Vitrectomy Surgery: Procedure, Recovery, and Risks Explained

What is a vitrectomy, and why is a Vitrectomy performed?

Vitrectomy is a surgical approach that enables the surgeon to access the back of the eye to carry out certain procedures, including:

• Removing blood, scar tissue, or a penetrating foreign object from inside your eye

• Using a laser to repair retinal detachments

• Treating holes or wrinkles in the central retina (called macular holes and puckers)

• Sealing off retinal blood vessels that are leaking (common in advanced diabetes)

• Treating serious eye infections

• Repositioning a dislodged artificial lens

• Vitreous hemorrhage – when blood leaks into the vitreous gel from damaged or abnormal blood vessels, it clouds vision rapidly. Patients often describe the onset as a sudden shower of floaters or a dark red haze that appears without warning. Vitrectomy surgery clears the blood and allows your surgeon to treat the underlying source of bleeding at the same time.

• Diabetic vitrectomy – in advanced diabetic eye disease, scar tissue can form on the retina and pull it away from the back of the eye. For patients whose vision is threatened by diabetic traction causing retinal detachment or persistent vitreous hemorrhage that will not clear on its own, vitrectomy surgery is often the most effective path to preserving sight. Because diabetic eye disease tends to progress silently, many patients are not aware of how advanced their condition has become until vision is already significantly affected, making timely specialist evaluation essential.

• Endophthalmitis – a serious intraocular infection that can develop after eye surgery or an eye injury. Because the infection spreads rapidly inside the eye, vitrectomy is often performed urgently to remove infected vitreous, deliver antibiotics directly to the site, and protect the retina from irreversible damage. Symptoms typically include sudden, severe eye pain, significant redness, and a rapid drop in vision. If you experience any of these signs after a recent eye procedure or injury, contact your surgeon immediately, as prompt treatment is critical to saving sight.

Each of these conditions calls for a high level of precision and specialist experience. At Assil Gaur Eye Institute, Dr. Svetlana Pilyugina performs vitrectomy surgery, a Stanford-trained, fellowship-certified retinal specialist trusted by patients across Los Angeles for world-class vitreoretinal care.

What should I expect during vitrectomy surgery?

Vitrectomies are performed as part of outpatient surgery. They involve little to no pain and use minimal anesthesia. Typically, this involves using numbing eye drops and medication to help you relax (called twilight anesthesia).

Next, we clean your eye with an antiseptic solution and apply sterile drapes. We cover and protect your other eye. A special tool keeps your operative eye open during surgery.

At AGEI, your surgeon uses microscopic tools introduced through tiny openings in the white part of your eye (called the sclera). These tools can include:

• A very thin probe containing a microscopic camera

• A light-tipped probe to illuminate the inside of your eye

• A special tool for carefully removing the vitreous gel (called a vitrector)

• Any other tool needed for whatever repair is required once the vitreous is removed (i.e., a laser probe to seal retinal tears or leaky blood vessels)

After the vitrector gently removes the vitreous gel, saline solution or gas is carefully pumped into the eye cavity in order to hold the retina in place and allow the surgeon to proceed with any required repairs. Once the work is complete, the eye is filled with either gas, saline, or silicone oil. When gas or oil is used, the patient must keep their head in a certain position during recovery (usually face-down) to help the retina heal.

The good news is that most patients tolerate a vitrectomy well, and it has very little effect on your eye health. If the eye has been filled with gas or saline solution, this is gradually replaced by new fluid produced within your eye. If silicone oil was used to replace your vitreous, you’ll need a second surgery in a few months to remove it.

What is vitrectomy surgery recovery like?

Immediately following vitrectomy surgery, most patients experience a mild sensation of having something in their eye. Severe pain is rare unless there’s unusual inflammation or elevated eye pressure. Some short-term post-op symptoms can include eyelid swelling, eye redness, and bruising around the eye. These improve rather quickly.

Some patients may notice decreased vision for a few days after surgery. It will gradually improve with time. If a gas bubble or silicone oil was used, it may take weeks to months for clear vision to return.

