What Is Vitrectomy?
Vitrectomy is a procedure that treats diseases of the retina by removing the vitreous — the gel-like substance that fills the inside of the eye. It is among the most technically demanding operations in ophthalmology, and in our group it is performed by surgeons who specialize in vitreoretinal surgery.
Main Conditions Treated
- Retinal detachment: The retina separates from the wall of the eye. Left untreated, it leads to blindness, so prompt surgery is essential.
- Diabetic retinopathy (proliferative retinopathy, tractional retinal detachment): Advanced damage to the retinal blood vessels caused by diabetes.
- Epiretinal membrane (macular pucker): A membrane forms over the central retina (macula), causing distorted vision and reduced visual acuity.
- Macular hole: A small hole opens in the macula, making it hard to see the center of your vision.
- Vitreous hemorrhage: Bleeding spreads into the vitreous, causing sudden vision loss.
- Diabetic macular edema
- Proliferative vitreoretinopathy
Emergency Care
For urgent conditions such as retinal detachment, we accept patients whenever possible — even outside regular hours — and surgery can be performed as soon as the same day. If you are in need of care, or if you are a medical institution considering a referral, please do not hesitate to contact us.
Our Approach: Micro-Incision Vitrectomy
Our group uses 25-gauge / 27-gauge micro-incision vitrectomy. Because the incisions are extremely small — about 0.4 mm — no sutures are needed, recovery is faster, and postoperative discomfort is reduced.
The Surgical Procedure
- Preoperative examinations (OCT, fluorescein angiography, ultrasound, etc.)
- Local anesthesia (general anesthesia for some cases)
- Three micro-incisions are made in the sclera (the white of the eye)
- The vitreous is removed with a vitrectomy cutter
- As needed: retinal reattachment, membrane peeling, laser photocoagulation, and filling of the eye with gas or silicone oil
Duration & Hospitalization
Depending on the case, surgery takes about 20 minutes to 2 hours.
Our group generally performs vitrectomy as day surgery. However, at Kitasato Institute Hospital, Kawasaki Municipal Kawasaki Hospital, and Yokohama Municipal Citizen's Hospital, surgery is performed on an inpatient basis. Please consult with us based on your general health and preferences.
Costs
Vitrectomy is covered by Japanese national health insurance. Your actual out-of-pocket cost depends on your co-payment rate (10–30%) and the high-cost medical expense benefit system. Please check with the reception desk of each medical institution for details.
Possible Complications
Reported complications include endophthalmitis, progression of cataract, retinal tears or detachment, and elevated intraocular pressure, though advances in minimally invasive surgery have lowered their incidence.
After surgery: If a gas tamponade is used, you will need to maintain a face-down position for a certain period. You also cannot travel by airplane while gas remains in the eye. We will explain the details before surgery.
Combined Surgery with Cataract Surgery
Patients in the age groups that undergo vitrectomy often also have cataracts, and depending on the case, we may perform cataract surgery at the same time.