Vitrectomy Surgery in Ranchi — Advanced Retina Surgery
Micro-incision vitrectomy for retinal detachment, macular hole, vitreous hemorrhage, and diabetic retinopathy — performed by Dr. Dibya Prabha, MS Ophthalmology, at Neurovision Clinic, Ranchi.
What is Vitrectomy (Vitreoretinal Surgery)?
Vitrectomy is a microsurgical procedure in which the vitreous gel — the clear, jelly-like substance filling the center of the eye — is removed to allow the surgeon direct access to the retina and other posterior segment structures. The vitreous is replaced with a balanced salt solution, gas bubble, or silicone oil depending on the condition being treated. Modern vitrectomy uses small-gauge instruments (23G, 25G, or 27G) that pass through tiny, self-sealing incisions in the sclera, typically not requiring sutures.
Vitrectomy is the foundational procedure for treating a wide range of retinal conditions: retinal detachment repair, macular hole closure, epiretinal membrane peeling, removal of vitreous hemorrhage, management of advanced diabetic retinopathy, retrieval of intraocular foreign bodies, and complications of cataract surgery. At Neurovision Clinic in Ranchi, Dr. Dibya Prabha (MS Ophthalmology) evaluates each patient with comprehensive retinal imaging — including OCT (Optical Coherence Tomography), OCTA (OCT Angiography), fundus photography, and B-scan ultrasonography when the view is obscured — before recommending vitrectomy.
The procedure is performed in a fully equipped operating theatre with strict aseptic protocols.
Why is Vitrectomy (Vitreoretinal Surgery) Done?
- •To repair a rhegmatogenous retinal detachment — where a retinal tear or hole allows fluid to accumulate under the retina, separating it from the underlying tissue; vitrectomy removes the vitreous traction, drains subretinal fluid, and uses laser or cryotherapy to seal the break
- •To close a full-thickness macular hole by removing the vitreous and any tractional membranes, followed by gas tamponade that presses the hole edges together while healing occurs
- •To peel an epiretinal membrane (macular pucker, cellophane maculopathy) — a scar-tissue layer on the macular surface that distorts vision; removal can improve or stabilize central vision
- •To clear non-resolving vitreous hemorrhage from diabetic retinopathy, retinal vein occlusion, trauma, or posterior vitreous detachment — restoring vision and allowing examination and treatment of the underlying retina
- •To manage advanced diabetic eye disease including tractional retinal detachment and vitreomacular traction unresponsive to anti-VEGF injections
- •To remove retained lens fragments, dislocated intraocular lenses, or intraocular foreign bodies following complicated cataract surgery or penetrating eye injury
- •To perform endophthalmitis vitrectomy — emergency removal of infected vitreous in severe intraocular infections — combined with intravitreal antibiotics
How Vitrectomy (Vitreoretinal Surgery) is Performed
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Anaesthesia and Preparation
Vitrectomy is performed under local anaesthesia (peribulbar or retrobulbar block) with monitored sedation, or under general anaesthesia in select cases. The eye and surrounding skin are cleaned with povidone-iodine, and a sterile drape is applied. The pupil is dilated with topical drops to allow visualization of the posterior segment.
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Trocar Placement
Three micro-incisions (typically 23G or 25G, each less than 0.5 mm) are made through the sclera (white part of the eye) using a trocar-cannula system. These ports accommodate the infusion line (which maintains intraocular pressure), the fibre-optic light pipe (for illumination), and the vitrectomy cutter plus other instruments.
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Vitreous Removal and Membrane Work
The vitrectomy probe cuts and aspirates the vitreous gel in a controlled manner. Depending on the condition, Dr. Prabha may then peel epiretinal membranes from the retinal surface using micro-forceps, perform laser photocoagulation around retinal breaks or ischemic retina, or drain subretinal fluid. For macular hole repair, the internal limiting membrane (ILM) is peeled to improve closure rates.
