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Retinal detachment repair is eye surgery to place a detached retina back into its normal position.
A detached retina means the light-sensitive tissue in the back of the eye has separated from its supporting layers.
Alternative NamesScleral buckling; Vitrectomy; Pneumatic retinopexy; Laser retinopexy
DescriptionMost detachment repair operations are urgent. A detached retina lacks oxygen, which causes cells in the area to die. This can lead to blindness.
If holes in the retina are found before a detachment occurs, an opthalmologist can close the holes using a laser. This is usually done in the doctor's office.
If the retina has just started to separate, a procedure called pneumatic retinopexy may be done to repair it. Pneumatic retinopexy (gas bubble placement) is also usually an office procedure. The health care provider injects a bubble of gas into your eye. You will be positioned so the gas floats up against the hole in the retina and pushes it back into place. The surgeon will use a laser to permanently seal the hole.
More severe detachments require more advanced surgery. The following procedures are done in a hospital or outpatient surgery center:
- The scleral buckle method bends the wall of the eye inward so that it meets the hole in the retina. Scleral buckling can be done under local or general anesthesia.
- The vitrectomy procedure uses very small instruments inside the eye to pull the retina forward. Most vitrectomies are done under local anesthesia.
For some complex detachments, both procedures may be done during the same operation.
Why the Procedure Is PerformedRetinal detachments do not improve without treatment. Repair is necessary to prevent permanent vision loss.
The urgency of the surgery depends on the location of the detachment. If the detachment has not affected the central vision area (the macula), surgery should be done quickly, usually the same day. This is necessary to prevent further detachment of the retina.
If the macula detaches, the surgery can still be done, but the vision result will not be as good. If the macula has already detached, there is less urgency. Surgeons can wait a week to 10 days to schedule surgery.
RisksRisks for retinal detachment surgery may include:
- Detachment not completely fixed (may require additional surgeries)
- Increase in eye pressure (elevated intraocular pressure)
- Bleeding
- Infection
General anesthesia may be required. The risks for any anesthesia are:
- Reactions to medications
- Problems breathing
The chances of successful reattachment of the retina depend on the number of holes, their size, and whether there is scar tissue in the area.
Most of the time, the retina can be reattached with only one operation, although some people need several surgeries. Less than 10% of detachments cannot be repaired. Failure to repair the retina always leads to poor or no vision in the eye.
After surgery, the quality of vision depends on where the detachment occurred:
- If the central area of vision was not involved, vision will usually be very good.
- If the central area of vision was involved for less than 1 week, vision will usually be improved, but not 20/20 (normal).
- If the central area of vision was detached for a long time, vision will return, but it will not be sharp.
The procedures usually do not require an overnight hospital stay.
You will need to limit activities for some time.
If the doctor repaired the retina using the gas bubble procedure, you must keep your head face down or turned to one side for several weeks. It is important to maintain this position so the gas bubble pushes the retina in place. Patients with a gas bubble in the eye may not fly.
ReferencesYanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004:786-791.
Costarides AP. Elevated intraocular pressure following vitreoretinal surgery. Ophthalmol Clin North Am. 2004;17(4):507-512.
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What is a Retinal Tear or Detachment?
Before delving into the procedures that repair retinal tears and detachments, it's essential to grasp the nature of these conditions.
How Much Does Retinal Detachment Treatment Cost?
Retina Detachment Surgery is a procedure that is performed to repair a detached or torn retina. It aims to reattach the retina to the back of the eye, allowing it to regain its normal function. There are different surgical approaches to retinal detachment, and the specific technique used depends on the characteristics and severity of the detachment.
Is retinal detachment surgery always necessary?
Yes, in most cases, surgery is necessary to repair a detached retina. Without prompt treatment, retinal detachment can lead to permanent vision loss. Surgery aims to prevent further detachment and restore the normal position of the retina.
How is retinal detachment treated by doctors?
Diagnosis of retinal detachment should be done by an ophthalmologist. A person who has flashes, floaters, or has a curtain-like blockage of their visual field should see an ophthalmologist immediately
Can retinal detachment surgery prevent future detachments?
