In the surgical procedure called a vitrectomy, the vitreous gel (vitreous body) is removed to prevent it from pulling on the retina and replaced with a bubble containing a mixture of air and gas. The bubble acts as an internal, temporary bandage that holds the edge of the macular hole in place as it heals. Vitrectomy surgery is performed under local anesthesia and often on an out-patient basis.
Several eye conditions may warrant treatment by a vitrectomy, including: macular holes, macular pucker, vitreous detachment, eye floaters, retinal detachment/detached retina, vitreous hemorrhage and diabetic retinopathy.
Following a vitrectomy operation, patients must remain in a face-down recovery position, from one day to several weeks. This position allows the bubble to press against the macula and be gradually reabsorbed by the eye, sealing the hole. As the bubble is reabsorbed, the vitreous cavity refills with natural eye fluids.
Maintaining a face down position is crucial to the success of the surgery. Because this position can be difficult for many people, it is important to discuss this with your doctor before surgery and use quality face down recovery equipment (click for more information).
What if I cannot remain in a face-down position after the surgery?
If you cannot remain in a face-down position for the required period after surgery, vision recovery may not be successful. People who are unable to remain in a face-down position for this length of time may not be good candidates for a vitrectomy. However, there are a number of devices that can make the “face-down” recovery period easier on you. There are also some approaches that can decrease the amount of “face-down” time. Discuss these with your doctor.
Why Facedown Recovery?
The gas bubble rises to the top of eye and does not cover the macular hole. Since the macula is at the back of the eye, the gas bubble will only work if the patient’s head is positioned facedown.
The gas bubble rises to top of eye and seals the macular hole. Pressure against the hole flattens the macula against the wall of the eye and the impaired visual area is minimized. During the recovery time, the afflicted eye will heal, the macula will re-bond to the eye wall, and a new vitreous fluid replaces the gas bubble.
Disclaimer: The information on this page is provided to help educate patients and originates primarily from National Institute of Health (NIH) materials. It is not meant to be, nor should be considered a substitute for your physician’s advice.