When is the second surgery for retinal detachment?

Written by Li Zhuo
Ophthalmology
Updated on September 09, 2024
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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.

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Written by Peng Xi Feng
Ophthalmology
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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.

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Written by Hu Shu Fang
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Is retinal detachment serious?

Retinal detachment is a very serious disease that affects vision, causing a black fog to appear in front of the eyes that significantly impairs visual function. If retinal detachment is not treated promptly, the eye will gradually lose vision until it finally loses all perception of sight. There are currently three causes of retinal detachment. The common cause is rhegmatogenous retinal detachment, which refers to the appearance of a tear in the retina leading to its detachment. Another type is tractional retinal detachment, commonly seen in diabetic retinopathy and other proliferative retinal disorders, where the retina is pulled away. There is also exudative retinal detachment. All require careful examination by a qualified doctor followed by timely treatment.

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Written by Li Zhen Dong
Ophthalmology
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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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Written by Li Zhuo
Ophthalmology
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Treatment methods for retinal detachment

Retinal detachment surgery primarily refers to the treatment of rhegmatogenous retinal detachment. There are two methods of treatment: one is external surgery, also known as scleral buckling. This involves using a compressive object to indent the sclera to support the choroid, and then employing cryotherapy to create a sterile adhesion between the choroid and the retina, thus treating the retinal detachment. Another method is internal surgery, also known as vitreoretinal surgery. This procedure involves making three incisions in the flat part of the sclera, removing the vitreous from the inside, flattening the retina with heavy water, and using a laser to create a sterile adhesion between the retina and the choroid. Currently, the surgical treatment for retinal detachment consists of these two approaches: internal and external surgeries.

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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.