Retinal Detachment Surgery
What is a Retinal Detachment?
The retina is the light-sensitive layer of nerve tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. A retinal detachment occurs when the retina becomes separated from the rest of the layers of the eye. This usually occurs after you develop a tear in the retina. The extent of permanent damage depends on how much of the retina is detached, whether the centre of the retina (the macula) is detached, and the duration for which retina remains detached. The macula is made up of special nerve cells that provide the sharp central vision needed for seeing fine detail (reading and driving etc.)
Why do I have a Retinal Detachment? What are the symptoms?
A retinal detachment occurs when a tear forms in the retina allowing fluid to get under the retina forming a detachment. They are more common in patients who are very near- sighted(high minus number glasses for distance), have a family history of retinal detachment, and in eyes that have had prior trauma or eye surgery. Patients often complain of flashes, multiple new floaters (black spots or threads moving in the eye) and a shadow/ curtain forming in their vision when a retinal detachment occurs.
Assessment for Retinal Detachment
We can detect a retinal detachment during an eye examination by a procedure called indirect ophthalmoscopy. Your surgeon will carefully examine your eye to identify all the retinal tears and determine the extent of the retinal detachment. He may need to gently press on your eye to examine your retina fully. He will then discuss with you an appropriate surgical plan to most safely and effectively reattach your retina.
Surgical Procedure
Your retinal detachment surgery will likely involve a scleral buckling and/or vitrectomy procedure. We use the most advanced surgical equipment and techniques available for retinal detachment surgery.
A scleral buckling surgery involves positioning a silicone band around your eye beneath your eye muscles to bring in/indent the walls of your eye.
A vitrectomy surgery involves making 3 tiny openings in the eye and using instruments to remove the jelly-like substance (the vitreous humour) that normally fills the centre of the eye. The removal of the vitreous inside the eye does not cause any permanent harm. The vitreous is replaced by natural fluid produced inside the eye. The retina is then reattached, and all retinal tears surrounded by laser.
Retinal reattachment surgery usually takes one-two hours to perform. It is typically performed the under local anesthesia so that you are awake and comfortable during the procedure and have minimal complications from anesthesia postoperatively. If you are awake, it is very important for you stay still during surgery.
What should I expect following surgery?
After the surgery you will have an eye shield placed on your eye. Do not remove this shield until we see you in the clinic the following day when we will remove it for you. You will be given instructions on which eye drops/ medications to use and any other restrictions if required. You do not need to use any eye drops the night of your surgery. Please bring all your eye drops to your first postoperative visit.
You may need prone positioning(sleeping with your stomach/chest side down or sitting with your neck bent and face towards the floor) for a few days after surgery. Your surgeon will review appropriate head positioning with you and your family members after surgery. It is very important that you maintain the position as instructed or your retina will be at a higher risk of detaching again.
The amount of vision regained depends on the factors mentioned earlier (under what is retinal detachment) and on the aggressiveness of the healing capacity of your retina.
