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Retinal detachment repair

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Definition:

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 Names:

Scleral buckling; Vitrectomy; Pneumatic retinopexy; Laser retinopexy

Description:

Most 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 seperate, 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. There 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.

Indications:

Retinal 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 visual 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.

References:

Yanoff 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 . Dec 2004; 17(4): 507-12, v.

• Review Date: 2/22/2007
• Reviewed By: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

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