Vitreoretinal Surgery
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Conditions We Treat with Surgery
Our fellowship-trained retina specialists provide surgical treatment for a wide range of serious retinal and vitreous conditions that threaten vision. Prompt, expert intervention often prevents permanent vision loss and helps patients maintain their quality of life.
A retinal detachment occurs when the retina pulls away from the back wall of the eye, creating a vision emergency. Our specialists use advanced techniques including vitrectomy, scleral buckling, and gas bubble procedures to reattach the retina and restore as much vision as possible. Quick treatment is essential for the best results.
Small holes in the macula or scar tissue growing on the retina surface can cause blurred or distorted central vision. Surgery removes the problematic tissue; a gas bubble is commonly used for macular hole repair and is not routinely required for an isolated epiretinal membrane. Most patients experience significant improvement in their ability to read and see fine details.
Advanced diabetic retinopathy can cause bleeding inside the eye and harmful scar tissue that pulls on the retina. Vitrectomy surgery removes blood and scar tissue while protecting the retina from further damage. This helps preserve remaining vision and prevents blindness in many cases.
While uncommon, cataract surgery can sometimes result in retinal problems such as cystoid macular edema, retinal detachment, or rarely, pieces of the lens falling into the back of the eye. Most cystoid macular edema is managed medically, while vitrectomy is considered for retained lens material, non-clearing vitreous hemorrhage, or retinal detachment; our retina specialists have extensive experience managing these issues.
Serious eye injuries from accidents, sports, or workplace incidents may damage the retina or vitreous. Emergency vitreoretinal surgery can often save vision by removing foreign objects, repairing tears, and addressing bleeding or swelling inside the eye.
Most retinal vein occlusions are treated with anti-VEGF injections (including newer agents) and, in some cases, laser. Vitrectomy is considered for selected complications such as non-clearing vitreous hemorrhage or significant traction/epiretinal membrane; if neovascularization is present, panretinal photocoagulation is typically performed intraoperatively. Tractional retinal detachment from RVO is uncommon but can occur in severe ischemic disease.
This serious condition occurs when scar tissue forms after retinal detachment, making the retina stiff and difficult to reattach. Complex surgery using silicone oil or gas may be needed to successfully treat this challenging problem and prevent permanent vision loss.
Advanced Surgical Procedures We Perform
At Retina Consultants, our fellowship-trained specialists perform the full spectrum of vitreoretinal procedures using state-of-the-art technology and proven techniques. Each surgery is customized to your specific condition and visual needs for optimal results.
Today’s vitreoretinal surgery uses tiny instruments and small incisions that often require no stitches, though sutures may still be needed in select cases for wound integrity or pressure control.
This is the most common type of retinal surgery, performed through tiny incisions in the white part of the eye. The surgeon removes the vitreous gel along with any blood, scar tissue, or debris that is affecting vision. Most vitrectomies today use 25-gauge or 27-gauge instruments that create self-sealing incisions, though sutures may still be required in select cases.
For certain types of retinal detachment, a thin silicone band is placed around the outside of the eye to gently push the wall inward and help the retina reattach. This time-tested procedure has excellent success rates and may be combined with other techniques for complex cases.
This procedure can often be performed in the office and involves injecting a small gas bubble into the eye to push the detached retina back into place. Laser or freezing treatment then seals the tear that caused the detachment. This less invasive option works well for specific types of detachment in the upper part of the retina.
Delicate forceps are used to carefully remove scar tissue or membranes from the retina surface. This precise technique can eliminate distortion and improve central vision in conditions like epiretinal membrane (macular pucker), macular hole, and symptomatic vitreomacular traction.
Focused laser energy creates small, controlled burns that seal retinal tears, reduce ischemia-driven signals, and treat neovascularization. This treatment is often performed in the office and can prevent progression of diabetic retinopathy, treat retinal tears, or address selected focal leaks.
Special gases or silicone oil may be placed inside the eye during surgery to hold the retina in position while it heals. Gas bubbles gradually dissolve over weeks to months, while silicone oil may be removed in a second procedure once healing is complete.
For macular holes and some tractional conditions, carefully peeling the internal limiting membrane reduces persistent traction and improves the likelihood of hole closure and visual recovery. A gas bubble is typically used to support the edges of the hole during early healing.
Our Expertise and Advanced Technology
Patients at Retina Consultants benefit from the latest surgical technology combined with the extensive experience of our fellowship-trained specialists. This combination of expertise and innovation maximizes safety and visual outcomes for every patient.
Our team includes Dr. Larisa Kayserman, Dr. Robert V. Vallar, Dr. SongEun Lee, Dr. Rony Gelman, Dr. Bradford Liva, and Dr. Justin Arnett. Each doctor has completed additional years of specialized training in retinal diseases and surgery at prestigious medical centers, bringing advanced skills and extensive experience to every procedure.
We use the most advanced diagnostic equipment, including high-resolution OCT scans, fluorescein angiography, ultra-widefield fundus photography, and ocular ultrasound. This technology allows precise surgical planning and helps our doctors achieve the best possible outcomes for each patient.
