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Version 8/4/20

Vitrectomy

Ophthalmologists (eye surgeons) treat some types of eye problems with a surgery called vitrectomy. This surgery is performed in the back part of your eye that contains the retina and the macula. It is filled with a gel called the vitreous. The vitreous is removed using suction. The ophthalmologist then performs an additional procedure.

Your ophthalmologist recommends a vitrectomy for one of these reasons:
•	Treat the retina with a laser.
•	Remove fibrous or scar tissue. The ophthalmologist may use a dye to see the scar better. 
•	Flatten the retina where it detached. The ophthalmologist may place a heavy liquid (perfluorocarbon) to help the retina stay attached.
•	Repair tears or holes in the retina or macula.
•	Remove epiretinal membranes.

Alternatives (choices and options) 
•	You can choose to have no treatment. You risk permanent vision loss with no treatment.
•	Retinal detachments can be treated with pneumatic retinopexy; gas is placed in the eye to flatten the retina. Some retinal detachments are treated with a scleral buckle to hold the retina in place. 
•	Vitreous hemorrhage can be treated with an injection of a medication into the back of your eye. 

At the end of the vitrectomy, the ophthalmologist may inject air, gas, or silicone oil to replace the vitreous. If your ophthalmologist uses air or a gas bubble, you can’t lie on your back, fly in an airplane, or travel to high elevations until the bubble is absorbed by your eye. If the ophthalmologist injects silicone oil, you will need surgery to remove it within a few years.

Benefits (how this surgery can help). The goal of vitrectomy surgery is to protect vision and stabilize your condition. 
•	Patients with vitreous hemorrhage may have better vision after the surgery. They may also have a lower risk of severe bleeding complications after the surgery.
•	Patients who have surgery to repair a retinal detachment may have better vision after the surgery. The improvement in the vision depends upon how big the detachment was. The retina can detach again. If it does, you will need another surgery to treat it.
•	Patients with a macular hole or epiretinal membrane may have better vision after the surgery.
•	There is no guarantee that your vision will improve after the vitrectomy. You may need another surgery or treatment for your condition. 

Risks (problems the surgery can cause). As with any surgical procedure, there are risks with vitrectomy. The surgery may not improve your vision.  it is properly performed. Your ophthalmologist cannot tell you about every risk. Here are some of the most common and serious risks: 
•	Retinal detachment with the need for another surgery to repair it
•	Elevated eye pressure (glaucoma)
•	Damage to the cornea, the clear covering of your eye that may not heal well. This damage may cause scarring or clouding, which causes poor vision.
•	Cataract, or clouding of the lens in your eye. You may need surgery to remove the cataract if it interferes with your vision.
•	Double vision
•	Eyelid droop
•	Loss of blood flow to parts of the eye, which may cause vision loss
•	Disfigurement and shrinkage of the eyeball (phthisis)
•	Silicone oil may cause damage to an intraocular lens implant. It may need to be removed or replaced.
•	Perfluorocarbon, the heavy liquid placed in the eye to help flatten the retina, may cause floaters or blind spots. If the floaters interfere with your vision, you may need surgery to remove them.
•	A complication may occur during the surgery, and the ophthalmologist may need to perform another surgery right away to treat it. The ophthalmologist may discover a new condition or problem for the first time during the surgery. The ophthalmologist may need to change the plan for surgery to treat this problem or condition right away.

Vitrectomy surgery is usually performed under regional or general anesthesia. 
•	Regional anesthesia is injected around the eye to numb the eye and keep it from moving. Risks of regional anesthesia include needle damage to the eyeball or optic nerve, which could cause vision loss; interference with circulation of the retina, which could cause vision loss; drooping of eyelid, double vision, and bruising of the skin around the eyes.
•	The ophthalmologist, anesthesiologist, or nurse anesthetist may also give you intravenous sedation to help you relax.  Intravenous sedation can cause heart and breathing problems. Very rarely, it can cause death.
•	An anesthesiologist or nurse anesthetist uses gases and medication to “put you to sleep” during general anesthesia. Intravenous sedation can cause heart and breathing problems. Very rarely, it can cause death.

By signing below, you consent (agree) that:
•	You read this informed consent form or had it read to you.
•	You were told you have a condition in the back of your eye that needs to be repaired with surgery. 
•	Your questions about having a vitrectomy to treat this eye problem were answered. 
•	You consent to have the ophthalmologist perform a vitrectomy on your ___________ (“right” or “left) eye. 

											
Patient (or person authorized to sign for patient)			Date