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Tamponade Exchange
The vitreous cavity is filled with the appropriate tamponade agent: a gas bubble (SF6, C2F6, or C3F8) for retinal detachment and macular hole cases, or silicone oil for complex detachments where prolonged tamponade is needed. Balanced salt solution may be left in simpler cases. The choice of tamponade determines post-operative positioning requirements.
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Closure and Immediate Recovery
The micro-cannulas are removed and the incisions self-seal without sutures in most cases. Antibiotic and steroid injections are given around or inside the eye. A patch and shield are applied. You rest in recovery and are discharged with detailed positioning instructions (e.g., face-down positioning if a gas bubble is used). Dr. Prabha sees you the next day for the first follow-up.
How to Prepare
- •Undergo a comprehensive retinal evaluation including OCT, fundus photography, and B-scan ultrasonography (if the view is obscured) to confirm the diagnosis and plan the surgical approach
- •Fast for at least 6–8 hours before surgery if sedation or general anaesthesia is planned; take morning medications with a small sip of water as instructed
- •Arrange for someone to drive you home — your eye will be patched and vision will be significantly reduced immediately after surgery
- •Discuss all current medications with Dr. Prabha, especially blood thinners (aspirin, clopidogrel, warfarin) — these may need to be paused in coordination with your physician for elective cases
- •If you have diabetes, ensure good glycaemic control before surgery — uncontrolled blood sugar increases the risk of post-operative inflammation and delayed healing
- •Prepare for post-operative positioning — if a gas bubble is used, you may need to maintain a specific head position (typically face-down) for 5–14 days. Set up your recovery area in advance with pillows, a massage-table face cradle, or a chair arrangement that supports this position comfortably
Related Conditions
Vitrectomy (Vitreoretinal Surgery) helps diagnose and monitor these conditions. Explore our condition pages for more detailed information about each.
Frequently Asked Questions
What is the success rate of vitrectomy?
Success rates vary by the specific condition being treated. For primary retinal detachment repair with vitrectomy, anatomical success (retina reattached) exceeds 90% after one surgery and 95% after a second procedure if needed. Macular hole closure rates with modern ILM peeling techniques exceed 90% for holes under 400 microns. Epiretinal membrane peeling improves or stabilizes vision in approximately 80–90% of patients. At Neurovision Clinic, Ranchi, Dr. Dibya Prabha discusses the specific prognosis for your condition based on your examination and imaging findings, including realistic expectations for visual recovery — which can take weeks to months.
How painful is vitrectomy surgery?
During surgery, local anaesthesia ensures you feel no pain. After surgery, most patients experience mild to moderate discomfort — described as a dull ache, grittiness, or foreign-body sensation — rather than sharp pain. This is managed with oral analgesics and the prescribed eye drops. Significant pain is unusual and should be reported to Dr. Prabha immediately, as it may indicate elevated intraocular pressure or other complications.
What should I expect during recovery after vitrectomy?
Recovery varies by indication and tamponade used. If a gas bubble is placed, your vision will be very poor in that eye until the bubble absorbs (typically 1–8 weeks depending on the gas type). You must avoid air travel and high altitudes until the gas fully resolves, as expansion of the gas at altitude can dangerously raise eye pressure. You must maintain prescribed head positioning. Eye drops (antibiotic, steroid, and dilating drops) are required for several weeks. Physical activity is restricted — no heavy lifting, bending, or strenuous activities for 2–4 weeks. Most patients resume desk work within 1–2 weeks. Full visual recovery and stabilization can take 3–6 months. Dr. Dibya Prabha provides a detailed, personalized recovery timeline during your pre-operative and post-operative consultations.
What is the cost of vitrectomy surgery in Ranchi?
The cost of vitrectomy at Neurovision Clinic, Ranchi depends on the complexity of the case, the instruments and tamponade agent used, and whether additional procedures (membrane peeling, laser, silicone oil) are performed. Dr. Dibya Prabha provides a detailed cost breakdown during your pre-operative consultation. The clinic maintains transparent pricing with no hidden charges, ensuring patients from Ranchi, all districts of Jharkhand, and neighboring states have access to affordable, high-quality retina surgery.