We employ state-of-the-art intraoperative OCT imaging during surgery. This real-time technology allows our surgeons to visualize microscopic retinal structures while operating, increasing safety and improving outcomes, especially during membrane peeling and macular operations.
All surgeries are performed at fully accredited ambulatory surgery centers equipped with the latest surgical microscopes, wide-angle viewing systems, and minimally invasive instruments. These advanced facilities meet the highest safety standards while providing a comfortable environment for patients and families.
Our surgeons use 25-gauge and 27-gauge vitrectomy systems that create tiny, self-sealing incisions. These modern instruments cause less trauma to the eye, reduce post-operative discomfort, and speed recovery compared to older surgical techniques requiring larger incisions and sutures.
With locations in Ridgewood, Belleville, and Jersey City, we work closely with referring eye doctors, primary care physicians, glaucoma and cornea specialists, and local hospitals throughout the tri-state area. This collaborative approach ensures seamless communication and comprehensive care for all our patients.
Our doctors stay current with the latest research and surgical techniques through continuing education, professional meetings, and clinical studies. We regularly evaluate new technologies and treatments to offer our patients the most effective and safest options available.
Emergency Retinal Care
Retinal emergencies require immediate attention to prevent permanent vision loss. Our team is prepared to respond quickly when urgent situations arise, with same-day appointments and after-hours availability for true emergencies.
Contact us immediately if you experience sudden vision loss, a large increase in floaters, flashing lights, or a shadow or curtain moving across your vision. These symptoms may indicate retinal detachment or other serious conditions requiring emergency treatment within hours to prevent permanent damage.
We reserve time each day for urgent patients and will see emergency cases immediately. Our staff understands the critical nature of retinal problems and will work to accommodate you the same day symptoms develop, even if it means staying late or rearranging schedules.
A retina specialist from our practice is always on call for true emergencies outside normal business hours. Our answering service can reach the on-call doctor 24 hours a day, seven days a week, ensuring you can access expert care when time is critical.
We work with local emergency rooms and hospitals throughout Bergen, Essex, and Hudson counties. If you go to an emergency room with eye symptoms, the ER doctor can contact our on-call specialist for immediate consultation and treatment recommendations.
When emergency surgery is needed to save vision, we can arrange operating room time as rapidly as possible at our affiliated surgery centers, based on diagnosis and anesthesia and OR availability. This rapid response capability has helped many patients preserve sight that might have been permanently lost with delayed treatment.
Recovery and Post-Operative Care
Successful recovery from vitreoretinal surgery requires careful attention to post-operative instructions and regular follow-up visits. Our compassionate team supports you through every step of the healing process to maximize your visual recovery.
After surgery, you will rest in our recovery area until the anesthesia wears off, and you feel ready to go home. Your eye will be covered with a protective shield, and you will receive detailed written instructions about eye drops, activity restrictions, and warning signs to watch for during healing.
Most patients use a topical antibiotic for a few days to about one week and an anti-inflammatory regimen tapered over several weeks. Our staff will demonstrate proper technique and provide a detailed schedule. Using drops exactly as prescribed helps prevent infection and reduces inflammation that could interfere with healing.
Heavy lifting, bending over, and strenuous exercise should be avoided for 1–2 weeks to prevent increased eye pressure. Restrictions are tailored to your surgery and any tamponade agent used; your surgeon will specify the appropriate duration.
Some surgeries, particularly macular hole repairs, may require face-down positioning for several days to weeks. If positioning is needed, we provide detailed instructions and information about equipment rentals to make this more comfortable. Not all retinal surgeries require special positioning.
Your first post-operative visit is typically within 1–2 days after surgery, then at regular intervals over several months. These visits allow us to monitor healing, adjust medications, and address any concerns. Keeping all follow-up appointments is essential for the best possible outcome.
Visual improvement varies depending on the condition treated and individual healing patterns. Some patients notice improvement within days, while others may need several weeks to months for full recovery. If a gas bubble is used, vision will be severely compromised until the bubble dissolves. Final visual results become clear once all inflammation resolves and healing is complete.
While vitreoretinal surgery is highly successful, the goal is often to prevent further vision loss rather than restore perfect sight. Many patients do experience meaningful improvement that allows them to return to activities like driving, reading, and enjoying hobbies. Your surgeon will discuss realistic expectations based on your specific condition.
Living with a Gas Bubble
If your surgery includes a gas bubble, special precautions are needed during the weeks it takes to dissolve it. Understanding these restrictions helps ensure safe healing and prevents serious complications that could threaten your recovery.
Flying and significant altitude changes are prohibited while a gas bubble remains in your eye, as pressure changes can cause dangerous expansion. As a general guide at typical concentrations, SF6 may take approximately 2–3 or more weeks to clear and C3F8 about 6–8 or more weeks, but absorption varies by gas mix and individual factors; you should not fly until your surgeon confirms the gas is fully gone and it is safe to travel.
