Retinal Surgery for a Torn or Detached Retina
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TREATMENT FOR A TORN OR DETACHED RETINA
A retinal tear or a detached retina is repaired with a surgical procedure. Based on your specific condition, Dr. Ganiban or Dr. Vaishnav will discuss the type of procedure recommended and will tell you about the various risks and benefits of your treatment options.
TORN RETINA SURGERY
Most retinal tears need to be treated by sealing the retina to the back wall of the eye with laser surgery or cryotherapy (a freezing treatment). Both of these procedures create a scar that helps seal the retina to the back of the eye. This prevents fluid from traveling through the tear and under the retina, which usually prevents the retina from detaching. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office.
- Laser surgery (photocoagulation) With laser surgery, your ophthalmologist uses a laser to make small burns around the retinal tear. The scarring that results seals the retina to the underlying tissue, helping to prevent a retinal detachment.
- Freezing treatment (cryopexy) Scatter treatment is used to slow the growth of new abnormal blood vessels that have developed over a wider area of the retina. Your retina specialist may make hundreds of laser burns on the retina to stop the blood vessels from growing. Patients may need two or more treatment sessions.
DETACHED RETINA SURGERY
Almost all patients with retinal detachments must have surgery to place the retina back in its proper position. Otherwise, the retina will lose the ability to function, possibly permanently, and blindness can result. The method for fixing retinal detachment depends on the characteristics of the detachment. In each of the following methods, your surgeon will locate the retinal tears and use laser surgery or cryotherapy to seal the tear.
- Scleral buckle This treatment involves placing a flexible band (scleral buckle) around the eye to counteract the force pulling the retina out of place. The ophthalmologist often drains the fluid under the detached retina, allowing the retina to settle back into its normal position against the back wall of the eye. This procedure is performed in an operating room.
- Pneumatic retinopexy In this procedure, a gas bubble is injected into the vitreous space inside the eye in combination with laser surgery or cryotherapy. The gas bubble pushes the retinal tear into place against the back wall of the eye. Sometimes this procedure can be done in the ophthalmologist’s office. Your retina specialist will ask you to constantly maintain a certain head position for several days. The gas bubble will gradually disappear.
- Vitrectomy This surgery is commonly used to fix a retinal detachment and is performed in an operating room. The vitreous gel, which is pulling on the retina, is removed from the eye and usually replaced with a gas bubble.
Sometimes an oil bubble is used (instead of a gas bubble) to keep the retina in place. Your body’s own fluids will gradually replace a gas bubble. An oil bubble will need to be removed from the eye at a later date with another surgical procedure. Sometimes vitrectomy is combined with a scleral buckle.
If a gas bubble was placed in your eye, your retina specialist may recommend that you keep your head in special positions for a time. Do not fly in an airplane or travel at high altitudes until you are told the gas bubble is gone. A rapid increase in altitude can cause a dangerous rise in eye pressure. With an oil bubble, it is safe to fly on an airplane.
Most retinal detachment surgeries (80 to 90 percent) are successful, although a second operation is sometimes needed.
Some retinal detachments cannot be fixed. The development of scar tissue is the usual reason that a retina is not able to be fixed. If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind.
After successful surgery for retinal detachment, vision may take many months to improve and, in some cases, may never return fully. Unfortunately, some patients do not recover any vision. The more severe the detachment, the less vision may return. For this reason, it is very important to see your retina specialist regularly or at the first sign of any trouble with your vision.