Opthamology
Retinal Detachment Surgery Treatment
Retinal Detachment Surgery
The retina present in the eye is the light-sensitive layer of nerve tissue that lines the inside of the eye and the retina sends the visual messages to the brain via the optic nerve. A retinal detachment occurs when the retina present in the eye becomes separated from the rest of the layers of the eye. This generally results after an individual develops a tear in their retina.
What is Retinal Detachment?
The retina present in the eye is the light-sensitive layer of nerve tissue that lines the inside of the eye and the retina sends the visual messages to the brain via the optic nerve. A retinal detachment occurs when the retina present in the eye becomes separated from the rest of the layers of the eye. This generally results after an individual develops a tear in their retina. The extent of permanent damage usually depends on how much of the patient’s retina becomes detached and whether or not the center of their retina has become detached. The macula consists of the special nerve cells that provide the sharp central vision required for viewing the fine detail (driving and reading etc.). If a person’s macula has become detached from its original position, the patients have a poorer visual prognosis and the patients may not regain perfect vision to driving or reading with that eye even if the operation is a success.
Who's at Risk?
The people who are more likely to get one the retinal detachment if:
- A person is severely nearsighted
- A person have had cataract surgery or an eye injury
- A person has a family history of retinal detachment
What Are the Symptoms?
A detached retina does not hurt. The retinal detachment can occur with no warning at all. But a person might notice the following:
- Flashes of light
- Seeing lots of new "floaters" (threads or small flecks)
- Darkening of the side (peripheral) vision
If a person has any of those symptoms, they must contact the eye doctor immediately.
Can You Prevent a Detached Retina?
Sometimes the detached retina can be prevented. The patients must get to their eye doctor immediately if the patients view flashing lights, develops new floaters, or notice any other changes in their vision. Early is always better than late when it comes to treating retinal detachments, tears, or any other serious issues. An eye exam can also show an early change in their eyes that a person may not notice. The patients must get their eyes checked once a year or more repeatedly if patients have problems like diabetes that make the patients more likely to have eye disease. Regular eye exams are also important if an individual is very nearsighted. This increases the possibility of having the retinal detachment. If the people have high blood pressure or diabetes, they must keep these conditions under control. By keeping these conditions under control the blood vessels present in the retinal remains healthy. The patients must wear eye protection if required. If the patients play racquetball or any other sports which could harm their eyes must try wearing sports goggles with polycarbonate lenses. The patients may also require special glasses if the patients work with chemicals, machines, or tools for their job or at home.
Surgical Procedure for the Retinal Detachment
The patient’s retinal detachment surgery is likely to involve a scleral buckling and/or vitrectomy surgery. A scleral buckling surgery involves positioning a silicone band around the patient’s eye under the eye muscles for bringing in the walls of the patient’s eye. This elongates the patient’s eye and makes them more nearsighted. A vitrectomy surgery requires the making of three holes in the eye and use of the instruments for removing the jelly-like substance (called as the vitreous humor) that usually fills up the center of the eye. The removal of the vitreous present inside the human eye does not cause any permanent harm. The vitreous is replaced with the natural fluid produced inside the human eye. The retina is then reattached and all retinal tears surrounded by the use of the laser. Then the eye is filled with an inert gas for keeping the retina in position as the retina heals. The gas bubble will be dissipated from the patient’s eye within 4 to 6 weeks. The patients should not fly on an airplane or undergo general anesthesia with nitrous oxide gas while a gas bubble is present in their eye. The surgeons will place a green bracelet around the patient’s wrist indicating this after surgery; the patients should not take off the bracelet until the gas is being dissipated from their eye. In some of the cases, the surgeons may use silicone oil instead of the inert gas. Retinal reattachment surgery generally required at least two hours for the completion. It is usually performed under the local anesthesia so that the patients remain awake and are comfortable during the surgery and have minimal complications due to anesthesia postoperatively.
Risks of Retinal Detachment Surgery
There are various risks associated with retinal detachment operation that the patients must be fully aware before the patient heads to the surgery. The most common risks are as follows:
- 1 in 1000 risk of infection (endophthalmitis): Any surgery that is performed on the eye there is always a possible complication of the infection. Sterile technique is used during the surgery for minimizing the risk of infection. Despite using the sterile technique, there is still a very small chance that an infection can be caused. If such an infection does occur it can be treated, but it may leave the patients with even worse vision or in the worst cases the infection can lead to blindness.
- 1 in 1000 risk of bleeding: Any surgery done on the eye bleeding can lead to a possible complication. The bleeding can occur in or around the eye and lead to permanent vision loss. The surgeons will review any medicines that the patients are taking before the surgery to ensure that the patients are not taking any blood thinners that can increase the risk of bleeding.
- Progression of cataract: If the patients have not yet had a cataract operation, having vitrectomy surgery will increase the progression of the cataract in the eye which was operated.
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