While retina detachment surgery can successfully repair a detached retina, it does not guarantee prevention of future detachments. However, certain lifestyle changes or additional procedures may be recommended by the ophthalmologist to reduce the risk of recurrence, such as avoiding activities that increase eye pressure or addressing underlying conditions that contribute to retinal detachment.
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What is the medical term meaning surgical fixation of the retina?
Retinopexy is surgical fixation of the retina.
Is the use of a laser to reattach a retinal detachment?
Detached Retina Symptoms - Fast Action Can Save Your EyesAre you experiencing hazy vision or are you bothered by floating specks? These are symptoms of a detached retina which needs immediate attention from your doctor. If not attended to right away, then this condition can lead to blindness. In order to properly function, the retina should receive oxygen and nutrients from the blood vessels underneath. When it separates from the blood vessels, the condition is called retinal detachment. In the United States alone, approximately 20,000 people annually suffer from retinal detachment. It is the result of an eye injury, cataract surgery, or an extreme case of nearsightedness.Men are more prone to having this condition than their female counterparts and its onset is higher in people with eye tumor and hypertension. Genetics also play a crucial factor in the development of the condition as it has the tendency to run in families. Doctors characterize it as a medical emergency which requires immediate surgery because it could lead to the permanent loss of vision in the affected eye.Although the condition is painless, detached retina symptoms manifest themselves prior to the detachment. It involves the shrinking and sagging of the vitreous fluid within the eyeballs. The tugging of the retina results to the sensation of flashing images. When strong enough, this may cause the retinal tear and consequently damage the small blood vessels paving the way for blood to seep into the vitreous.Whether or not surgical procedures will help is determined by the condition of the patient. For example, if there is only retinal tearing but no detachment from the blood vessels below is involved, laser treatment or photocoagulation can undo the damage. Likewise, performing cryopexy, which involves application of cold temperature to produce a scar which holds the retina in place, can also repair the damaged retina.Surgical procedures are only resorted to when there is detachment of the retina. The treatment should be performed at once because rods and cones die when detached from their source of nourishment for an extended period of time. This could lead to permanent blindness and nothing can bring back the loss vision.Detached retina symptoms are usually treated using one of three surgical methods, some of which are integrated with photocoagulation or cryopexy. These surgical procedures are designed to close retinal holes or tears in order to minimize the tugging of the retina from a shrinking vitreous. The kind of procedure to be recommended by the surgeon is dependent on the kind, size, and position of the detached retina. These procedures can successfully treat over 90 percent of retinal detachment patients although another treatment is sometimes needed.Looking to make a change? Nothing can make a dramatic impact like non prescription colored contacts. See how cosmetic contact lenses can change your life.
What are some routine ophthalmic procedures?
Surgery on the eye is routinely performed to repair retinal defects, remove cataracts or cancer, or to repair eye muscles.
Retinal detachment?
