Vitrectomy is a surgical procedure used to treat several conditions affecting the retina and vitreous, including retinal detachment, vitreous haemorrhage, macular holes and epiretinal membranes.
Although it is a well-established procedure, like any surgery, vitrectomy carries certain risks and possible complications. Understanding these risks can help you know what to expect before and after the procedure.
The likelihood of complications can vary depending on the condition being treated, the health of the retina, the complexity of the surgery and whether additional procedures or materials, such as a gas bubble or silicone oil, are used.
For a broader overview of vitrectomy and the conditions it can treat, see the Vitrectomy page.
What Are the Possible Risks of Vitrectomy?
Vitrectomy is generally considered a safe and established eye procedure, but complications can occur during or after surgery. Some may be temporary and improve as the eye heals, while others may require medication, close monitoring or additional treatment.
Possible complications of vitrectomy include:
- Cataract development or progression
- Changes in eye pressure
- Bleeding inside the eye
- Retinal tear or retinal detachment
- Infection inside the eye
- Inflammation
- Macular swelling
- Persistent or worsening vision problems
- Problems related to a gas bubble or silicone oil
- The need for additional eye surgery
Not every patient will experience these complications, and the risks are influenced by the reason for surgery and the condition of the eye before treatment.
Cataract Development After Vitrectomy
Cataract formation or progression is one of the recognised complications following vitrectomy, particularly in older adults. A cataract occurs when the natural lens of the eye becomes cloudy, which can gradually cause blurred or hazy vision.
If a cataract develops or progresses after vitrectomy and begins to affect vision, cataract surgery may be recommended. In some patients, cataract surgery may also be considered at the same time as vitrectomy, depending on the condition of the eye and the surgeon's treatment plan.
The development of a cataract does not necessarily mean that the vitrectomy has been unsuccessful. It is a separate condition that can often be treated when appropriate.
Changes in Eye Pressure
Changes in the pressure inside the eye, known as intraocular pressure, can occur after vitrectomy. In some patients, the pressure may increase, while in others it may become lower than normal.
Increased eye pressure may be associated with discomfort and, when persistent, can affect the optic nerve. This is one reason why eye pressure is checked during postoperative follow-up visits.
The use of a gas bubble or silicone oil can also influence eye pressure in some cases. If pressure becomes too high or too low, your ophthalmologist may recommend eye drops or other treatment depending on the cause.
Retinal Tear or Retinal Detachment
Retinal complications are particularly important because vitrectomy is often performed to treat conditions involving the retina. Although the procedure is intended to address the underlying problem, a retinal tear or retinal detachment can sometimes occur after surgery.
Retinal detachment occurs when the retina separates from its normal position. Depending on the circumstances, further treatment or surgery may be required.
Sudden flashes of light, a sudden increase in floaters, a dark shadow or curtain across the vision, or a sudden decrease in vision can be warning signs of a retinal problem. These symptoms should be assessed promptly by an eye specialist.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Infection After Vitrectomy
Infection inside the eye, known as endophthalmitis, is a rare but potentially serious complication of eye surgery. Because an infection can threaten vision, prompt treatment is important if it occurs.
Symptoms that may indicate an infection include increasing redness, significant eye pain, worsening vision or unusual discharge from the eye.
Some redness and discomfort can be expected during normal recovery, but symptoms that become more severe rather than gradually improving should be discussed with your ophthalmologist.
Bleeding Inside the Eye
Bleeding can occur during or after vitrectomy. The risk may be influenced by the condition being treated and the health of the blood vessels inside the eye.
For example, patients undergoing vitrectomy for conditions involving abnormal blood vessels or bleeding may already have an increased risk of bleeding. Your surgeon will assess the eye and manage any bleeding that occurs during the procedure.
Minor bleeding may settle as the eye heals, while more significant bleeding may require additional monitoring or treatment.
Inflammation and Eye Discomfort
Some degree of inflammation is a normal part of the body's healing response after eye surgery. It may cause redness, irritation, mild discomfort or temporary blurred vision.
Anti-inflammatory eye drops may be prescribed after vitrectomy to help control postoperative inflammation. The amount and duration of inflammation can vary depending on the individual and the type of surgery performed.
