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Retinal detachment
Retinal detachment refers to the condition where the retina pulls away from its normal position.
The structure of the human eye consists of three layers: the sclera, the choroid, and the retina. Retinal detachment is not actually a separation between the retina and the choroid, but rather a separation between the neural epithelial layer and the pigment epithelial layer of the retina, which means it is a detachment between the inner nine layers and the outermost layer of the retina. Retinal detachment can be classified into three types: rhegmatogenous retinal detachment, which is mainly caused by a tear in the retina allowing the vitreous fluid to enter the subretinal space; tractional retinal detachment, which occurs due to vitreous and retinal proliferation exerting traction on the retina, commonly seen in diabetic retinal detachment; and exudative retinal detachment, which is caused by accumulation of fluid between layers due to abnormal choroiditis.
When is the second surgery for retinal detachment?
The question you asked is about when the second surgery for retinal detachment should take place, which implies that the first surgery for retinal detachment failed, necessitating a second surgery. Due to the proliferation of the retina, which generally peaks around two to three weeks, it is recommended that if the first surgery fails, the second surgery should be conducted about 10-14 days after the first surgery, which is about half a month later. This timing can help reduce the failure rate of the surgery and avoid the peak proliferation period of the retina.
Can you take a plane with a detached retina?
Retinal detachment and flying are divided into pre-surgery and post-surgery considerations. Before retinal detachment surgery, it is generally permissible to fly, as this typically does not significantly impact the symptoms of retinal detachment. However, what occurs after the surgery must be considered. If, after surgery, only silicone oil is used as a filler, flying is permissible as it does not affect pressure changes. However, if an inert gas is used as a filler after retinal detachment surgery, it can expand due to changes in air pressure at high altitudes. This expansion increases its volume, which can alter the internal pressure of the eye, potentially compressing the eyeball and the retina, leading to ischemia of the central retinal artery. In such cases, where inert or expansible gases are filled within the eye, flying is not advisable until the gas has dissipated.
What is the vision like after the removal of silicone oil for retinal detachment?
Silicone oil is temporarily used to support the retina in our eyes, and its refractive power is roughly equivalent to that of a 600-degree pair of glasses. Thus, if you are not myopic, you might become nearsighted after the silicone oil is used. After the retina detaches and the silicone oil is removed, the vision mainly depends on the function of the retina, which has no relation to the silicone oil. Just as with myopia, wearing a pair of glasses might change the vision, but once the glasses are removed, the vision will revert to the retina's vision. Therefore, it mainly depends on how much vision was left before the retina detached. The recovery of the retinal function and the optic nerve function is related, and this doesn't have much to do with the silicone oil. The vision primarily depends on the remaining function of the retina.
Symptoms of secondary retinal detachment
The symptoms of a secondary retinal detachment are actually not much different from the first detachment; it's like a fixed shadow. Therefore, if you have ever experienced retinal detachment, you can cover one eye and use the other eye to check the visible range. Remember what range you can see now and then pay attention to any changes in the future. This way, you can clearly understand the changes in your field of vision. In the early stages, there may be an increased sensation of flashing lights or some floating dark shadows, so if these symptoms appear, it is important to go to the hospital for an examination.
Can you swim after retinal detachment surgery with a lens implant?
Retinal detachment and having an implanted lens means you cannot swim, and if you wish to swim, it must be at least six months later. There are generally two types of surgeries for retinal detachment: vitrectomy with retinal repositioning, and scleral buckling. If a lens has been implanted, it means the natural lens was removed and replaced with an artificial lens. Therefore, after surgery, it is important to rest properly, maintain correct posture, attend timely follow-up appointments, monitor visual recovery and eye pressure, and use eye drops as prescribed.
Is retinal detachment a minor surgery?
Retinal detachment surgery is considered major surgery in ophthalmology, where retinal detachment refers to the separation of the retinal neuroepithelium from the pigment epithelium. There are many surgical methods for retinal detachment, including external scleral buckling, internal vitrectomy, gas injection into the vitreous, and the use of silicone oil, among others. Generally, internal procedures carry a greater risk than external ones. Retinal detachments can be categorized into rhegmatogenous retinal detachment and non-rhegmatogenous retinal detachment. Rhegmatogenous retinal detachment usually requires surgical treatment and is commonly seen in cases of high myopia, artificial intraocular lenses, aphakia, and ocular trauma that cause retinal detachment. Non-rhegmatogenous retinal detachment can be divided into tractional retinal detachment and exudative retinal detachment. Tractional retinal detachment often requires surgical treatment, whereas exudative retinal detachment usually does not require surgery.
Can a retinal detachment be treated after one year?
If retinal detachment is discovered or diagnosed only after a year, the effectiveness of surgical treatment tends to be poorer. However, if there is no eyeball atrophy, no corneal, lens, or vitreous abnormalities at this time, surgery to reposition the retina can still be considered first, followed by assessment of vision recovery. Additionally, an ophthalmic examination should be conducted, including tests like uncorrected visual acuity, corrected visual acuity, intraocular pressure, ocular B-ultrasound, and fundus photography, to decide and predict the outcome of the surgery and post-operative conditions. Nevertheless, even if a year has passed since the retinal detachment occurred, active treatment should still be pursued, and one should not give up.
Causes of Retinal Detachment
Retinal detachment can be categorized into three main types: rhegmatogenous, tractional, and exudative. Rhegmatogenous retinal detachment is commonly seen in the elderly, highly myopic individuals, those having undergone trauma to the eye leading to the absence of the natural lens or having artificial lens implants, and those with a history of retinal detachment or a family history of the condition, which are risk factors. Tractional retinal detachment is caused by proliferative membranes pulling on the retina. It is observed in conditions like diabetic retinopathy, central retinal vein occlusion, and other ischemic retinal diseases leading to neovascular membranes, or due to proliferative scarring from penetrating eye injuries. Exudative retinal detachment typically occurs in conditions such as Coat’s disease, uveitis, and malignant hypertension.
How many days does retinal detachment surgery take?
Retinal detachment surgery is divided into internal and external approaches. Generally, the surgery takes about one to two hours, or two to three hours. One method involves compressing from the outside of the eardrum, pushing the eardrum inward to reattach the retina, while the other involves operating from inside the vitreous body outward to adhere the retina to the choroid. The recovery time for these surgeries generally reaches a stable condition from one to three months. The duration of the surgery depends on the complexity of the condition; it can be as quick as just over half an hour in simple cases, or up to two to three hours in complex cases. Postoperative vision recovery primarily depends on the duration and morphology of the retinal detachment, as well as the proliferation conditions of the detached retina and the vitreous body.