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Retinal Detachment: Surgical Techniques

Pneumatic retinopexy, scleral buckle, and pars plana vitrectomy: indication-based selection

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Retinal Detachment: Surgical Techniques?

Retinal detachment is classified as rhegmatogenous (RRD - retinal break with vitreous traction, most common), tractional (TRD - fibrovascular proliferation, e.g., diabetic), or exudative (subretinal fluid without break, e.g., uveitis, tumor). Surgical strategy targets the underlying mechanism: closing the retinal break, relieving vitreous traction, and re-apposing the retina.

Pneumatic retinopexy: gas bubble (SF6 or C3F8) injection + cryopexy/laser, suitable for superior single break in upper 8 clock hours, no PVR. Success 60-80%. Scleral buckle: silicone band around eye externally indents sclera, supporting the break. Best for phakic eyes with peripheral breaks, lattice degeneration, young patients. Success 85-95%.

Pars plana vitrectomy (PPV): three-port 23/25/27-gauge approach, vitreous removal, fluid-air exchange, endolaser around break, gas (SF6/C3F8) or silicone oil tamponade. Indications: posterior breaks, vitreous hemorrhage, giant retinal tears, PVR, pseudophakic detachments. Combined buckle-PPV for complex cases. Success 90-95% primary, 95-99% with multiple surgeries.

Symptoms

Sudden onset floaters (vitreous detachment with break)
Photopsia (flashing lights - vitreoretinal traction)
Curtain or shadow in peripheral vision
Progressive visual field loss (depending on extent)
Central vision loss (macula-off detachment)
Metamorphopsia (macular involvement)
Eye pain (rare, except with associated conditions)

Risk Factors

High myopia (>-6 D, axial length >26 mm)
Posterior vitreous detachment (PVD)
Lattice degeneration, retinal tears
Trauma (blunt or penetrating)
Previous cataract surgery (pseudophakic detachment risk)
Family history of retinal detachment
Marfan, Stickler syndrome
Previous retinal detachment in fellow eye

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden onset multiple floaters (especially with photopsia)
  • Curtain or shadow appearing in peripheral vision
  • Sudden vision loss in part of visual field
  • Flashing lights persistent for hours
  • Acute vision loss (macula-off detachment - urgent <24-48 hours)
  • Post-traumatic vision changes
  • Increased floaters in high-myopia patient

Treatment Methods

01
Pneumatic retinopexy (gas + cryo/laser - office procedure for select cases)
02
Scleral buckle (silicone band, external approach - young phakic patients)
03
Pars plana vitrectomy 23/25/27G (modern microincision - complex cases)
04
Endolaser photocoagulation (around retinal break)
05
Gas tamponade (SF6 14 days, C3F8 6-8 weeks - face-down posturing)
06
Silicone oil tamponade (long-term, requires removal 3-6 months)
07
Combined buckle-vitrectomy (giant tears, PVR)
08
Heavy liquid (perfluorocarbon) intraoperative use
09
Postoperative posturing (face-down for inferior breaks)
10
Long-term follow-up (PVR, recurrence, cataract progression)

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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