Retinal Detachment Surgery: Types, Recovery and Success Rate

Overview

Retinal detachment is an eye-related medical condition commonly noticed in elders. The retina is a sensitive layer of the eye that has photoreceptors. The retinal layer is essential in capturing an object's image and providing clear vision. Any detachment or tear in the position of the retina is known as retinal detachment. Retinal detachment surgery involves treating the tears. If left untreated, it may lead to loss of vision.

What is Retinal Detachment?

The retina is a thin layer of tissue on the rear side of the eye. Retinal detachment is a medical condition caused when the retina gets detached from its position. The isolated retinal cells and blood vessels result in a lack of oxygen and nourishment to the eye.

Signs and Symptoms of Retinal Detachment:

Though no pain is experience, the following signs and symptoms are seen before the retina gets detached:

• Partial vision loss. The person feels if a dark curtain is suddenly pulled before their eyes.
• Sudden flashes of light appearing before one or both eyes
• Suddenly seeing many floaters.

The symptoms of retinal detachment are often seen very quickly. If the issue is left untreated, it can go beyond just detachment. It can lead to complete vision loss too. Therefore, diagnosing the disease is very important.

Causes of Retinal Detachment

There are many different causes of retinal detachment, but the most common is a break or hole in the retina. This can happen due to a variety of things, such as aging, trauma, or certain medical conditions. The following are the most common causes of retinal detachment:

1. Family history of retinal detachment
2. History of past eye injury
3. History of eye surgery for cataract
4. Aging
5. If the patient has extreme nearsightedness
6. Eye diseases such as diabetic retinopathy, posterior vitreous detachment, thinning of the retina

Diagnosing Retinal Detachment:

Treatment for any disease depends on its diagnosis. Doctors run checkups to identify the causing factor and then suggest a treatment plan. To diagnose retinal detachment they do eye checkups. They check:

• Vision
• Eye Pressure
• Physical appearance of the eyes
• Ability to see colours
• Ability of the retina to send impulses to the brain
• Blood flow throughout the eyes (especially in the retina)

Doctors use two types of examination- Retinal Examination and Ultrasound Imaging.

Retinal Examination: Doctors use an instrument with a bright light and special lenses that gives clear view of the eyes, especially retina. It helps the doctor to detect if there is any hole, tears or detachment in the retina.

Ultrasound Imaging: Bleeding in the retina can obstruct the vision. In that case, doctors use this method. Depending on the findings, doctors determine the treatment option.

Types of Retinal Detachment

Retinal detachment can be broadly classified into the following types:

1. Rhegmatogenous Retinal Detachment

The gel-like fluid in the middle of your eye enters the rear side of the retina through gaps or tears. Your retina will then detach from the back of your eye.

Rhegmatogenous retinal detachment is caused due to ageing.

2. Tractional Retinal Detachment

It occurs when the retinal scar tissue misplaces the retina. The eye disorder known as diabetic retinopathy, which affects persons with diabetes, is the most frequent cause of tractional retinal detachment.

Diabetic retinopathy can damage the retinal layer of blood vessels, gradually creating a scar on the retina.

If you have diabetes, make sure to get an eye checkup every year. You can avoid or postpone vision loss by controlling your diabetes with regular exercise, a balanced diet, and medication use.

3. Exudative Retinal Detachment

When fluid accumulates behind your retina, yet there are no tears or fractures in your retina, this condition is known as exudative retinal detachment. Your retina can separate from the back of your eye if enough fluid is trapped behind it.

Exudative retinal detachment can be found in conditions with leaking blood vessels. Sometimes, it can also be caused by the swollen rear side of the eye.

Your eye's blood vessels may leak or swell for several reasons, including:

•  Eye damage or injury  
• Age-related macular degeneration (AMD)
• Eye tumours
• Inflammatory eye diseases
• The uncommon eye condition Coats disease

Surgery And Treatment For Retinal Detachment:

Often surgery becomes mandatory to treat retinal detachment. However, in mild cases, a simple procedure can also work. The common treatment options for this issue are:

Photocoagulation: This method is used if you have a hole or tear in the retina but it is not detached. Through laser, the retina is affixed back to the eyes.
Cryopexy: It is another approach to deal with the problem. In this procedure, the scarring that results from the freezing probe application by the doctor over the retinal tear location outside of the eye will help keep the retina in place.

