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Alternative Names Return to topScleral buckling; Vitrectomy; Pneumatic retinopexy; Laser retinopexy
Definition Return to top
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.
Description Return to top
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:
For some complex detachments, both procedures may be done during the same operation.
Why the Procedure is Performed Return to top
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.
Risks Return to top
Risks for retinal detachment surgery may include:
General anesthesia may be required. The risks for any anesthesia are:
After the Procedure Return to top
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:
Outlook (Prognosis) Return to top
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.
References Return to top
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.Update Date: 8/22/2008 Updated by: Paul B. Griggs, MD, Department of Ophthalmology, Virginia Mason Medical Center, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.