Vitrectomy
Keyhole eye surgery that removes the jelly inside the eye so the surgeon can treat problems at the back of the eye, such as the retina or macula.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A vitrectomy removes the eye's jelly so the surgeon can treat the retina, macula or bleeding behind it.
- What it can achieve depends on the underlying condition — it is a tool, not a guarantee of better vision.
- If a gas bubble is used you may need to hold a head or face-down position for days and you must not fly until the bubble has gone.
- Most eyes develop a cataract within a year or two after a vitrectomy, which can be treated separately.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Gives a clear view to treat problems at the back of the eye
An eye with no realistic visual potential may not benefit from a vitrectomy.
The eye is sore, red and watery and vision is blurry. If a gas bubble is used you may be asked to hold a set head or face-down position for much of the...
Clear, written head-posturing and no-fly instructions when gas or oil is used.
The eye is sore, red and watery and vision is blurry. If a gas bubble is used you may be asked to hold a set head...
You use eye drops, keep water out of the eye and avoid strenuous activity. Do not drive until the team says your...
A gas bubble shrinks and disappears over a few weeks; you may see it wobbling in your vision as it shrinks. You...
Vision continues to settle. A cataract often develops and may need its own small operation later to clear the...
What is a vitrectomy?
A vitrectomy removes the clear jelly (the vitreous) that fills the middle of the eye. Taking the jelly out gives the surgeon space and a clear view to treat problems at the back of the eye.
It is used for many different conditions — for example a detached retina, a macular hole, a pucker or scar on the macula, bleeding inside the eye (often from diabetes), or to remove infection. At the end of the operation the eye may be filled with a gas bubble, silicone oil or simply fluid, depending on what was treated.
A vitrectomy is a means to an end, not a single fixed operation: what it can achieve depends entirely on the underlying problem it is being used to treat. Two things are very common afterwards — needing to hold a head position if gas is used, and developing a cataract within a year or two.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Vitrectomy for retinal detachment
The jelly is removed, the retina is flattened, tears are sealed with laser or freezing, and the eye is filled with gas or oil to hold the retina in place.
Vitrectomy for macular hole or macular pucker
The jelly is removed and a very thin membrane is peeled off the macula to release the pulling that keeps a hole open or wrinkles the surface. A gas bubble is usually used for...
Vitrectomy for vitreous haemorrhage
Blood that has filled the eye, often from diabetic eye disease, is removed so vision can clear and the retina can be treated, for example with laser.
Vitrectomy for infection or inflammation
Used to remove infected material (endophthalmitis) or to take a sample to find the cause of inflammation inside the eye.
Preparing for your surgery
- Make sure you understand which condition the vitrectomy is treating and what it can realistically achieve for your eye.
- Tell the team about all your medicines, including blood thinners, and any heart, lung or anaesthetic problems.
- Ask whether your eye will be filled with gas, oil or fluid, because gas means no flying and may mean head posturing.
- Arrange a lift home and help for the first days, as the operated eye will see poorly at first.
- Plan time off work and ask how much reading, screen time and close work you can do early on.
- If you have a gas bubble, ask about avoiding certain anaesthetic gases for any future surgery and carrying a warning band.
What happens
The operation is done under local anaesthetic (often with sedation) or general anaesthetic. The surgeon makes a few tiny openings in the white of the eye, no bigger than a pinhole, and removes the jelly using a fine cutting instrument while keeping the eye gently filled with fluid.
The surgeon then treats the underlying problem — for example flattening a detached retina, peeling a membrane off the macula, or removing blood. At the end, the eye is filled with gas, silicone oil or fluid. The tiny openings usually seal themselves without stitches. The operation typically takes one to two hours and many people go home the same day.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- An eye with no realistic visual potential may not benefit from a vitrectomy.
- Some problems can be treated without surgery, so a vitrectomy is not always the right step.
- A patient who cannot tolerate the necessary anaesthetic or posturing may need a modified plan.
- Surgery may be deferred if the condition is stable and not threatening sight.
Delay surgery if…
- There is an active infection elsewhere or unstable medical problems that make anaesthetic unsafe for now (unless the eye itself is an emergency).
