Retinal detachment repair

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Detached retina

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.

This article describes the repair of rhegmatogenous retinal detachments -- retinal detachments that occur due to a hole or tear in the retina.

Scleral buckling; Vitrectomy; Pneumatic retinopexy; Laser retinopexy

Most retinal detachment repair operations are urgent. A detached retina lacks oxygen, which causes cells in the area to die. This can lead to blindness.

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If holes or tears in the retina are found before a detachment occurs, an ophthalmologist can close the holes using a laser. This is usually done in the doctor's office.

If the retina has just started to detach, a procedure called pneumatic retinopexy may be done to repair it.

• Pneumatic retinopexy (gas bubble placement) is usually an office procedure. The eye doctor injects a bubble of gas into the eye.
• You are then positioned so the gas bubble floats up against the hole in the retina and pushes it back into place.
• The doctor will use a laser to permanently seal the hole.

Severe detachments need more advanced surgery. The following procedures are done in a hospital or outpatient surgery center:

• The scleral buckle method indents 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 release tension on the retina, allowing it to move back into proper position. Most vitrectomies are done under local anesthesia.

For some complex detachments, both procedures may be done during the same operation.

Retinal detachments do not improve without treatment. Repair is needed to prevent permanent vision loss.

The urgency of the surgery depends on the location and extent 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 and to increase the chance of preserving good vision.