How to perform surgery for retinal detachment?

Written by Li Min
Ophthalmology
Updated on September 11, 2024
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Firstly, there are three types of retinal detachment: rhegmatogenous, tractional, and exudative retinal detachment. For rhegmatogenous and tractional retinal detachment, surgical treatment is generally adopted. There are two common surgical methods: one is external surgery, known as scleral buckling, and the other is internal surgery, involving vitrectomy with complex retinal detachment repositioning. The choice of surgical method requires assessment by an ophthalmology specialist before a decision can be made. Exudative retinal detachment is generally treated by addressing the underlying disease and does not require surgery.

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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.

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Can retinal detachment heal by itself?

Retinal detachment refers to the separation between the neural epithelial layer and the pigment epithelial layer of the retina. Based on its cause, it can be categorized into rhegmatogenous retinal detachment, tractional retinal detachment, and exudative retinal detachment. Rhegmatogenous retinal detachment requires repositioning of the retina and closure of the break. If it is tractional retinal detachment, it is necessary to remove the cause, generally requiring vitrectomy and retinal reposition surgery. Exudative retinal detachment generally occurs due to inflammation or other irritations causing exudation or bleeding in the retina, resulting in detachment, typically without retinal breaks. This type of retinal detachment only requires treatment for the underlying disease, and aggressive treatment of the primary disease can generally lead to a cure. Therefore, retinal detachment must be treated; it cannot heal on its own.

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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.

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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.

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Can retinal detachment be treated with laser?

Retinal detachment can also be treated with laser therapy. Retinal detachment is a common eye disease and a type of fundus disease. It is usually caused by eye trauma, or the development of dry breaks or degenerative areas in the peripheral retina. Patients with retinal detachment experience symptoms such as shadows obstructing parts of their vision, distorted vision, and decreased visual acuity. If the area of detachment is small, it can be treated with laser therapy to seal off the detached area, thereby preventing the condition from worsening. If the area of retinal detachment is large, it cannot be cured with laser therapy alone. Surgical treatment is needed to reposition the retina, and during surgery, laser treatment is also necessary to seal the tears or deformed areas on the retina to prevent recurrence of the detachment.