It’s important to plan to have someone take you home after surgery. Your doctor may instruct you to hold your head in a certain position to keep the gas bubble in the right place to support your retina. If you have gas in your eye, you will not be able to fly above 2,000 feet until the gas bubble has completely dissolved (this takes several weeks). This is because increased air pressure can cause the bubble to expand and damage your eye.

Post-operative instructions and activity restrictions

Following your surgeon’s post-op guidance closely is one of the most important ways to protect your results. Here is what most patients can expect during recovery from vitrectomy surgery:

Eye drop regimen after vitrectomy surgery

Prescription eye drops are critical to your recovery. Your surgeon will typically prescribe a combination of antibiotic drops to prevent infection, anti-inflammatory drops to reduce swelling, and in some cases drops to manage eye pressure. Most patients use multiple drops several times a day during the first few weeks, tapering off as healing progresses. Never skip doses or stop drops early without consulting your doctor, even if your eye feels comfortable.

Realistic timeline for vision restoration

Vision recovery after vitrectomy surgery is gradual and highly individual. Patients without a gas bubble often notice improvement within the first one to two weeks. Those with a gas bubble should expect blurry or obscured vision until the bubble dissolves, which typically takes four to eight weeks depending on the gas used. If needed, silicone oil may require a separate removal procedure before your vision fully clears. The encouraging news is that vitrectomy surgery has a success rate of over 90 percent, and AGEI’s world-class retinal expertise means a specialist guides your recovery and is committed to delivering the best possible outcome for your vision.

What happens before vitrectomy surgery?

Knowing what to expect in the days leading up to vitrectomy surgery can make the experience feel much less daunting. Preparation is straightforward, but following each step carefully helps your surgical team deliver the precision and enviable outcomes you deserve.

Here is what your care team at AGEI will typically walk you through ahead of your procedure:

• Medical evaluation: Your surgeon will review your full medical history, current medications, and any allergies. Your surgeon may order blood work or other pre-operative tests to confirm you are cleared for surgery.

• Medication adjustments: Certain blood thinners, anti-inflammatory drugs, and supplements can increase bleeding risk during vitrectomy surgery. Your surgeon will advise you on which medications to pause and for how long before your procedure date.

• Fasting requirements: You will generally be asked to stop eating and drinking for at least six to eight hours before surgery, since the procedure is performed under local or general anesthesia.

• Arrange a driver: You will not be able to drive yourself home after vitrectomy surgery. Plan ahead and arrange for a trusted friend or family member to pick you up and stay with you for the first day of recovery.

• Eye drop instructions: Your care team may prescribe antibiotic or anti-inflammatory eye drops to begin using in the days before surgery to reduce infection risk.

• Comfortable clothing: Wear loose, comfortable clothing on the day of your procedure and leave jewelry and contact lenses at home.

If you have any concerns about your health leading up to surgery, it is always a good idea to know when to reach out to your ophthalmologist right away. Your AGEI team is here to guide you every step of the way.

When should I contact my doctor after vitrectomy surgery?

Knowing your recovery timeline after vitrectomy surgery is important, but knowing when to pick up the phone is just as critical. Most patients heal smoothly, yet certain symptoms deserve immediate attention. Do not wait for your next scheduled appointment if you notice any of the following red-flag warning signs.

Some mild discomfort, light sensitivity, and blurry vision are completely normal in the days following vitrectomy surgery. The symptoms listed above, however, fall outside the expected recovery experience. If you are ever unsure whether what you are feeling is normal, it is always better to reach out. Knowing when to see an ophthalmologist as soon as possible can genuinely protect your vision and your long-term outcome. At Assil Gaur Eye Institute, our world-class retinal team is here to support you every step of the way.

What are the risks of vitrectomy surgery?

Serious complications following a vitrectomy are extremely rare. In fact, vitrectomies are successful well over 90 percent of the time. As instrumentation and surgical techniques advance, the list of procedures that can be done alongside a vitrectomy continues to grow.

