Retinal Detachment - Surgery
Surgery for retinal detachment
Surgery is the only
treatment for retinal detachment . The goals of surgery are:
Almost all retinal detachments can be repaired with
scleral buckle surgery, pneumatic retinopexy, or vitrectomy.
But even with such a high rate of success for
surgery, it is important to act quickly. The longer you wait to have surgery,
the lower the chances that good vision will be restored. When the retina loses
contact with its supporting layers, vision begins to get worse. An eye doctor
(ophthalmologist) who specializes in retinal
detachments will usually do surgery within a few days of your being
diagnosed with a detachment.
How soon you need surgery usually
depends on whether the retinal detachment has or could spread far enough to
central vision. When the
macula, the part of the retina that provides central
vision, loses contact with the layer beneath it, it quickly loses its ability
to process what the eye sees.
- Having surgery while the macula is still
attached will usually save vision.
- If the macula has become
detached, surgery may occur a few days later than it would have otherwise. Good vision after surgery is still possible but less likely.
Your doctor will decide how soon you need surgery based
on the result of the retinal exam and the doctor's experience in treating
Surgery for retinal tears
Treating a retinal tear
may be useful if the tear is likely to lead to detachment. Symptoms such as
flashing lights are key factors in deciding whether to
treat a tear. A tear that occurs right after a
posterior vitreous detachment (PVD) with symptoms is
usually much more dangerous and more likely to progress to a retinal detachment
than one that occurs without symptoms.
when to treat a retinal tear, your doctor will
evaluate whether the torn retina is likely to detach. If the tear is very
likely to lead to detachment, treatment can usually repair it and prevent
detachment and potential vision loss. If the tear is not likely to lead to
detachment, you may not need treatment.
Common methods of repairing a retinal detachment
- Pneumatic retinopexy. In this procedure, your eye
doctor injects a gas bubble into the middle of the eyeball. The gas bubble
floats to the detached area and presses lightly against the detached retina,
flattening it so that the fluid below it can be reabsorbed. The eye doctor then
uses a freezing probe (cryopexy) or laser beam
(photocoagulation) to seal the tear in the
- Scleral buckling surgery.
Your eye doctor places a piece of silicone sponge,
rubber, or semi-hard plastic on the outer layer of your eye and sews it in
place. This relieves pulling (traction) on the retina, preventing tears from getting
worse, and it supports the layers of the retina.
- Vitrectomy. This is the removal of the
vitreous gel from the eye. Vitrectomy gives your eye
doctor better access to the retina and other tissues. It allows him or her to
peel scar tissue off the
retina, repair holes, close very large tears, and
directly flatten a retinal detachment.
Common methods of repairing a retinal tear
- Laser photocoagulation, in which an
intense beam of light travels through the eye and makes tiny burns around the
tear in the retina. The burns form scars that prevent fluid from getting under
- Cryopexy (freezing), in which your eye
doctor uses a probe to freeze and seal the retina around the tear.