Retinal Detachment Surgery
A retinal detachment (RD) is a very serious condition for which surgery is almost always required to prevent blindness in the affected eye. Each RD is unique, and several different surgical procedures are available to the retinal specialist who will carefully evaluate the eye to determine the best procedure for each case. Since RD surgery is highly complex, it is not possible to fully describe the decision making process and details of each surgical procedure in a brief manner. However, the retinal specialist chooses from the following options: 1) pneumatic retinopexy (an office procedure applicable only in rare situations), 2) scleral buckle, 3) vitrectomy or 4) combined scleral buckle/vitrectomy.
RD surgery is performed under strict sterile conditions in an operating room. Like other eye surgery, an RD repair is usually performed as an outpatient procedure under a local anesthesia in which the patient is awake but gently sedated and the eye is numbed with anesthetic. While the eye is anesthetized, it typically cannot see any detail so the patient cannot "see" what is happening during the surgery. The opposite eye is covered for protection. A very calm environment is maintained in the operating room. During the surgery, the patient can hear the surgeon speak but feels no pain. Regardless of the procedure chosen, the surgery requires small incisions that are self-sealing or are closed at the end of the procedure with very fine dissolvable sutures.
The eye will usually be quite red with variable swelling after surgery. Mild to moderate eye discomfort is common in the first few days following surgery. Severe pain is uncommon. Postoperative requirements and care vary depending on the nature and complexity of the RD. All cases require medicated eye drops and/or ointment for up to several weeks. In some situations, the eye will have an intraocular gas bubble. In these cases, special postoperative positioning will be required for a time. The retina specialist will provide detailed instructions after surgery.
RD surgeries are very delicate, complex and highly refined procedures which require great skill and experience on the part of the retinal specialist. However, even with the most skilled surgeon properly performing the correct procedure, more than one surgery can sometimes be required to attain permanent retinal reattachment. Even with successful surgery, vision in an eye that has had an RD is not likely to be perfect. How much vision the eye eventually has will depend upon the extent and duration of the RD, the level of vision prior to surgery, the occurrence of proliferative vitreoretinopathy (scar tissue on the retina) and many other factors.