Retinal Detachment Repair
Retinal detachment is a common condition in patients over the age of 40, in which the two layers of the retina detach from each other and from the retinal wall, causing floaters, blurred vision and the appearance of a curtain over the field of vision. If not treated immediately, retinal detachment can often cause permanent vision loss.
There are several treatment options available for retinal detachment, depending on the severity of the condition and overall health of the patient. Over 90 percent of patients with a retinal detachment can be successfully treated, although some may need a second treatment. Patients with small tears can usually be treated through laser surgery or a freeze treatment called cryopexy. Others may require retinal surgery to put the retina back into its proper position.
During vitrectomy surgery, the vitreous traction on the retina is relieved, laser treatment is performed, and a gas bubble is placed into the eye. After the surgery, the bubble holds the retina in place while the laser spots develop a firm adhesion. The gas bubble slowly absorbs over a few weeks. In some cases, a thin band is placed on the outside of the eye to help relieve traction and enable the retina to reattach (see section on scleral buckle).
Pneumatic retinopexy may also be used to treat retinal detachment. This procedure involves a bubble of gas that pushes the retina back against the wall of the eye, allowing for fluid to be pumped out from beneath the retina. This procedure is performed in Dr. Brown’s office under local anesthetic. Dr. Brown will inject a gas bubble into the middle of the eyeball and position your head so that the bubble flows to the detached area and applies light pressure. Cryopexy or laser treatment may then be used to seal the tear. The bubble remains on the eye for about a week to help flatten the retina before the bubble is absorbed.
After this procedure, patients must keep their head and eye in a certain position for most of the day, to keep the bubble in the right position to help seal the retinal tear. Most patients experience effective results after one treatment, although some may require additional procedures.
Although this procedure is considered safe, there are certain risks associated with any surgical procedure. Some of these risks may include scarring on the retina, formation of new tears, trapped bubbles of gas, increased eye pressure and bleeding in the vitreous or retina. Patients can eliminate some of these risks by choosing an experienced doctor.
Scleral Buckle Repair
Scleral buckle is a surgical procedure commonly used to repair a retinal detachment. Retinal detachment occurs when the two layers of the retina become separated from each other and from the wall of the eye, causing shadows and vision loss. This condition is most common in older adults and requires prompt and thorough treatment to prevent permanent vision loss.
During this outpatient procedure, the patients is placed under general or local anesthetic and the scleral buckle, which is a thin strip of silicone made to look like a belt, is secured around the eyeball under the conjunctiva. This device is placed on the sclera, or white of the eye, and is placed behind the eyelids, not visible from the outside. The scleral buckle is usually left on the eye permanently.
Over time, the scleral buckle pushes in, or “buckles,” the sclera towards the middle of the eye, relieving the pull on the retina and narrowing the space between the two layers that have torn apart. This makes it easier for the retina tear to settle against the wall of the eye.
After the placement of the retinal buckle, patients may experience pain, swelling and redness for a few days. Dr. Brown may prescribe eye drops to treat these symptoms and prevent infection. This procedure usually takes one to two hours to perform. Over 90% of patients who undergo the scleral buckle procedure experience a successful retina reattachment.
Although this procedure is considered safe for most patients, there are certain risks associated with any surgical procedures. Some of these risks may include infection, bleeding, increased fluid pressure, detachment of the choroid or repeated detachment. Patients can reduce these risks by choosing an experienced doctor and adhering to post-procedure instructions.