Vitrectomy Surgery

Mr Robert Henderson BSc MBBS MD FRCOphth · Consultant Vitreoretinal Surgeon, Moorfields Eye Hospital & GOSH

Vitrectomy is an operation to remove the vitreous gel from the eye so that conditions affecting the retina and vitreous can be treated. Mr Henderson performs small-incision vitrectomy, with the surgical approach tailored to the condition and the needs of each eye.

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At a Glance

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Approach25-gauge small-incision

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AnaestheticLocal anaesthetic

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SettingDay case procedure

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LocationMoorfields Eye Hospital

The Procedure

What is Vitrectomy?

Vitrectomy involves removing some or all of the vitreous gel through three small entry sites in the white of the eye. Small cannulas hold these entry sites open while instruments pass through them. Once the vitreous is removed, the surgeon gains direct access to the retinal surface to perform the delicate work required — peeling membranes, closing macular holes, reattaching detached retina, or clearing vitreous haemorrhage.

In 25-gauge vitrectomy, the instrument shafts are approximately 0.5 mm in diameter. The surrounding entry cannulas are wider; their external diameter depends on the system used. The entry sites are checked at the end of surgery and a stitch is placed if needed. Most patients can go home the same day, while recovery depends on the condition treated.

Conditions Treated with Vitrectomy

Macular hole

Epiretinal membrane

Retinal detachment

Vitreous haemorrhage

Diabetic tractional detachment

Proliferative vitreoretinopathy

Severe vitreous floaters

Dropped nuclear fragment

Endophthalmitis

Paediatric vitreoretinal conditions

What to Expect

The Vitrectomy Journey

Consultation & Planning

A thorough assessment including OCT imaging, visual acuity, and clinical examination to confirm the diagnosis and plan the surgical approach.

Admission (Day Case)

Arrive at Moorfields on the day of surgery. Anaesthetic drops and pre-operative assessment are completed before going to the operating theatre.

Local Anaesthetic

A local anaesthetic block numbs the eye completely. You will be awake but comfortable, and will see only light during the procedure. General anaesthetic is available when required.

Surgery (30–90 minutes)

The vitreous is removed and the specific retinal work performed. The eye may be filled with gas or silicone oil depending on the condition treated.

Recovery & Discharge

Most patients go home the same day with a pad over the eye, eye drops to use, and written instructions. A follow-up appointment is arranged for the following day or within a few days.

Postoperative Recovery

Vision is typically blurred for several weeks, particularly if gas has been used. Full visual recovery depends on the underlying condition and may take several months.

Questions & Answers

Frequently Asked Questions

Is vitrectomy painful?

The eye is completely anaesthetised before surgery. You will feel no pain during the procedure, though you may feel gentle pressure at times. After surgery, the eye may be mildly uncomfortable or gritty for a few days, which is well controlled with simple analgesics and eye drops.

Will I need gas in my eye after vitrectomy?

This depends on the condition being treated. Macular hole surgery and retinal detachment repair typically require a gas tamponade to support the repair while it heals. The gas absorbs naturally over two to eight weeks depending on the type used. You must not fly while gas is present in the eye, as altitude changes can cause a dangerous rise in pressure.

Will vitrectomy cause cataract?

Vitrectomy accelerates cataract development in patients who still have their natural lens. Cataract typically becomes noticeable within one to two years of surgery and can be treated with straightforward cataract surgery at a later date. In some patients, particularly those over 60, combined cataract and vitrectomy surgery at the same sitting may be recommended to avoid two separate procedures.

How soon can I drive after vitrectomy?

You must not drive until your vision meets the legal standard and your surgeon has confirmed it is safe to do so. If gas has been used, driving is not permitted until the gas has fully absorbed. Most patients can return to driving within four to eight weeks, though this varies with the underlying condition and speed of visual recovery.

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Making a decision about surgery

Your consultation will cover the potential benefits, risks of complications, alternatives and recovery. The likely result depends on your diagnosis, the health of your eye and any previous treatment. An assessment does not commit you to an operation.

Arrange a Consultation

Discuss your symptoms, ask questions and understand your options before deciding on treatment.

To discuss vitrectomy surgery or arrange an assessment, please contact the practice secretaries:

07762 112552 or 07974 015691 · moorfields.rhenderson@nhs.net

Or use the contact form on this website.

Mr Robert Henderson BSc MBBS MD FRCOphth is a Consultant Vitreoretinal Surgeon at Moorfields Eye Hospital and Great Ormond Street Hospital, and Clinical Lead for Ophthalmology at GOSH. He holds an Honorary Associate Professorship at UCL-GOSH Institute of Child Health.