How much vision can be recovered after vitrectomy?

Recovery depends on disease type and macular involvement. Macular hole: ~80-90% of patients achieve significant vision improvement after successful hole closure. ERM: vision improvement and reduced distortion emerge over 3-6 months. Retinal detachment: if the macula was uninvolved at the time of surgery, prognosis for vision recovery is excellent; if the macula was detached, some permanent vision loss is common despite successful anatomical reattachment.

Why can't I fly with intraocular gas?

At altitude, reduced atmospheric pressure causes gas to expand, increasing its intraocular volume and driving IOP to levels that can exceed 60 mmHg. This compresses the optic nerve and retinal vessels, causing acute ischemia and potentially irreversible vision loss. Flying is strictly prohibited until the gas has fully absorbed (SF6 ~2 weeks; C3F8 ~6-8 weeks) and the physician has confirmed it is safe.

Are there long-term effects of vitreous removal?

After vitrectomy, the vitreous cavity fills with aqueous humor and visual function is essentially normal. However, cataract formation is accelerated — particularly after gas tamponade — and many patients require cataract surgery within a few years. A small proportion of patients may develop recurrent retinal detachment and require long-term surveillance. High myopia patients need particularly close follow-up after PPV.

Treatment Procedure

Ophthalmic Surgery

Pars Plana Vitrectomy (PPV)

Vitrectomy Surgery23G/25G/27G Micro-Incision VitrectomyPPV Retinal Surgery

Micro-incision vitreous removal with direct surgical access to the vitreoretinal interface — the definitive procedure for retinal detachment, macular hole, epiretinal membrane, and a broad range of posterior segment diseases.

Pars Plana Vitrectomy (PPV) is the foundational surgical procedure for posterior segment diseases. Three micro-incision ports are created at the pars plana (3.5-4 mm posterior to the limbus) using 23G, 25G, or 27G trocar cannula systems. A vitreous cutter, infusion cannula, and endoilluminator are inserted, enabling the surgeon to remove the vitreous gel and directly address pathology at the vitreoretinal interface under high-magnification microscopy and wide-field endoillumination. Contemporary small-gauge (25G/27G) systems create incisions of only 0.5-0.7 mm that are typically self-sealing, dramatically reducing surgical trauma and speeding recovery. The indications for PPV are extensive: rhegmatogenous retinal detachment (especially with proliferative vitreoretinopathy or giant tears), tractional retinal detachment (diabetic, RVO-related), macular hole (with internal limiting membrane peeling to promote closure), epiretinal membrane (membrane peeling), vitreous hemorrhage, intraocular foreign body removal, infectious endophthalmitis, and symptomatic vitreous floaters (floaterectomy). At procedure completion, an intraocular tamponade agent is typically instilled — air, SF6 gas, C3F8 gas, or silicone oil — to support retinal reattachment. Gas tamponade requires strict postoperative face-down or disease-specific positioning until absorption (SF6 ~2 weeks; C3F8 ~6-8 weeks). Silicone oil requires a planned secondary removal procedure at 3-6 months.

Start Planning View Process Steps

Quick Reference

Treatment

1 hours – 3 hours

Observation

1 days – 0.2 months

Est. Cost

¥3,218.89 – ¥10,241.91

Department

Ophthalmology

1 hours – 3 hoursDuration

¥3,218.89 – ¥10,241.91Cost

Who Is This For

Is Pars Plana Vitrectomy (PPV) Right for You?

Good Candidates

Rhegmatogenous retinal detachment — especially with PVR, giant retinal tear, or posterior pole breaks
Tractional retinal detachment (diabetic or RVO-related)
Full-thickness macular hole (stage II-IV)
Epiretinal membrane with significant vision loss or metamorphopsia
Vitreous hemorrhage not clearing with observation, or associated with retinal detachment requiring urgent surgery
Severely symptomatic vitreous opacities (dense floaters, amyloid deposition)

May Not Be Suitable

Systemic condition precluding surgical anesthesia (requires medical optimization before proceeding)
Active intraocular infection (except endophthalmitis where vitrectomy is the treatment)
Severe corneal opacity limiting surgical visibility (corneal surgery may be needed first)
Inability to comply with required postoperative positioning (e.g., face-down for macular hole — requires individual assessment in elderly patients or those with cervical disease)
End-stage retinal disease with minimal visual potential (individual risk-benefit evaluation required)

Step-by-Step Process

How Pars Plana Vitrectomy (PPV) Works

Anesthesia and Positioning

Anesthesia is chosen based on surgical complexity and patient cooperation: peribulbar or retrobulbar block for cooperative adults; general anesthesia for children, uncooperative patients, or anticipated operative duration >2 hours. The patient lies supine with the head stabilized.

