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Vitrectomy for the Treatment of Vitreous Hemorrhage

A surgical procedure called a vitrectomy is performed for severe cases of vitreous hemorrhage to remove the blood and improve vision and also treat the underlying cause of the hemorrhage.

Blood in the vitreous clears on its own with time without requiring vitrectomy surgery. However, vitrectomy is considered if the blood in the vitreous is taking a long time to clear, frequent hemorrhages are observed and the doctor feels that an early vitrectomy could prevent further complications from vitreous hemorrhage.

The surgery may require an overnight stay or sometimes it is done as an outpatient procedure lasting about 2-3 hours. Vitrectomy is performed under local anesthesia. Your surgeon uses a microscope and surgical instruments to perform the surgery. Three small incisions are made in the sclera (white outer wall of the eye) to remove the vitreous and infuse fluid in order to maintain the shape of the eye. The procedure involves removal of the vitreous fluid and blood from the vitreous cavity, then replacing the vitreous with a special saline solution that resembles the natural vitreous in the eye.

With newer surgical techniques and instrumentation, the surgery can be performed through tiny 'self-sealing' incisions without the need for sutures. Surgical recovery generally takes about 6 weeks and vision recovery a little longer.

The cause for the hemorrhage such as a retinal tear, retinal detachment, or diabetic retinopathy might also require treatment. Once the vitreous is removed, the doctor accesses the back of the eye and treats the cause as needed. This may include laser treatment for diabetic retinopathy or retinal tears, removal of scar tissue, and repair of holes.

Though vitrectomy is commonly performed, certain risks do exist and include cataract formation and possible vision loss when associated with retinal detachment.

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