PostOp Eyes

Vitrectomy Recovery: What to Expect

Illustration for vitrectomy recovery

General information about typical recovery, not medical advice. Every eye and every surgery is different, and your surgeon's instructions override anything on this page. Read our full disclaimer.

A vitrectomy is surgery on the back of the eye. The surgeon removes the clear gel that fills the middle of the eye, called the vitreous, so they can reach and repair the retina. The American Academy of Ophthalmology explains that the gel is then replaced with a saltwater solution, an air or gas bubble, or silicone oil. Most vitrectomies are done as outpatient surgery, and the American Society of Retina Specialists reports that anatomic success is over 90 percent for many conditions.

If your surgeon put a gas bubble in your eye, that bubble drives almost everything about your recovery. It floats upward inside the eye and presses the retina into place while the eye heals. To keep the bubble sitting on the right spot, your surgeon may ask you to hold your head in a face-down or side-facing position for a period of time. The bubble slowly shrinks and disappears on its own as your eye refills with its own fluid.

Two rules that come with a gas bubble are not flexible. You cannot fly, go to high altitude, or scuba dive until the bubble is completely gone, and you must not be given nitrous oxide anesthesia. Both can make the bubble expand and push eye pressure to dangerous levels. Everything else on this page is a typical range from published patient guidance. Your surgeon knows which gas you got and how your retina looked, so your surgeon's instructions override everything here.

Vision usually takes a while to come back. ASRS notes that some people see a drop in vision for a few days, and people who received a gas bubble or silicone oil may need weeks or even months for vision to improve.

The typical timeline

Typical full recovery: 6 weeks to several months, depending on the bubble. Ranges below are what published guidance describes for most people; your surgeon may set different limits for your eye.

StageWhat to expectRestrictions
Surgery dayDay 0Vitrectomy is almost always an outpatient procedure done in a hospital or surgery center. AAO notes the operation can take one to several hours and is done under local or general anesthesia. You go home the same day with the eye patched. ASRS describes the surgery itself as involving little or no pain.Someone else drives you home. If a gas bubble was placed, positioning starts right away, and the no-flying and no-nitrous-oxide rules are already in effect from the moment the gas goes in.
First 24 hoursDay 0-1The eye is usually covered with a patch. AAO says a scratchy, sandy, or gritty feeling, as if something is in the eye, is common, and that pain is very rare after vitrectomy. Vision through a gas-filled eye is typically very poor, often just light and shapes.Keep the patch and shield on for as long as your surgeon says, usually a few days. Hold the positioning your surgeon assigned. Do not rub the eye. No air travel, no altitude, no scuba, and no nitrous oxide anesthesia while gas is in the eye.
The positioning stretchDay 1 through roughly week 1-2If a gas bubble was used, this is the demanding part. AAO explains that recovering with your head down lets the bubble float into the correct position, and that this can last days to weeks. AAO's retinal detachment guidance describes head positioning for a length of time such as 1 to 2 weeks. You will see the bubble as a dark dome or moving line in your vision.AAO instructs patients to stay face-down or sideways when they stand, sit, eat, walk, and sleep, unless the surgeon says otherwise, and warns that the surgery may not work if you do not recover in the recommended position. Drops continue. Still no flying, altitude, diving, or nitrous oxide.
Bubble shrinkingWeek 1 through week 8, depending on the gasThe bubble gets smaller and the line across your vision drops lower each week. StatPearls reports that plain air lasts about 5 to 7 days in the eye, sulfur hexafluoride (SF6) lasts about 1 to 2 weeks, and perfluoropropane (C3F8) lasts about 6 to 8 weeks. AAO's EyeNet review gives similar figures, with nonexpansile SF6 lasting about two weeks and C3F8 about eight weeks.The flying, altitude, scuba, and nitrous oxide restrictions stay in place for the whole time any gas remains, not just the positioning period. Only your surgeon can confirm the bubble is gone by looking in your eye.
Vision starting to sharpenWeek 4 through month 3Once the bubble clears, vision usually starts improving. AAO's retinal detachment guidance says vision often begins improving around 4 to 6 weeks after surgery, though it can take months to stabilize. ASRS notes that people who had a gas bubble or silicone oil may need weeks or even months for vision to improve.Most normal activity comes back in this window, but the specific green light depends on your surgeon. AAO advises limited activity for several weeks after retinal surgery.
Late recovery and silicone oil removalMonth 3 and beyondFor more complicated cases, silicone oil is used instead of gas. ASRS explains that a second procedure may be performed several months after surgery to remove the silicone oil, and that oil is often chosen for complex detachments such as those with scar tissue or a giant tear. AAO also notes that cataract is a common later effect of vitrectomy, especially in people over 50, so a cataract operation later on is a normal part of the path for many patients.Silicone oil does not expand at altitude the way gas does, so the flying rule is a gas rule. Even so, ask your surgeon before booking travel, because only your surgeon knows what is actually inside your eye.

Day by day

When can I...

Is this normal?

Common questions

Can I fly with a gas bubble in my eye?
No. AAO states you cannot fly in an airplane, go to mountains or high altitudes, or scuba dive until the gas bubble is gone, because the falling cabin pressure makes the bubble expand and dramatically raises eye pressure, which AAO says can cause severe pain, permanent vision loss, or even blindness. ASRS says air travel and ascending to higher altitudes should be strictly avoided when a gas bubble has been used. Only your surgeon can confirm the bubble is gone by examining your eye.
Why can I not have nitrous oxide anesthesia after a vitrectomy with gas?
Nitrous oxide moves into a gas bubble far faster than the gas can move out, so the bubble swells and eye pressure spikes. StatPearls notes nitrous oxide is 117 times more water-soluble than SF6 and that it must be stopped 15 to 20 minutes before gas is injected during surgery. ASRS states that nitrous gas anesthesia should be strictly avoided when a gas bubble has been used. Many practices give patients a wristband or alert card to show any anesthesia provider, and you should keep telling every dentist, surgeon, and emergency clinician until your retina surgeon confirms the gas has fully absorbed.
How long does the gas bubble last?
It depends on which gas your surgeon used. StatPearls reports that plain air lasts about 5 to 7 days in the eye, sulfur hexafluoride (SF6) about 1 to 2 weeks, and perfluoropropane (C3F8) about 6 to 8 weeks. AAO's EyeNet review gives about two weeks for nonexpansile SF6, about three weeks for C2F6, and about eight weeks for C3F8. These are typical ranges, and your own bubble can run shorter or longer, so ask your surgeon which gas you received.
How long do I have to stay face down?
AAO describes face-down recovery lasting days to weeks, set by your surgeon based on your case, and its retinal detachment guidance mentions keeping the head in one position for a period such as 1 to 2 weeks. AAO instructs patients to stay face-down or sideways when they stand, sit, eat, walk, and sleep unless the surgeon says otherwise, and warns that the surgery may not work if you do not recover in the recommended position. Ask your surgeon for both a number of days and a number of hours per day.
How long until my vision comes back after a vitrectomy?
ASRS notes that some people see a decrease in vision for a few days, while those who received a gas bubble or silicone oil may need weeks or even months for vision to improve. AAO's retinal detachment guidance says vision improvement typically begins around 4 to 6 weeks after surgery, with complete stabilization taking months. How much vision comes back depends heavily on what was wrong to begin with, especially whether the center of the retina was involved, so your surgeon is the only one who can give you a realistic personal estimate.

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