- Essential travel or altitude exposure is planned soon and gas would be used — discuss timing with the surgeon.
- Important results or imaging of the eye are still awaited.
- Blood-thinning medicines need review before surgery.
Alternatives to discuss
- Watchful waiting or monitoring if the condition is mild or stable.
- Eye injections or laser instead of, or before, surgery for some conditions.
- Treating the underlying disease medically, for example better diabetes control.
- No surgery in an eye with no useful vision, after careful discussion.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Gives a clear view to treat problems at the back of the eye
- Can reattach a detached retina or close a macular hole
- Can clear blood that is blocking vision
- Can remove infection or take a sample to find a cause
- Can relieve pulling or scarring on the macula
Risks & complications
- Blurry vision, redness and a sore, watery eye for weeks
- Very poor vision while a gas bubble is in the eye
- Developing a cataract in the months after surgery
- Needing to hold a head position for several days if gas is used
- Raised pressure inside the eye
- A new tear or detachment of the retina
- Bleeding inside the eye
- Slow healing of the small wounds
- Serious infection inside the eye (endophthalmitis)
- Significant or permanent loss of vision
- Drooping eyelid or double vision
The single biggest thing to plan for is cataract: almost everyone develops one within a year or two of a vitrectomy, because the surgery disturbs the eye's natural fluids. If gas is used, posturing and the no-fly rule matter a lot. Ask your surgeon what your vitrectomy is treating, whether you will have gas or oil, and whether your lens will be removed at the same time.
Published figures to discuss
Because a vitrectomy is used for many different conditions, success and complication rates depend mostly on the underlying problem rather than the technique. A few outcomes are common across most vitrectomies and are worth planning for.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Cataract after vitrectomy | Very common in phakic eyes; many series report the large majority needing cataract surgery within 1–2 years | Speeded up by the surgery and by any gas used; treatable with routine cataract surgery. | Guide sourcesClinical context |
| Serious infection inside the eye (endophthalmitis) | Rare; meta-analyses of modern vitrectomy report roughly 0.03–0.11% depending on gauge and setting | Sudden pain, redness and loss of vision after surgery must be treated urgently. | Anatomical success of pars plana vitrectomy for RRD — PMCpmc.ncbi.nlm.nih.govPublished figure |
| New retinal tear or detachment | Uncommon, but risk depends strongly on the reason for vitrectomy and whether the retina was already abnormal | Why returning flashes, floaters or a shadow need urgent review after surgery. | Anatomical success of pars plana vitrectomy for RRD — PMCpmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery depends on what the vitrectomy was treating, but in general the operated eye sees poorly at first and clears slowly over weeks to months. A gas bubble makes vision very blurry until it absorbs.
- A red, watery, gritty or sore eye for the first weeks
- Very blurry vision, especially while a gas bubble is present
- Seeing a moving bubble or line in your vision as gas absorbs
- Vision that clears only slowly over weeks to months
- Needing a cataract operation later
Aftercare
- Use all prescribed eye drops exactly as directed to prevent infection and inflammation.
- Hold the head position you are given if a gas bubble is used.
- Do not fly or travel to high altitude while any gas bubble remains in the eye.
- Avoid heavy lifting, straining, swimming and rubbing the eye in the early weeks.
- Do not drive until the team confirms your vision meets the legal standard.
- Keep follow-up appointments so the eye pressure and back of the eye can be checked.
- Know the warning signs that need urgent review and who to contact.
- Prescribed eye drops collected and understood
- Head-posturing instructions written down (if gas used)
- No-fly advice noted and travel checked
- Lift home and help for the first days arranged
- Time off work agreed with the team
- Emergency eye contact number saved
Scars and how they heal
There is no skin scar. The surgeon works through a few pinhole-sized openings in the white of the eye, which usually seal themselves without stitches. The eye looks red and may feel gritty while these tiny wounds heal.
⚠ Get urgent help if…
- Sudden worsening or loss of vision
- A new shadow, curtain, flashes or shower of floaters
- Increasing eye pain, especially with nausea or a hard, red eye (raised pressure)
- Increasing redness, swelling or discharge (possible infection)
- A severe headache or feeling very unwell after surgery with a gas bubble
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is that the underlying problem is treated — for example the retina stays flat, the hole closes, or the eye clears — with a comfortable, infection-free eye afterwards. How much vision improves depends on the original condition, not on the vitrectomy itself.
