Информации за тековно работење во услови на Ковид - 19


Vitrectomy is the most complex microsurgical operation that treats diseases of the posterior segment of the eye such as: bleeding in the eye, retinal detachment (retinal ablation), macular degeneration, diabetic retinopathy, rupture (hole) of the macula etc.

With the development of technology, nowadays, vitrectomy is a minimally invasive operation that takes an average of about an hour and the patient checks out of the hospital after the operation. This operation is completely painless, without sutures and causes minimal eye trauma.


Vitrectomy is a surgical procedure performed by an experienced vitreoretinal surgeon. This operation removes the vitreous gel (vitreous) that fills the inside of the eye.

This operation is used in certain eye conditions in which the removal of the vitreous will provide better vision for the patient and preservation of the ocular organ.

It is performed in an operating room, where the vitreoretinal surgeon, a team of nurses and an anesthesiologist are present to monitor the patient’s vital functions.

It is usually performed with enhanced anesthesia, if necessary, general anesthesia.

In our clinic, vitrectomy is done with 25 and 27g, which enables painless and minimally invasive treatment. Recovery is fast and there are no delays or waiting for surgery.


Vitrectomy is used in patients which are recommended for surgery due to the following diagnoses:

Diabetic retinopathy;
Wet macular degeneration;
Macular rupture (hole);
Macular edema;
Proliferative vitreoretinopathy;
Vitreomacular traction;
Epiretinal membrane;
Injury to the eye due to bleeding in the eye;
Patients with retinal detachment (retinal ablation).


A subspecialty examination is performed, which consists of refraction, determination of visual acuity, measurement of eye pressure, examination of the fundus – examination of the anterior and posterior segment of the eyes.

If necessary, OCT – Optical Coherence Tomography is performed as well as additional diagnostic examinations at the request of the surgeon.

After the examination, the patient receives the report and the results of the diagnostic tests.

Preoperative preparation

The preparation is started by the nurse, during which the vision, tonus and refractive measurement are taken again.

The patient is then transferred to the preoperative block and a medical history is taken. Blood pressure and blood sugar are checked. Then, in consultation with the ophthalmic surgeon, if necessary, additional diagnostics are conducted and the preparation ends with dilation of the pupils.

Patients with chronic diseases, depending on the therapy they receive, have special preparations for which they are informed on the day of the operation.

Once the patient is fully prepared, they are admitted to the operating room.

Course of surgery

The anesthesiologist is responsible for monitoring vital functions, ECG, blood pressure, respiration and oxygenation as well as controlling anesthesia.

A brace is placed on the eye itself to hold the eyelids. This holder may be a little uncomfortable, but it keeps the eye open. During the operation the patient is conscious and communicative with the surgeon.

The surgeon makes incisions through 4 small holes in the sclera (less than 1 mm) to remove the vitreous in the eye, after which it is replaced with a special gas (which is resorbed over time) or silicone oil. If the patient has ruptures (holes) in the retina, they are repaired by laser photocoagulation.

At the end of the operation, a tamponade is made with gas or silicone oil, which depends on the condition of the retina.

After the operation, the patient is taken to an apartment. About half an hour after the operation, the patient is checked out of the hospital (one-day surgery) with a bandage on the operated eye.

After surgery, the patient also receives written instructions on limitations and postoperative care.

Postoperative care

The following day after the operation is the first follow up on which the bandage is removed. Then, in agreement with the surgeon, the following examinations are scheduled.

The period of recovery and normalization of vision is from 1 to 4 weeks.

Normal signs after surgery that can last from a few days to weeks are:

Bruised eye;
Blood-like red eye;
Swollen eyelids and face;
Frequent tearing; mucous discharge.

Normal vision symptoms after surgery that can last from a few days to weeks are:

Blurred vision that has deteriorated. It is normal for vision to improve slowly over time;
Opacities (flies);
Irritation of the eye (feeling as if there is something in the eye);
Sensitivity to light;
Double image;
Pain in the eye or around the eye, which is more pronounced during eye movements.

Vitrectomy is a successful surgical procedure if performed on time without additional waiting.


Restrictions after the intervention are temporary and do not last long and are always in accordance with the surgeon’s recommendation.

The patient is prescribed therapy and is obliged to use it according to the time period appointed by the surgeon.

The bandage is removed the following day for control. After 3-4 days, the patient can wash their face, take a bath and perform daily activities. It is necessary to avoid physical exertion.

In case the patient feels very strong pain in the eye area, severe headache, nausea, vomiting, they should contact their ophthalmic surgeon or our clinic immediately.

Cooperation with the HIF

The vitrectomy operation is covered by the Health Insurance Fund of RNM.

You can read more information in the section titled Cooperation with HIF.

For more information contact us by phone 02 3097 000 or electronically at contact@sistinaoftalmologija.mk.


The package includes: preoperative preparation, surgery, home therapy and two follow-up examinations.

The package through the Fund includes: co-payment; surgery; preoperative preparation and one free follow-up examination.

There is an opportunity to pay in installments without interest and additional costs.

You can check more about the payment method on the current price list of Sistina Ophthalmology.

Detailed eye examination

Refraction, visual acuity measurement, eye pressure measurement, evaluation of posterior segment – examination of anterior and posterior segment.



Оoptical coherent topography on anterior segment or posterior segment.



Surgery for posterior segment. Price is for one eye. This surgery is covered by HIF only for Macedonian residents.


Vitrectomy via HIF

Surgery for posterior segment. Price is for one eye. This surgery is covered by HIF only for Macedonian residents.


Vitrectomy and cataract surgery

Surgery of posterior segment and cataract surgery with implantation of intraocular lens. The price is for one eye.