Retinal tear surgery and retinal detachment surgery are distinct medical procedures.
The retina is a thin layer of light-sensitive tissue at the back of your eyes. Your eye lens focuses light onto your retina, which converts the light into neural signals and sends the signals to the brain.
Retinal tears and detachments can cause blurred vision, flashes of light, and the loss of seeing things you’re not directly looking at (peripheral vision).
A retinal tear is when a small tear or crack occurs in the retina. It typically occurs due to the gel-like fluid in the eye, called vitreous, pulling on the retina or from an eye injury. It can lead to retinal detachment.
Retinal detachment occurs when liquid vitreous enters the retina break. As the gel accumulates, the retina lifts away from its normal position at the back of the eye. Scar tissue in the retina, aging, or diseases, like cancer, can contribute to it.
Retinal detachment is often not painful, but it’s a medical emergency. It can lead to partial or total vision loss if not treated promptly.
This article discusses the different medical procedures for treating and repairing retinal tears and retinal detachments. It also discusses how to prepare for surgery and recovery tips.
Retinal tear surgery and retinal detachment surgery are distinct procedures.
Retinal tear surgery:
- repairs any hole or tear in the retina
- prevents vitreous fluid from flowing underneath the retina
- prevents retinal detachment
Retinal detachment surgery:
- reattaches the retina to the back of the eye
- seals any hole in the retina
- helps preserve vision
Surgeries for retinal tears include:
Laser photocoagulation uses heat from a medical laser to make microscopic burns that create small scars around a retinal tear. The scar tissue then seals off the tear.
During laser photocoagulation:
- Your surgeon may administer numbing medication to your eyes.
- They may also dilate your pupils and place a special contact lens in front of your eyes to focus the laser.
- Your surgeon shines the laser through your pupil to seal the tear.
Cryotherapy, or cryopexy, uses a freezing probe to freeze the torn portion of the retina, causing a scar to form around the retina. It’s considered a noninvasive procedure and may treat larger tears.
Other risks of the procedure to consider include:
- unintended damage to surrounding eye tissue
During the procedure:
- Your doctor asks you to sit comfortably.
- They use a specially designed freezing probe to apply cold therapy over the tear.
- You may feel some pressure or cold while your doctor is using the freezing probe.
Common types of surgery for retinal detachment repair include:
Scleral buckle involves fitting and securing a piece of silicone or a sponge completely around the white of the eye (sclera). It pushes the sclera back inward to the detached retina to repair the detachment.
Possible risks include:
- new retinal tears
- repeated detachments
Most scleral buckle procedures are performed under general anesthesia.
During a scleral buckle procedure:
- Your surgeon may apply eye drops to dilate your pupils so they can see the retina.
- They attach a silicone band to the eye and stitch a sponge underneath the band, where the retinal break has occurred.
- If you have a retinal tear, your surgeon may perform additional surgery to repair it.
Pneumatic retinopexy involves a surgeon injecting a gas bubble into the eyes and positioning the bubble over the detached area to push the retina against the back of the eye. It’s considered an effective, less-invasive procedure.
Risks associated with this procedure include:
- eye infection
- trapped gas in the eyes
- recurring retinal detachment
During a pneumatic retinopexy:
- Your surgeon gives you medications to relax, numb your eye, and dilate the eye.
- They may remove some vitreous fluid from your eye, and then inject a gas bubble that presses against the detached retina.
- Your surgeon allows your retina to move back into place and then uses laser surgery or cryotherapy to seal any tears.
Vitrectomy involves removing the vitreous fluid and replacing it with sterile salt water or a bubble made of oil or gas. This eliminates any traction on the retina.
Vitrectomy is a more invasive procedure than pneumatic retinopexy. It’s used for larger tears.
The procedure may cause temporary:
- high pressure in the eyes
- problems with eye movement
During a vitrectomy:
- Your surgeon gives you anesthesia to relax and numb any sensations. You may be awake or asleep, depending on the type of anesthesia.
- Your surgeon makes an incision in the outer layer of your eye.
- They use a microscope to view inside your eyes. They use tools to remove the vitreous and any foreign material in the eye.
- Your surgeon performs any additional procedures to repair tears.
- They replace the removed vitreous with sterile saline, silicone oil, or a gas bubble.
- Your surgeon closes the incision.
Preparation depends on the procedure. Your care team will advise you on the steps to follow. Keep in mind that retinal detachment may require immediate surgery.
Your doctor may ask you not to eat or drink anything after midnight on the day of surgery. Additionally, your doctor may ask you to:
- wear a loose, comfortable outfit
- remove fixed eyelashes and contact lenses
- avoid taking certain medications, such as diabetes drugs
- take medication prescribed for the eye, such as eye drops
Recovery is gradual. Some people may experience blurry vision for 24 hours or a few days, while others may see floaters. They typically subside over time.
Your doctor may prescribe medications, like eye drops, to prevent side effects, such as swelling. They may also ask you to avoid driving or strenuous activities while your eye heals.
The cost of retinal surgeries varies depending on factors like:
- the procedure and doctor
- underlying cause of your retinal issues
- whether you have insurance coverage
- your region
According to CostHelper, a platform that researches the price of products and services, retinal detachment surgery could cost $5,000–$10,000.
For people with insurance, the cost may be $100 or more, with a coinsurance of 10–50%.
Procedures like cryopexy for retinal tears are less expensive and can cost $2,000–$5,000.
- pneumatic retinopexy: $2,343
- scleral buckling: $4,662
- pars plana vitrectomy: $5,061
However, since this is an older study, your cost may differ from what this study reports.
Some hospitals offer discounts. Do not hesitate to talk with the billing department to learn all your options.
Here are some frequently asked questions about retinal surgery:
How serious is retina surgery?
Retinal detachment is a serious condition. Procedures to correct it are considered emergency surgery.
If not treated, retinal detachment can cause vision loss.
What are the most common retinal surgeries?
There are different types of surgery for the retina. Some common ones include:
- laser photocoagulation
- scleral buckle
How long can retinal detachment go untreated?
Retinal detachments require immediate surgical intervention. If left untreated, they can lead to permanent vision loss.
Speak with a doctor about your symptoms. They can let you know if waiting is acceptable depending on your diagnosis.
If you notice any abnormal changes in your vision, it’s crucial to talk with an eye doctor for a proper diagnosis.
If you have a retinal tear or detachment, a doctor will recommend appropriate treatment, such as surgery. They will walk you through the steps of your procedure.
Your doctor may continue monitoring you after the surgery to know how well you are recovering and to reduce the risk of future issues.