Vision usually settles slowly over months, and a cataract forming afterwards can temporarily blur things until it is treated. Your surgeon should explain what level of vision is realistic for your particular eye.
A vitrectomy permanently removes the eye's jelly, which is not replaced and is not normally missed. Whether the result lasts depends on the condition treated — for instance, diabetic eye disease can keep progressing, and the other eye can develop its own problems, so ongoing eye care often continues.
Combining with other procedures
A vitrectomy is often combined with, or followed by, cataract surgery because a cataract is so likely afterwards. It may also be combined with laser treatment (for example in diabetic eye disease) or with membrane peeling on the macula.
Follow-up & long-term care
You will usually be reviewed within a day or two and then over the following weeks to check the back of the eye, the pressure and any gas or oil. Report any sudden vision change, increasing pain or signs of infection straight away.
- Cataract surgery later if vision clouds after the vitrectomy
- Planned removal of silicone oil if oil was used
- Ongoing treatment of the underlying condition (for example diabetic eye disease)
- Regular monitoring of both eyes if you have ongoing risk factors
- Awareness of detachment warning signs for life
Revision and secondary surgery reality
- If silicone oil is used, a planned second operation to remove it is usual.
- Some conditions, such as diabetic eye disease, may need more surgery or laser later.
- Cataract surgery is very commonly needed afterwards if not done at the same time.
- A new problem can develop in the other eye and need its own treatment.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear, written head-posturing and no-fly instructions when gas or oil is used.
- An urgent contact route and named team for sudden pain or vision change.
- Early and regular review of the eye pressure and back of the eye.
- A plan for later cataract surgery and, if relevant, silicone oil removal.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The underlying condition being treated and the complexity of the surgery
- Surgeon's (vitreoretinal specialist) fee
- Anaesthetic and theatre or facility fees
- Whether gas or silicone oil is used and whether oil removal is later needed
- Whether cataract surgery is combined or done separately
- Number of follow-up visits and any repeat surgery
- The vitreoretinal surgeon's fee
- Theatre/facility and anaesthetic fees
- Cost of any gas, oil or implants used
- Whether combined cataract surgery or oil removal is included
- Number of follow-up appointments included
- What happens, and what it costs, if a complication or further surgery is needed
On the NHS? Vitrectomy is commonly available on the NHS when clinically indicated; private care is used mainly for choice of surgeon, timing or second opinion for non-urgent conditions.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being warned that a cataract is very likely afterwards.
- No clear explanation that gas means no flying and may mean strict posturing.
- Expecting the vitrectomy itself to restore vision when the outlook depends on the underlying disease.
- No written emergency plan for sudden pain or vision loss.
Marketing red flags
- Promising vision improvement without explaining it depends on the underlying condition.
- Downplaying posturing, no-fly rules or the likelihood of later cataract surgery.
- Not mentioning the chance of further surgery.
- Presenting keyhole surgery as without risks.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What condition is the vitrectomy treating, and what can it realistically achieve for me?
- Will my eye be filled with gas, oil or fluid, and what does that mean for me?
- Will I need to posture, and will I be unable to fly afterwards?
- Will you remove my cataract at the same time, or will I need that later?
- How likely am I to need further surgery?
- What symptoms should make me contact you urgently?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will I miss the jelly that is removed?
Why will I get a cataract afterwards?
Why do I have to hold my head in a position?
Why can't I fly after a vitrectomy?
Will my vision improve?
Is it available on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Detached retina (mentions vitrectomy) Royal College of Ophthalmologists — patient information Moorfields Eye Hospital — patient information hub Cambridge University Hospitals — posturing after vitrectomy and gas/oil Gloucestershire Hospitals NHS — vitrectomy surgery Anatomical success of pars plana vitrectomy for RRD — PMC Endophthalmitis after vitrectomy — systematic review/meta-analysis (PMC) Ten-year outcomes after retinal detachment repair
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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