DefinitionRetinal detachment is a separation of the light-sensitive membrane in the back of the eye (the retina) from its supporting layers.Causes, incidence, and risk factorsThe retina is a transparent tissue in the back of the eye. It helps you see the images that are focused on it by the cornea and the lens. Retinal detachments are often associated with a tear or hole in the retina through which eye fluids may leak. This causes separation of the retina from the underlying tissues.Retinal detachment often occurs on its own without an underlying cause. However, it may also be caused by trauma, diabetes, an inflammatory disorder. It is most often caused by a related condition called posterior vitreous detachment.During a retinal detachment, bleeding from small retinal blood vessels may cloud the interior of the eye, which is normally filled with vitreous fluid. Central vision becomes severely affected if the macula, the part of the retina responsible for fine vision, becomes detached.The risk factors are previous eye surgery, nearsightedness, a family history of retinal detachment, uncontrolled diabetes, and trauma.SymptomsBright flashes of light, especially in peripheral visionBlurred visionFloaters in the eyeShadow or blindness in a part of the visual field of one eyeSigns and testsTests will be done to check the retina and pupil response and your ability to see colors properly. These may include:Electroretinogram (a record of the electrical currents in the retina produced by visual stimuli)Fluorescein angiographyIntraocular pressure determinationOphthalmoscopyRefraction testRetinal photographyTest to determine your ability to see colors properly (color defectiveness)Visual acuitySlit-lamp examinationUltrasound of the eyeTreatmentMost patients with a retinal detachment will need surgery, either immediately or after a short period of time. (However, surgery may not be needed if you do not have symptoms or have had the detachment for a while.)Types of surgery include:Cryopexy (intense cold applied to the area with an ice probe) to help a scar form, which holds the retina to the underlying layerLaser surgeryto seal the tears or holes in the retinaPneumatic retinopexy (placing a gas bubble in the eye) to help the retina float back into placeLaser surgey is performed after pneumatic retinopexy to permanently fix it in place. This is often done in a doctor's office.More extensive detachments may require surgery in an operating room. Such procedures include:Scleral buckle to indent the wall of the eyeVitrectomy to remove gel or scar tissue pulling on the retinaSee also: Retinal detachment repairExpectations (prognosis)What happens will depend on the location and extent of the detachment and early treatment. If the macula has not detached, the results of treatment can be excellent. Most retinal detachments can be repaired, but not all of them.ComplicationsThe unsuccessful reattachment of the retina results in loss of vision.Calling your health care providerA retinal detachment is an urgent problem that requires medical attention within 24 hours of the first symptoms.PreventionUse protective eye wear to prevent eye trauma. Control your blood sugar carefully if you have diabetes. See your eye care specialist at least yearly, especially if you have risk factors for retinal detachment.ReferencesCostarides AP. Elevated intraocular pressure following vitreoretinal surgery. Ophthalmol Clin North Am. Dec 2004; 17(4): 507-12, v.Fay A. Diseases of the Visual System. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 449.Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004:786-791.
How much does it cost to surgically repair a detached retina?
It is difficult to say how much retinal surgery costs. The price is dependent on the location of the surgery, how much a particular doctor charges, as well as on whether or not one has insurance.
Retinal detachment repair - series?
Normal anatomyThe retina is the internal layer of the eye that receives and transmits images that have passed through and been focused by the lens and cornea.IndicationsRetinal detachments are associated with a tear or hole in the retina through which the internal fluids of the eye may leak, causing separation of the retina from the underlying tissues. This is most often caused by trauma, and the risk of retinal detachment after minor trauma, such a blow to the head, is increased in the elderly, and in patients with tumors or inflammation near the retina. In some cases, retinal detachment occurs in the absence of trauma. Symptoms of retinal detachment include bright flashes, "floaters", or loss of part of the visual field. Emergency retinal detachment surgery is necessary to prevent vision loss.Procedure, part 1The most common technique used to repair retinal detachment is called a scleral buckle. Prior to performing a scleral buckle procedure, breaks and tears in the retina are closed. There are two major methods used to close breaks and tears in the retina. Cryopexy, uses an intensely cold probe (cryoprobe). This produces an inflammation that leads to formation of a scar which holds the retina to the underlying tissue.Procedure, part 2A laser treatment (photocoagulation) can also be used to seals holes in the retina. The choice of cryopexy or photocoagulation is usually determined by the preference of the surgeon-both procedures are equally effective in most cases.Procedure, part 3After sealing breaks and tears in the retina with either laser or cryoporbe treatment, the scleral buckle is applied. This consists of a silicone patch wrapped around the eye, compressing the globe and elongating it slightly, thus pushing the retina up against the posterior aspect of the eye, and sealing the detachment. The silicone patch is usually left in place permanently, unless it causes problems later, such as infection.AftercareScleral buckling for detachment may require a few days in the hospital. Keep the head elevated at all times. Patients should not bend over or strain with lifting or bowel movements. Vigorous exercise should be avoided for 3 to 4 weeksReviewed ByReview Date: 08/12/2010David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
