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HomeHealth articlesretinal detachmentWhat Are the Types of Surgical Methods Performed in Retinal Detachment?

Combined Surgical Treatment of Retinal Detachment

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Retinal detachment surgery aims to reattach the detached retina to the choroid layer of the eye and prevent permanent vision loss. Continue reading to know more.

Medically reviewed by

Dr. Shachi Dwivedi

Published At March 30, 2023
Reviewed AtMarch 30, 2023

Introduction

The retina is the layer of the eye that transmits images to the brain via the optic nerve. Millions of cells make up the retina, which functions like a camera to detect light. It is an integral component of the eyeball's back and essential for vision. Retinal detachment occurs when the retina, a light-sensitive inner layer at the back of the eye, is pulled away from its natural position. The signs of retinal detachment might be scary. A gray veil or floating objects may appear in the field of sight. A retinal detachment might result in vision loss if not treated immediately. Early treatment of retinal detachment is essential to save vision as it is a medical emergency. Patients may require surgery to reattach the eye's retina if the retina has detached. After surgery, patients might be required to stay for a short period.

What Are the Types of Surgical Methods Performed in Retinal Detachment?

Surgery aims to prevent permanent vision loss by repairing the detached retina. The surgery may depend on several factors, including the extent of the retinal detachment and its location in the eye. There are different types of surgical management that doctors perform to repair a retinal detachment. They are:

  • Pneumatic Retinopexy - During this procedure, the doctor may apply the area with an anesthetic agent and later remove a small amount of fluid from the eye with a tiny needle. Next, a gas bubble is injected inside the eye. The detached retina is pushed back into place by the bubble pressing against it. The retina is then firmly reattached into place using a laser or cryotherapy. In a few days, this gas bubble disappears after some time.

  • Scleral Buckle Surgery - During scleral buckle surgery, the doctor may place a small, flexible band around the white portion of the eye (sclera). The band gently pushes on the sides of the eye and pulls them inside toward the retina, facilitating the reattachment of the retina. After the procedure, the band remains on the eye permanently. The doctor may also apply a laser or freeze procedure to correct retinal tears. This treatment can be carried out in a hospital or clinic, and the patient might spend the whole day there.

  • Vitrectomy - Severe retinal detachments are treated with a vitrectomy. In this procedure, the vitreous fluid in the eye may need to be partially removed with the help of local anesthesia. The treatment is often carried out in a hospital or surgical clinic.

What Are the Precautions Taken for Retinal Detachment Surgery?

The precautions taken for retinal detachment surgery includes:

1. Changes In Lifestyles - It will be better for the long-term health of persons who stop smoking. Also, keep the weight in control. If patients are overweight, they may be more likely to experience difficulties.

2. Lying In the Same Position - Before the procedure, the doctor might instruct patients to maintain a particular position, like sleeping straight on one side. This may prevent the situation from worsening by preventing extra fluid from accumulating under the retina. If a local anesthetic is used, the patient must remain still and flat during the procedure.

The patient's face is covered with a cloth to work on a sterile surface. The nose is gently blown with air. Inform the doctor if someone is claustrophobic (afraid of being in small places).

What Are the Complications of Surgery for Retinal Detachment?

Most surgeries usually do not require general anesthesia to reattach a detached retina. However, the procedure itself may result in other problems, such as:

1. General Complications:

  • Pain.

  • Inflammation and swelling.

  • Bleeding.

  • Feeling of pressure inside the eye.

  • Watering of eyes.

2. Specific Complications:

  • Double vision (diplopia).

  • Vision loss.

  • Excessive bleeding (hemorrhage).

  • Chest infections.

  • Cataract formation.

Are There Any Alternative Methods for Surgery?

The patients might not require surgery if their retina has a tear or hole formation but has not detached. However, the doctor might suggest the following techniques to close the hole.

  • Laser Surgery - Laser surgery is one of the methods for repairing retinal detachment. The doctor flashes a laser beam into the eye to create tiny burns around the hole. This seals off the retina from tearing and prevents retinal detachment.

  • Freezing - Another option is freezing, or "cryopexy," as doctors call it. During this procedure, the doctor first numbs the eye before applying a tiny, freezing probe. Like laser surgery, the freezing technique produces scar tissue around the hole to fix the condition.

  • Diseases or Injury - Sometimes, the retina separates without tearing. This generally occurs if an injury or disease causes fluid to accumulate behind the retina. Surgery might not be necessary for such circumstances since the detached retina might be healed by managing the disease.

What Can Be Expected After the Retinal Detachment Surgery?

The severity of the tear and detachments and how much scar tissue has developed in the retina influence the success of a retinal repair. After the surgery, It can take a few months to determine how good the vision will be. However, if the repair is made before the macula and the retina's central portion detaches, the patient has the best chance of a successful outcome. Usually, the retina may be attached in a single procedure, but occasionally, numerous surgeries are needed. More than 90 percent of detachments are repairable. However, in less than 10 percent of retinal detachment cases, the patient will have either impaired vision or no vision in that eye that cannot be healed.

Conclusion

Retinal detachment is a most common condition when the retina, a light, sensitive layer at the back of the eye, is pulled away from its natural position. A retinal detachment might result in vision loss if not treated immediately. Early treatment of retinal detachment is essential to save vision as it is a medical emergency. Surgery aims to prevent permanent vision loss. There are different types of surgical management where doctors are performed to repair a retinal detachment, like pneumatic retinopexy, scleral buckle surgery, etc. The severity of the tear and detachments and how much scar tissue has developed in the retina influence the success of a retinal repair.

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Dr. Shachi Dwivedi
Dr. Shachi Dwivedi

Ophthalmology (Eye Care)

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retinal detachment
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