Three-Port Setup

Three trocar cannulas (23G/25G/27G) are inserted at the pars plana (3.5-4 mm posterior to the limbus): an infusion cannula inferiorly for IOP maintenance, and two instrument ports superotemporally and supranasally. Infusion is activated and confirmed flowing freely into the vitreous cavity.

Core and Peripheral Vitrectomy

A wide-field visualization system (BIOM or RESIGHT) is attached. Under bright endoillumination, the high-speed vitreous cutter (5,000-10,000 rpm) removes central and peripheral vitreous gel systematically, simultaneously clearing hemorrhage, inflammatory cells, or opacities.

Retinal and Interface Management

Disease-specific steps are performed: Macular hole/ERM — triamcinolone-assisted ILM or membrane staining, then microforceps peeling; Retinal detachment — perfluorocarbon liquid (PFCL) injection to flatten the retina, break treatment by endolaser, subretinal fluid drainage; Diabetic tractional membrane — staged delamination and segmentation of fibrovascular proliferation to relieve traction.

Tamponade and Wound Closure

Fluid-air exchange replaces PFCL if used; tamponade agent is then injected (air, SF6, C3F8 gas, or silicone oil depending on diagnosis and retinal status). Trocar cannulas are removed; 25G/27G wounds typically self-seal without sutures. Subconjunctival antibiotic and steroid injection, antibiotic ointment, and eye patch are applied.

Postoperative Positioning Instruction

Macular hole patients immediately begin face-down positioning. Retinal detachment patients assume the position that keeps the gas bubble in contact with the treated break. Nurses provide detailed, confirmed instruction before the patient leaves the operating suite.

PPV is a single procedure, though secondary surgery may be needed (silicone oil removal at 3-6 months; repeat PPV for complex retinal re-detachment). Postoperative antibiotic, steroid, and mydriatic drops are required for 4-6 weeks.

Cost Information

Cost Estimate for Pars Plana Vitrectomy (PPV)

Estimated Price Range

¥3,218.89 – ¥10,241.91

What's Included

Public tier-3A International Medical Department: 25G micro-incision vitrectomy (retinal detachment) including hospitalization approximately ¥22,000-35,000; complex cases (PDR with tractional detachment, silicone oil fill) including hospitalization approximately ¥35,000-55,000. Premium private eye centers: micro-incision vitrectomy (retinal detachment/macular hole) full course approximately ¥40,000-70,000, with private room, ample surgical time, senior specialist as primary surgeon, and detailed postoperative management.

Before Your Visit

What to Prepare

Required Tests & Examinations

If you already have recent valid test results, bring the reports. If not, these assessments can usually be completed in China before the procedure.

Macular OCT (assess retinal structure, vitreoretinal interface status, detachment extent)

B-scan ocular ultrasound (assess vitreous and retinal status, essential when media are opaque)

Fundus fluorescein angiography (FFA — evaluate retinal vasculature; mandatory before diabetic PPV)

Axial length and keratometry (for high myopia assessment; IOL calculation if silicone oil removal is planned)

Intraocular pressure measurement

Systemic preoperative screening (ECG, CBC, coagulation, blood glucose)

Documents & Materials to Bring

Required to Bring

Recent fundus OCT, B-scan, and FFA reports

Medical history (diabetes control is especially critical)

Anticoagulant medication records (aspirin, warfarin — perioperative management plan needed)

Prior ocular surgery records

Passport and valid visa

Companion & Support

Hospitalization of 3-7 days (longer for complex cases) is required, and family caregiver presence is essential — particularly to assist with face-down positioning for macular hole (5-7 days of face-down posturing severely limits daily function and requires dedicated caregiver support). Continued accompaniment to outpatient follow-up visits is also important.

After Treatment

Recovery & Follow-Up

Strict adherence to the prescribed postoperative positioning (face-down for macular hole — typically 5-7 days) is critical to surgical success; do not deviate from instructions

Do not board any aircraft while intraocular gas is present — altitude-related gas expansion can cause an acute IOP spike exceeding 60 mmHg, risking permanent vision loss

Very poor vision during the gas tamponade phase is normal; vision gradually improves as the gas absorbs

Apply all prescribed eye drops (antibiotic + mydriatic + steroid) strictly for 4-6 weeks

Avoid strenuous activity, bending at the waist, and heavy lifting for at least 1 month

Seek immediate attention for sudden vision loss, a dramatic increase in floaters, or worsening redness

Follow-Up Schedule

Follow-up at day 1, day 3, week 1, week 2 (assess gas absorption), month 1, and month 3. Patients with silicone oil are scheduled for oil removal surgery at 3-6 months.

Related Conditions

Ready to Plan Pars Plana Vitrectomy (PPV) in China?

Let Carevia help you find the right hospital, coordinate your treatment, and arrange every detail of your medical trip.

Start Planning

Frequently Asked Questions

Need personalized guidance?

Our care coordinators can help you assess whether this procedure fits your situation.