Retina Surgery & Vitrectomy

Surgery is required to repair a detached retina. The procedure usually is performed by a retinal specialist — an ophthalmologist who has undergone advanced training in the medical and surgical treatment of retinal disorders. Generally, the sooner the retina is reattached, the better the chances that vision can be restored. Surgical procedures used to treat a retinal detachment include: Scleral buckling surgery. This is the most common retinal detachment surgery, and consists of attaching a small band of silicone or plastic to the outside of the eye (sclera). This band compresses (buckles) the eye inward, reducing the pulling (traction) of the retina and thereby allowing the retina to reattach to the interior wall of the eye. The scleral buckle is attached to the posterior portion of the eye and is invisible after surgery. Scleral buckling surgery often is combined with one of the following procedures to fuse the retina to its underlying supporting tissue (called the retinal pigment epithelium, or RPE). Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back onto the RPE. Pneumatic retinopexy. In this procedure, the surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the RPE. If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to "spot weld" the retina firmly onto the RPE and underlying tissues and thereby seal the tear. If a laser is used, this is called laser photocoagulation; use of a freezing probe is called cryopexy. Surgical reattachment of the retina isn't always successful. The odds for success depend on the location, cause, and extent of the retinal detachment, along with other factors. Also, successful reattachment of the retina doesn't guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.