However, severe or increasing pain, worsening redness or a sudden change in vision should not be assumed to be part of normal recovery and should be assessed by an eye specialist.
Macular Swelling
The macula is the central part of the retina responsible for detailed vision, including reading and recognising faces. Swelling in this area, known as macular oedema, can affect central vision after eye surgery.
Macular swelling may cause blurred or distorted vision. Depending on its cause and severity, it may improve with time or require additional treatment.
Your ophthalmologist can determine whether changes in vision are related to macular swelling or another aspect of the healing process.
Temporary Blurred Vision
Blurred vision is common during the early recovery period after vitrectomy and does not necessarily indicate a complication.
Vision may be particularly blurred when a gas bubble has been placed inside the eye. As the bubble gradually disappears, vision may change and become clearer. The speed of visual recovery varies between patients.
The final visual outcome also depends on the condition that led to vitrectomy. If the retina has already been damaged by retinal detachment, bleeding, diabetes or another eye disorder, surgery may not completely restore vision that was lost before treatment.
Complications Related to Gas or Silicone Oil
During some vitrectomy procedures, a gas bubble or silicone oil may be placed inside the eye to help support the retina while it heals. These materials can be an important part of treatment, but they also require specific precautions and follow-up.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
If a gas bubble is used, vision may remain blurred until the bubble gradually disappears. Air travel and significant changes in altitude can be unsafe while certain gas bubbles remain in the eye because changes in pressure can cause the bubble to expand.
Patients with a gas bubble should also inform their doctor or anaesthetist before undergoing any medical procedure involving anaesthesia.
Silicone oil may remain inside the eye for a longer period and, in some cases, may need to be removed during a later procedure. Your surgeon will determine whether and when removal is appropriate.
Can Vitrectomy Cause Permanent Vision Loss?
Severe permanent vision loss after vitrectomy is uncommon, but it is a possible complication of eye surgery. Serious infection, significant bleeding or severe retinal complications can potentially cause substantial damage to vision.
However, the visual outcome after vitrectomy also depends greatly on the condition being treated. Some retinal conditions can cause permanent damage before surgery takes place.
In such situations, the primary goal of surgery may be to prevent further deterioration or preserve the vision that remains rather than completely restore normal sight. This is why visual recovery can differ considerably between patients, even when they undergo similar procedures.
How Can You Reduce the Risk of Complications?
Not all complications can be prevented, but following your ophthalmologist's postoperative instructions can support the healing process and help reduce avoidable problems.
- Use your prescribed eye drops exactly as directed.
- Attend all scheduled follow-up appointments.
- Avoid rubbing or putting unnecessary pressure on the operated eye.
- Follow any recommended face-down or other positioning instructions.
- Follow your doctor's advice regarding physical activity and lifting.
- Follow all precautions related to air travel if a gas bubble has been used.
- Inform other healthcare professionals that you have a gas bubble in your eye before receiving medical treatment or anaesthesia.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Your surgeon's instructions may vary depending on the condition treated and the technique used, so postoperative care should always be tailored to your individual situation.
How Common Are Complications After Vitrectomy?
The likelihood of complications varies because vitrectomy is performed for many different eye conditions and can involve different surgical techniques. Some effects, such as cataract progression, are more commonly seen over the longer term, while serious complications such as severe infection are uncommon.
It is therefore difficult to apply one complication rate to every patient. The most useful risk assessment comes from your ophthalmologist, who can consider your diagnosis, retinal condition, planned surgical technique and other individual factors.
The Bottom Line
Vitrectomy is an established treatment for several conditions affecting the retina and vitreous, but it carries potential risks just like any surgical procedure. Cataract progression, changes in eye pressure, bleeding, retinal complications, inflammation and infection are among the possible concerns.
Not every patient experiences complications, and the risks depend largely on the underlying eye condition, the complexity of surgery and the individual's eye health. Following postoperative instructions and attending scheduled follow-up appointments can help your ophthalmologist monitor healing and identify problems early.
If you experience sudden changes in vision, severe eye pain, increasing redness, new flashes or a sudden increase in floaters after vitrectomy, seek prompt medical attention.
