Treatment of Retinal Detachment

Retinal detachment is a medical emergency and need prompt as well as right (adequate and appropriate) treatment to save vision; otherwise it may lead to permanent blindness. Treatment of retinal detachment depends on the type of retinal detachment, number of openings (breaks) in the retina etc. In general the treatment of retinal detachment needs three principles to be followed, which are to find out the number of breaks (tears or openings), sealing of all the breaks and relieve present as ell as future vitreoretinal traction, which may appear later and cause retinal detachment in future.

There are some basic surgical procedures which are followed for treatment of retinal detachment depending on the type of retinal detachment. The surgical procedures which can be used for treatment of retinal detachment are cryopexy and laser photocoagulation, scleral buckle surgery, pneumatic retinopexy and vitrectomy.

Cryopexy and laser photocoagulation for treatment of retinal detachment:

These procedures are sometimes used in treatment of retinal detachment, when only a small area of retina is detached, to prevent further spread or widening of retinal detachment. Cryopexy is use of extreme cold to freeze the detachment and laser is used in laser photocoagulation to seal the detachment from further spread.

Scleral buckle surgery for treatment of retinal detachment:

This is a commonly used procedure for treatment of retinal detachment where one or more silicon bands are sewed to sclera. This procedure allows the retina to reattach by reducing vitreous traction by closing the break or by reducing the flow of liquid. Sometimes the accumulated fluid is drained from sub-retinal space before scleral buckle surgery. The common side effect after scleral buckle surgery is myopia which can also be managed appropriately.

Modifications may be required according to number of breaks, for example circumferential scleral buckle surgery is performed for multiple breaks, anterior breaks and wide breaks, and encircling scleral buckle surgery is done for breaks that cover more than two quadrant of retinal area.

Pneumatic retinopexy for treatment of retinal detachment:

This procedure is done under local anesthesia and as outpatient procedure. In this procedure a gas bubble is injected into the eye after cryopexy or laser photocoagulation is applied to the retinal hole. After that the head of the patient is positioned in such a way that the gas bubble rests against retinal hole. The retinal hole is slowly healed and the retina slowly moves back to its original position. The patient may need to keep the head in a particular position for several days, which makes this procedure less popular.

Vitrectomy in treatment of retinal detachment:

This procedure is gaining popularity. This procedure involves removal of vitreous humour and replacement with gas or silicon oil. If silicon oil is used it has to be replaced 2-8 months after the procedure. But, if gas is used it will be absorbed slowly in about few weeks time.

The disadvantage of using vitrectomy for treatment of retinal detachment is rapid progression of cataract after surgery in the operated eye.

Prognosis of treatment of retinal detachment:

Most (approximately 85%) of the treatment procedure of retinal detachment are successful. The remaining approximately 15% cases may need 2 or more operations. The vision recovers gradually in few weeks time. Visual acuity may not return to normal, especially if macula is involved in the detachment.

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2 Comments

  • Dave Kennedy July 20, 2011 07.34 am

    Excellent read, I just passed this onto a colleague who was doing a little research on that. And he actually bought me lunch because I found it for him smile So let me rephrase that: Thanks for lunch! Harry

    • admin July 20, 2011 11.22 am

      Thanks for passing the info to your friend. This will motivate me to write better.

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