Surgery

In case only a hole in the retina is detected, which is the early stage of retinal detachment, a laser treatment (pneumatic retinopexy) is carried out. In this procedure, the retina surrounding the hole is sealed with the subjacent choroid, so that it cannot detach anymore.

If another disease such as an inflammation or a metabolic dysfunction is the cause of retinal ablation, the fundamental disease should be treated. Thus, exudative retinal detachment can sometimes degenerate without any surgical treatment of the eye. If not, then the detachment also has to be treated operatively.

The type of surgery depends on the severity of the alterations and the triggering cause.

1. Buckling retinal surgeries with a seal or band (cerclage) are conducted whenever a retinal tear can clearly be located as the trigger for the detachment. The aim of this surgery is to indent the area of the retinal tear by suturing a local silicone sponge or an encircling silicone band to the sclera, which will then permanently hold the retina in position. Additionally, the tear is sealed externally with a cryoprobe, which makes use of extreme cold to induce an inflammatory reaction and thus fix the tissue. This is called retinal cryotherapy.

2. Surgery of the vitreous humor, the so-called vitrectomy, is conducted if no retinal tear can be distinctively located or whenever tractional ablation is identified. In this procedure the vitreous humor including the membranes adhering to the retina are removed. Either a self-reabsorbing gas mixture or nonabsorbing silicone oil is injected into the eyeball to restore normal pressure and enable the retina to resettle onto the subjacent retinal pigment epithelium.