In case of a retinal detachment, the surgery should be done as soon as possible because it increases the chance of good visual acuity in that eye. There are several types of surgeries and your surgeon will decide which procedure is the best for you.
If the retina has not yet started to detach, but there are only tears and if the patient came as soon as they noticed the first symptoms, the occurrence of the detachment can be prevented by a laser. Then, small burns are made around the tear in order to “weld” the retina back to its place.
However, it is usually necessary to perform the surgery called vitrectomy which implies the removal of the vitreous body from the inside of the eye. During the vitrectomy, an eye surgeon makes a small incision in the sclera, then, using a small instrument, penetrates the eye and removes the vitreous body, the gelatinous mass that fills most of the space inside the eye and gives the eye its round structure. Upon that, gas or oil is placed inside the eye as a substitute to the vitreous body in order to return the retina to its proper position, because they mechanically push the retina back towards the eyewall. In the following period, the eye generates liquid that gradually replaces the gas within 2 to 8 weeks, whereas a balloon of silicone oil requires a subsequent minor surgery during which the oil is removed from the eye. The vision is blurry in the period of the air or oil presence.
In order for the surgery to be successful, it is necessary to follow the advice of the physician regarding the head position during the following ten days, which implies a certain positioning of the head in order to have the oil balloon support the retina in the best manner. This can present the hardest part of the recovery after the surgery, but it is very important and needs to be perceived as the second part of the surgery.
This surgery is usually done in local anesthesia. You are awake all the time, but you will feel no discomfort. You will not see the surgery and the other eye will be covered.
The degree of the visual acuity after the surgery is not always possible to be predicted. Sometimes a couple of months are necessary in order to get the final result. Even under the best circumstances and after multiple attempts, each patient is different, and some retinal detachments are harder to be treated than others. On some occasions, even after successful surgery, the visual acuity does not become satisfactory. The result is the best if the patient has surgery before even the macula (the part of the retina in a change of the fine, precise vision) gets detached. Because of that, it is of great importance to immediately contact your eye doctor if you notice a sudden or gradual increase in either the number of “floaters” and/or light “flashes” or dark curtains over the field of vision.
The greatest benefit of this surgery is certainly the prevention of blindness of the affected eye. Modern surgery can successfully treat an enormous percentage of retinal detachments, although sometimes it is necessary to perform a re-operation. The success rate of retinal surgery is 90% for one operation, so one in ten patients requires re-operation. The reason for that is new retinal tears that are created by the scar tissue pulling the retina. Usually, the cataract surgery is performed together with the retinal detachment surgery and an artificial lens is inserted into the eye.
