Retinal detachment surgery

Specialty of Ophthalmology


What is retinal detachment surgery?

The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages via the optic nerve to the brain. When the retina detaches, it is pulled from its normal position. Retinal detachment is caused by a retinal tear and can lead to blurred or lost vision. Surgery is the only treatment for retinal detachment. The goals of retinal detachment surgery are to reattach the retina and to prevent or reverse vision loss.

What is retinal detachment?
Retinal detachment is an eye condition, which involves the separation of the retina from the underlying tissues within the eye. Retinal detachments are usually caused by a retinal break, hole or tear. These types of detachments are known as rhegmatogenous retinal detachment and occur when the vitreous gel (a clear liquid that fills two-thirds of the inside of the eye) pulls loose or separates from its attachment to the retina.

When the retina has torn, the vitreous gel passes through the tear and gathers behind the retina. This build-up behind the retina is what separates the retina from the choroid and retinal pigment epithelium (lining tissue). As more liquid vitreous collects behind the retina, it can lead to a total retinal detachment. It always affects one eye at a time.

Types of procedures for retinal detachment surgery:
There are three types of eye surgery to treat retinal detachment, which are performed by an ophthalmologist.

  • Vitrectomy – this is the most common surgical procedure for retinal detachment. The procedure removes the vitreous gel from the middle of the eye. The doctor uses small tools to remove the vitreous gel and replace it with either a gas or silicone bubble to hold the retina in position from the inside.
     
  • Scleral buckling – this involves fine bands of silicone rubber or sponge that are stitched onto the outside of the white of the eye (the sclera), where the retina has detached. The bands act like a buckle, which presses the sclera in towards the middle of the eye so that the torn retina can lie against the wall of the eye. Laser or freezing treatment is used to scar the tissue around the retina, in order to create a seal between the retina and the wall of the eye.​
     
  • Pneumatic retinopexy – this procedure is often used if the detachment is small and uncomplicated. A small bubble of gas is injected into the eye to press the retina back into place. Laser or freezing treatment is often then used to create scar tissue to keep the retina in place. Over the next few weeks, the bubble is slowly absorbed into the eye.

Risks of retinal detachment surgery
There are a few complications, which are not too common but may occur following a surgical procedure and another operation may be needed to fix the retina. Possible complications include:

  • Bleeding inside the eye
  • More holes in the retina
  • Bruises
  • Glaucoma – swelling inside of the eye
  • Cataracts – cloudy lens
  • Double vision
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