That said, like any surgical procedure, vitrectomy carries a small set of known risks that every patient deserves to understand before moving forward. Being informed is part of receiving world-class care, and Dr. Pilyugina walks every patient through these possibilities during their consultation so there are no surprises.

The most commonly discussed risks of vitrectomy surgery include:

• Infection (endophthalmitis): A rare but serious bacterial infection inside the eye. Antibiotic eye drops before and after surgery significantly reduce this risk.

• Bleeding inside the eye: Small amounts of intraoperative bleeding can occur, particularly in patients with diabetic retinopathy or fragile retinal vessels. In most cases, this resolves on its own.

• Retinal detachment: Manipulating the vitreous gel can, in rare cases, create traction or a tear that leads to retinal detachment. Prompt follow-up care is essential for catching this early.

• Cataract development: Vitrectomy can accelerate the natural clouding of the eye’s lens, particularly in patients over 50. Many surgeons plan cataract surgery later if this occurs.

• Elevated or reduced intraocular pressure: Eye pressure can change after surgery and is monitored closely at follow-up visits. Most pressure changes are manageable with drops or minor intervention.

• Persistent floaters or visual disturbance: Some patients notice temporary floaters or blurred vision during the healing period as the eye adjusts.

• Diplopia (double vision): In rare cases, small incisions in the eye wall can affect surrounding muscles, causing temporary double vision that typically resolves as healing progresses.

• Corneal changes: The cornea can occasionally become temporarily cloudy or irritated after vitrectomy, particularly if the procedure is lengthy. This usually clears within days to weeks with appropriate post-operative care.

Certain patient factors can also influence the overall risk profile. Patients with diabetes, a history of prior eye surgery, or advanced age may face a slightly higher likelihood of some complications, which is exactly why a thorough pre-operative evaluation with Dr. Pilyugina is so important. She reviews each patient’s full ocular and medical history to tailor the surgical plan and minimize every avoidable risk before the procedure even begins.

The precision and advanced surgical techniques used by our fellowship-trained retinal specialist mean that the risk profile for vitrectomy at AGEI is as low as modern medicine allows. If you have concerns about any of these risks, a complimentary evaluation with Dr. Pilyugina is the best place to start.

What are the benefits of vitrectomy surgery?

After reading through the risks, it’s natural to wonder whether vitrectomy surgery is worth it. For most patients, the answer is a confident yes. When a retinal specialist recommends this procedure, it is because the underlying condition poses a far greater threat to your vision than the surgery itself. Here is a closer look at what vitrectomy surgery can do for you.

• Restored or preserved vision: Vitrectomy surgery directly addresses the source of vision loss, whether that is a retinal detachment, macular hole, or diabetic bleeding. With a success rate exceeding 90 percent, the procedure gives patients a genuine opportunity to reclaim meaningful sight.

• Relief from visual disturbances: Floaters, blurring, and distorted vision caused by vitreous clouding or scar tissue can be dramatically reduced once the problematic vitreous gel is removed and replaced.

• Prevention of permanent damage: Conditions like retinal detachment worsen rapidly without intervention. Vitrectomy surgery stops that progression before irreversible damage sets in, making timing a critical advantage.

• Treatment of complex retinal conditions: Advanced cases of diabetic retinopathy, macular puckers, and severe eye trauma often cannot be managed with medication alone. Vitrectomy surgery gives your surgeon the precision access needed to repair delicate retinal tissue directly.

• Improved quality of life: Patients often report that clearer vision after recovery means a meaningful return to everyday activities, from reading to driving.

If you are concerned about a retinal condition, knowing when to see an ophthalmologist can make all the difference in protecting your long-term vision.

Why trust AGEI for vitrectomy surgery?

The AGEI staff includes a highly skilled Stanford-trained retina specialist, Dr. Svetlana Pilyugina, or “Dr. P,” as her patients know her. Dr. Pilyugina is an ophthalmologist with fellowship training and board certification in vitreoretinal diseases and surgery.