Pneumatic retinopexy: This procedure is used to treat minor detachments. 

Scleral buckling: This surgery is used to treat more severe conditions. However, it is a simple procedure that allows you to return home on the same day.

Vitrectomy: This is another effective retinal detachment surgery where the surgeon gets to remove the vitreous and also all those tissues that are tugging the retina. Silicone oil, gas, or air gets injected into the vitreous section to flatten the retina.

The liquid, gas, or air gets absorbed, and the vitreous section gets refilled with the body fluid. When the surgeon has used silicon oil, it will get removed surgically after several months. Surgeons perform this procedure along with the scleral buckling method. Further:

• A small incision will be made in the sclera of the eye.
• A microscope will be inserted to see inside the eye.
• Any abnormalities such as scar tissue, vitreous (gel-like fluid), or cataracts will be removed.
• The retina will be put back in its place with a gas bubble.
• Laser surgery or freezing will be done to repair any holes or tears.

Purpose of Repairing a Retinal Detachment

The retina plays an important role in sending images to the brain via the optic nerve. For the human body, the retina replicates the functions of a camera. During a retinal detachment, the blood supply starts to subsidize. Eventually, with a lack of or without blood supply, the retina cells start to lose their function and die. This condition can even cause serious and permanent damage to your eye and vision.

Procedure for Repairing a Retinal Detachment

The doctor injects gas or an air bubble into the eye's vitreous cavity. The bubble reaches the retinal layer, where it is detached, stopping the fluid from flowing. This helps attach the retina to the eye wall.

There are cases where cryopexy is used. Cryopexy is a method through which extreme cold is passed to promote scar tissue formation.

How Do You Prepare for Retinal Detachment Surgery?

Here are key points to remember while going for a retinal detachment surgery:

• Explain all the symptoms to your doctor
• Mention the medications and supplements you're consuming
• Speak to the doctor and clarify your doubts

How Risky is Detached Retina Surgery?

Today, retinal detachment is quite common. However, retinal detachment surgery has some risks, such as:

• Glaucoma
• Infections
• Haemorrhage
• Cataracts

In the Long Run, What Can Be Expected?

After the retinal detachment surgery, things might be quite different for you. Fortunately, nine out of ten retinal detachment surgeries are successful.

To keep the air bubble in the right spot, you will have to keep your head steady. Until the eye heals completely, you are recommended not to perform any heavy work. You will need to rest for four to six weeks.

Retinal Detachment Surgery Recovery

If a retinal detachment is not treated immediately, it might cause irreversible vision loss. The typical recovery duration for the procedure is three to six weeks. Here are some things to be followed after the retinal detachment surgery:

• Your doctor will recommend a few eyedrops that will prevent infections and reduce inflammation.
• If needed, doctors might also prescribe pain relievers.
• After the surgery, you might need to wear an eye patch for 24 hours. After removing the eye patch, you must wear sunglasses outside the house.

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Retinal Detachment Surgery Success Rate

The first success rate for retinal detachment surgeries was 90%. Nine out of ten patients undergo successful retinal detachment surgery on the first attempt. However, one in ten patients would require multiple operations because of the formation of new tears in the retinal layer after the surgery.

A few factors affect the success rate of retinal detachment surgery, like the extent of retinal damage, amount of vision loss, or any complications during the surgical procedure.

Conclusion

In conclusion, taking proper care of the eye is important. Retinal detachment surgery is a must for retinal tears or damage. If you are suffering from retinal detachment, speak to a Retinal detachment surgery doctor immediately. If you are worried about taking a retinal detachment test or surgery, Nanavati Max Healthcare will guide you with the help of well-experienced doctors.