Hospital — Retinal detachment surgery (PDF)
Have you been told you need a vitrectomy? Book a retinal consultation at Indian Eye Institute & Laser Center in Tirana. Your doctor will explain whether surgery is needed and what your recovery will involve. Book an appointment · Tel. +355 67 503 0017