Dr. P has been performing retinal surgery and laser therapy for over a decade and has considerable experience in the treatment of a broad range of retinal conditions.

Her precision-driven approach to vitrectomy surgery is backed by world-class surgical technology, including advanced wide-field imaging systems and micro-incision vitrectomy instruments that allow for faster recovery and more predictable outcomes. Every procedure at AGEI reflects the same commitment to excellence that has made the institute a trusted name in vision correction across Los Angeles and beyond.

That commitment shows up in the numbers. AGEI surgeons have performed more than 100,000 vision correction procedures and have trained over 14,000 ophthalmologists worldwide, a depth of experience that is virtually unmatched in the field. For vitrectomy surgery specifically, AGEI achieves a success rate exceeding 90%, giving patients a reliable, evidence-backed confidence anchor when facing what can feel like a daunting diagnosis.

Patients consistently describe their experience at AGEI in the same way: “I knew I was going to the very best.” That confidence is earned. With surgeons who have trained over 14,000 ophthalmologists worldwide and performed more than 100,000 vision correction procedures, AGEI brings unmatched expertise to every operating room.

The advanced technology inside AGEI’s operating rooms reinforces that trust at every step. Dr. Pilyugina uses state-of-the-art wide-field imaging systems that provide an exceptionally detailed, real-time view of the retina during surgery, along with premium micro-incision vitrectomy instruments that reduce trauma to surrounding tissue. The result is a more precise procedure, a more comfortable recovery, and outcomes patients notice from their first follow-up visit.

Patients who have undergone vitrectomy surgery with Dr. P regularly describe the experience as transformative. Many arrive anxious about their diagnosis and leave with a restored sense of clarity, both in their vision and in their confidence about the future. That kind of outcome is what AGEI is built on, and it is why patients across Los Angeles and beyond trust the institute with their most precious sense.

If you are experiencing symptoms of a retinal condition or have been referred for vitrectomy surgery, do not wait. Schedule a complimentary evaluation with Dr. Pilyugina and take the first step toward protecting your vision with a specialist you can trust.

Written by The AGEI Educational Team

The Assil Gaur Eye Institute Education Team is dedicated to providing accurate, accessible, and patient-centered eye health information to support not only our patients, but the broader community as well. Working closely with our physicians and specialists, the team helps develop educational content designed to empower patients to better understand their vision, eye conditions, treatment options, and advances in ophthalmology. Our goal is to make complex medical topics easier to understand while upholding the highest standards of clinical accuracy, trust, and patient care.

The Assil Gaur Eye Institute Education Team is dedicated to providing accurate, accessible, and patient-centered eye health information to support not only our patients, but the broader community as well. Working closely with our physicians and specialists, the team helps develop educational content designed to empower patients to better understand their vision, eye conditions, treatment options, and advances in ophthalmology. Our goal is to make complex medical topics easier to understand while upholding the highest standards of clinical accuracy, trust, and patient care.

Medically Reviewed by Dr. Kerry Assil

Kerry K. Assil, MD, is regarded as one of the world’s foremost experts in refractive surgery, having made significant advances in the field with his numerous inventions. Additionally he has the unique distinction of having trained thousands of eye surgeons in the latest refractive surgical techniques. Dr. Assil has authored more than one hundred textbooks, textbook chapters and articles on refractive surgery and has appeared regularly on major television network news programs as a pioneer in refractive surgery. He also leads educational forums for other eye care professionals, which have included featured lectureships at Harvard University, Johns Hopkins University and Tokyo University.

Kerry K. Assil, MD, is regarded as one of the world’s foremost experts in refractive surgery, having made significant advances in the field with his numerous inventions. Additionally he has the unique distinction of having trained thousands of eye surgeons in the latest refractive surgical techniques. Dr. Assil has authored more than one hundred textbooks, textbook chapters and articles on refractive surgery and has appeared regularly on major television network news programs as a pioneer in refractive surgery. He also leads educational forums for other eye care professionals, which have included featured lectureships at Harvard University, Johns Hopkins University and Tokyo University.