General anesthesia and certain gases used during anesthesia for other medical procedures can be dangerous if you have a gas bubble in your eye. Always inform any doctor or dentist about your recent retinal surgery, and avoid nitrous oxide (N2O) anesthesia entirely while a gas bubble is present.
Depending on where your retinal problem was located, you may need to maintain specific head positions to keep the gas bubble in the right place. We provide detailed positioning instructions and demonstrate proper techniques to help the bubble work effectively during healing.
While the gas bubble is present, your vision will be markedly blurred, and you may see a moving line or dark area that changes position when you move your head. This is normal and temporary, vision typically improves as the bubble slowly dissolves.
Gas bubbles gradually dissolve and are absorbed by your body over 2–8 weeks, depending on the type of gas used. During follow-up visits, we monitor the bubble size and will let you know when it has completely disappeared and restrictions can be lifted.
Return to Daily Activities
Getting back to your normal routine after retinal surgery happens gradually as your eye heals. Understanding the timeline for different activities helps you plan your recovery and avoid complications that could interfere with healing.
Driving is not permitted immediately after surgery due to vision changes, eye shields, and potential effects of anesthesia. Resume driving only when your vision meets legal and safety standards, and you have been cleared by our retina specialists; this may be longer if a gas bubble is present.
Office work and light duties can often resume within a few days to a week after surgery. Jobs involving heavy lifting, exposure to dust or chemicals, or risk of eye injury may require 2–4 weeks off work. We provide work restriction letters when needed for your employer.
Light walking is encouraged soon after surgery to promote circulation and general health. Avoid heavy lifting, running, contact sports, and swimming for 2–4 weeks depending on your specific procedure. Gradually increase activity as approved during follow-up visits.
Reading, watching television, and light computer use are generally allowed as comfort permits. Vision may be blurry initially, so take frequent breaks and use good lighting. These activities do not harm the healing eye, so you can do as much as feels comfortable.
Light housework and cooking are usually fine after a few days. Avoid heavy cleaning, moving furniture, or activities that involve bending over or reaching overhead. Ask family members to help with more strenuous tasks during your recovery period.
Most social activities can resume as you feel ready, but protect your eye from injury and avoid smoky or dusty environments. Swimming, hot tubs, and saunas should be avoided for several weeks to prevent infection. Wear sunglasses outdoors for comfort and protection.
Frequently Asked Questions
Our retina specialists at Retina Consultants answer common questions from patients considering or preparing for vitreoretinal surgery. Understanding the process can reduce anxiety and help you feel more confident about your treatment.
Most patients experience minimal discomfort during surgery due to local anesthesia and sedation. Afterward, you may feel mild soreness or a scratchy sensation for a few days, similar to having something small in your eye. Over-the-counter pain relievers are usually sufficient for any discomfort.
Vision improvement varies greatly depending on your condition and the surgery performed. Some patients notice better vision within days, while others need weeks to months for maximum recovery. If a gas bubble is used, vision will be severely limited until the bubble starts to dissolve, which can take several weeks.
Having assistance for the first few days is recommended, especially if positioning restrictions are required or if you live alone. Help with meals, transportation to follow-up visits, and household tasks makes recovery more comfortable and safer during the initial healing period.
Retinal surgery is typically performed on one eye at a time to reduce risks and allow for proper healing. If both eyes need surgery, the procedures are usually scheduled several weeks apart to ensure the first eye is healing well before treating the second eye.
While most patients experience vision stabilization or improvement, results vary based on the severity and duration of your retinal problem. Even if vision doesn't improve dramatically, surgery often prevents further deterioration and preserves the sight you still have, which is valuable for maintaining independence.
Warning signs include severe or increasing pain, sudden vision loss, heavy discharge, persistent nausea or vomiting, or new flashing lights. Contact our office immediately if you experience any of these symptoms, as prompt treatment can often prevent complications from becoming serious.
Your glasses prescription may change after surgery, particularly if cataract surgery is also needed. We typically wait until your eye has fully healed before updating your prescription, usually 2–3 months after surgery. Many patients do need new glasses for optimal vision.
While some retinal conditions cannot be prevented, controlling diabetes, maintaining healthy blood pressure, protecting your eyes from injury, and having regular eye exams can reduce your risk of developing problems that might require surgery. Early detection and treatment often prevent the need for more complex procedures.
Our practice focuses exclusively on retinal diseases, with multiple fellowship-trained specialists and over 750 five-star patient reviews. We offer the latest surgical techniques, convenient locations throughout northern New Jersey, and a compassionate team dedicated to achieving the best possible outcomes for every patient.
Schedule Your Consultation
If you have been diagnosed with a retinal condition or are experiencing symptoms that concern you, contact Retina Consultants today. Our experienced team of fellowship-trained retina specialists provides advanced surgical care with locations in Ridgewood, Belleville, and Jersey City, serving patients throughout Bergen, Essex, and Hudson counties and the greater New York tri-state area.