Surgical treatment in which the retina, which has separated from the eye wall, is reattached, most commonly with pars plana vitrectomy (PPV).
Indication
- Rhegmatogenous (tear-related) retinal detachment
- Sudden onset of light flashes, multiple new floaters and a curtain-like defect in the visual field
- Retinal tear and detachment after trauma
- Detachment occurring on a background of high myopia or lattice degeneration
- Tractional detachment in conditions such as diabetes or advanced retinopathy of prematurity
- Recurrent detachment after previous retinal surgery
Preparation
- Urgent ophthalmological evaluation and retinal examination through a dilated pupil
- Mapping of the condition with ocular ultrasonography and OCT when needed
- Rapid surgical planning; the procedure is usually recommended within 24-72 hours after diagnosis
- Anesthesia assessment for general or regional anesthesia
- Short-term adjustment of blood thinners and accompanying medical conditions
How it's performed
- The patient is positioned on the operating table and the eye area is sterilely prepared
- General or regional anesthesia is administered
- Tiny incisions are made through the white of the eye to insert a light source and microsurgical instruments
- With pars plana vitrectomy, the gel inside the eye (vitreous) is removed and retinal tears are identified
- The retina is repositioned and the tears are sealed around with laser or cryotherapy
- The eye is filled with air, gas or silicone oil to support the retina staying in place
Post-procedure
- Patients with gas tamponade should follow the head positioning recommended by the physician for several days
- Air travel and mountain climbing are forbidden until the gas has fully dissolved
- Care with antibiotic, steroid and intraocular pressure-lowering eye drops
- Follow-up visits on day 1, week 1, month 1 and month 3
- In cases with silicone oil, a planned additional procedure to remove the oil
Risks
- Development of cataract or progression of an existing cataract
- Increase in intraocular pressure (transient or permanent)
- Re-detachment and formation of new tears
- Intraocular infection (endophthalmitis) — rare but serious
- Vision not returning to the fully expected level, especially with delayed presentation
FAQ
Is retinal detachment an emergency?
Yes. It is a sight-threatening emergency. When sudden light flashes, multiple new floaters or a curtain-like darkening in the visual field appear, an ophthalmologist should be consulted on the same day.
Will my vision return to normal after surgery?
Visual recovery depends on whether the detachment involves the central vision area (macula) and on how much time has passed. With early intervention, meaningful improvement is achieved in many patients; however, full return to previous sharpness cannot always be guaranteed.
How should I position my head after surgery?
If gas has been placed inside the eye, a specific head position (face-down or side-lying) is recommended depending on the location of the detachment. This position is maintained for most of the day for several days and is determined individually by the physician.
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