Floaters,—objects appearing to float across your eye—or a gray veil moving across your field of vision are frightening symptoms. These could be signs of a retinal detachment, a serious condition where oxygen is no longer getting to the retina of your eye. You could lose your vision if you do not act quickly. Retinal detachment repair is a surgery that is used to restore circulation to the retina and preserve vision.
Your retina is the part of your eye that sends images through your optic nerve to the brain. Your retina contains millions of cells that detect light like a camera. It is part of the very back of your eyeball and is essential to your vision.
Retinal detachment occurs when the retina pulls away from the back of the eye and the blood supply. Without a blood supply, the retinal cells will start to die, resulting in permanent damage to your vision. If the macula (central vision area) begins to loosen, your vision may be permanently damaged. If the macula completely detaches, your vision may be lost completely. Reattaching the retina quickly is very important to prevent such a serious complication.
Retinal detachment can occur because the vitreous fluid of the eye (a gel-like liquid) retracts from the back of the eye, pulling the retina and tearing it. That tear can then pull away from the back of the eye and detach the retina. You may be at greater risk of retinal detachment if you have glaucoma, severe trauma, nearsightedness, or have had previous cataract surgery, previous retinal detachment in your other eye, or a family history of retinal detachment.
There are several types of surgery to repair a detached retina. A simple tear in the retina can be treated with cryotherapy (freezing) or a laser procedure. During more serious surgery, any tears found in the retina will likely be treated with cryotherapy.
Different types of retinal detachment require different kinds of surgery and different levels of anesthesia. When pneumatic retinopexy is done, a gas bubble is injected into the eye. The bubble presses against the detached retina and pushes it back into place. A laser or cryotherapy is then used to reattach the retina firmly into place. The gas bubbly will dissolve in a few days. A pneumatic retinopexy can be done in an ophthalmologist’s office.
A scleral buckle is a procedure that is done by placing a flexible band around the eye to counteract the force that is pulling the retina out of place. The fluid behind the detached retina will be drained, and the retina should return to its normal place in the back of the eye. This procedure is used for more serious retinal detachments and is done in a hospital, operating room, or surgery clinic. Local or general anesthesia will be used, and you will probably not need to stay overnight in the hospital.
A vitrectomy is a procedure done for the more serious retinal detachments. It may require partially removing the vitreous fluid inside the eye. Local anesthesia is used and the procedure is usually done in a surgical clinic.
Retinal detachment repair is usually done on an emergency basis. Be sure to tell your doctor about any medications you may be taking that could interfere with the surgery or the anesthesia.
Surgery always carries some risk. Anesthesia can interfere with breathing, and some people have serious reactions to the medication.
The specific risks of retinal repair surgery include:
- bleeding in the eye
- high pressure inside the eye (glaucoma)
- cataract (clouding of the lens)
- the need for additional surgeries
If damage to the retina occurred before reattachment, there can be permanent loss of vision.
Usually the retina can be attached in a single operation, but sometimes multiple procedures are required. More than 90 percent of detachments can be repaired. In the less than 10 percent of detachments that cannot be repaired, the patient will have either poor vision or no vision in that eye.
The success of a retinal repair depends on the seriousness of the tears and detachment and how much scar tissue was formed in the retina. If the macula or central portion of the retina was not affected, vision will be good. If the macula was detached for a long time, some vision will return, but it will often be very bad, meaning less than 20/200 or legally blind. It may take several months of healing after surgery to determine how much vision will return.