Surgery for a retinal detachment

introduction

Only surgery can effectively treat retinal detachment. Before the operation, it is important to maintain bed rest and keep your head strictly still to avoid further detachment of the retina.

surgery

In order to preserve and improve eyesight, the detached retina reattached.
This intervention usually happens under local anesthesia eye drop or injection next to or behind the eyeball (Para- or retrobulbar anesthesia), but can also be in general anesthetic respectively.

execution

During the operation, the Severed conjunctiva and the detached point of the retina was sought from the outside of the eyeball.
Then there are different ways to reattach the retina.
One of the methods is to dent the eyeball from the outside so that the retina almost attaches itself again. This Indentation comes with either a Plastic sealsewn to the dermis from the outside, or with a Lacing ring (Belt thread, cerclage), which is placed around the eyeball.
Another possibility is that Gas injection (pneumatic retinopexy). A special gas mixture is introduced into the inside of the eye. Depending on where on the eyeball the detachment occurs, the patient may need one after the operation certain head positioning adhere to this so that the gas can fix the retina again to the sclera and dermis. The gas is gradually absorbed by the body and disappears from the inside of the eye within a few weeks.
The two variants mentioned are in addition to one Laser treatment or one Cold treatment (Cryocoagulation) performed, with which the retina can be reattached to the base in the detached areas.
If an accumulation of fluid has formed under the retina, this fluid must often be sucked out with a fine instrument.
When the operation is complete, the initially severed conjunctiva is sutured again. Sutures can be used that dissolve by themselves or that are non-absorbable, which must then be pulled by the ophthalmologist after the suture has grown together.

Possible expansion of operations

By Complications or unforeseen additional difficulties During the operation it can happen that the selected surgical method has to be modified and additional measures have to be taken.

Complications

In the surgical treatment of retinal detachment, it can Secondary bleeding or Bleeding come.
Structures close to the eyes can be injured during the operation. By sewing the seal, for example, the Pierce the wall of the eyeball become.
Through the intervention on the eye you can Infections arise. It is also possible that this was caused by the procedure Increase in intraocular pressure negative on the retina and the sharpest point of sight (Macula) affects and so the Eyesight impaired becomes.
The operation can cause a repeated retinal detachment which then often occur together with Changes to Vitreous occurs. Sometimes it happens after the seal has been sewn Double vision. In part, the treatment leads to permanent deterioration in vision up to Blindness or that Loss of eye.
There are allergic reaction possible on the materials used, which may lead to the seal or threads having to be removed again.

forecast

The smaller the area of ​​detached retina, the better the chances of success.
If there are no vitreous changes, the prognosis is even better.
After the operation, vision improves in approximately 85% of cases.
Is the Macula (Point of sharpest vision) is also affected, the initial vision can rarely be completely restored.
Even after years there is still one Renewed retinal detachment possible and join around 20% of patients on.
Vitreous opacities represent another long-term complication. In addition, cords of connective tissue can develop that lead to a Displacement of the retina being able to lead.

Before the operation

Medicines that the Inhibit blood clotting, should be discontinued in consultation with the doctor. This is among other things at aspirin and Marcumar the case.

After the operation

The operation takes place mostly stationary. If the operation is to be carried out on an outpatient basis, the patient must be picked up because he Driving a motor vehicle is prohibited for 24 hours is.
Significant decisions and the operation of machines are also not legally permitted.
The freshly operated eye must be handled carefully and should be done in the days following the operation no strenuous physical activity be performed.
Depending on the type of operation, it must also bed rest adhered to and the Head held in a certain position become.
Ordered by the doctor Medication and Eye drops / eye ointments should be as recommended used regularly become.
If a gas mixture was introduced into the eye therapeutically during the operation, the patient must not be exposed to any major pressure fluctuations, such as those that occur when diving or flying.
If a follow-up operation of any kind is necessary, the attending anesthetist (anesthetist) must be informed that such an operation has been performed.
If there are any abnormalities, the doctor should be informed as soon as possible, as these can indicate complications and action must be taken quickly to preserve the eyesight.