When the retina pulls away from the back of the eye, this is retinal detachment, an emergency situation requiring surgery to save the patient’s vision. At Wilkinson Eye Center, we are fortunate to have Dr. Cagri Besirli perform these surgeries. He is our retina specialist at Wilkinson. Dr. Besirli is a board-certified ophthalmologist and has completed fellowships specializing in disease and surgery of the retina and vitreous. Dial (248) 334-4931 today to schedule a retinal detachment surgery consultation at Wilkinson Eye Center and learn whether you are a candidate for treatment!
What is retinal detachment?
There are three different types of retinal detachment. Each requires surgery to save the patient’s vision.
- Rhegmatogenous — This is the most common form of retinal detachment. They are caused by a hole or tear in the retina that allows fluid to pass through and collect underneath the retina, pulling the retina away from the underlying tissues.
Rhegmatogenous detachment is usually caused by normal aging. As we age, the gel-like material that fills the inside of the eye, the vitreous, can change in consistency and shrink or become more liquid. This separation usually happens without incident, but one complication is a tear. As the vitreous separates or peels off the retina, it may tug on the retina with enough force to create a retinal tear. If not addressed, the liquid vitreous can pass through the tear into the space behind the retina, causing the retina to detach.
- Tractional — In people with poorly controlled diabetes and other conditions, scar tissue can grow on the surface of the retina. This scar tissue can cause the retina to pull away from the back of the eye.
- Exudative — In this type of detachment, fluid accumulates beneath the retina, but there aren’t any holes or tears in the retina. Exudative detachment can be caused by age-related macular degeneration, injury to the eye, tumors, or inflammatory disorders.
What is retinal detachment surgery?
If the retina has a tear or hole but has not detached, Dr. Besirli may perform two procedures: photocoagulation or cryopexy. Photocoagulation uses a laser beam directed into the eye through the pupil. The laser energy burns around the retinal tear, creating scarring that attaches the retina to the underlying tissue. Cryopexy uses a freezing probe applied to the outer surface of the eye directly over the tear. The freezing creates scar tissue that helps secure the retina to the eyewall.
If you have a detached retina, you’ll need surgery with Dr. Besirli soon after your diagnosis. Here are three methods he may employ:
- Pneumatic retinopexy — In this surgery, Dr. Besirli injects a bubble of air or gas into the center of your eye, the vitreous cavity. The bubble then pushes the area of the retina containing the hole or holes back against the outer wall of the eye. This stops the flow of fluid into space behind the retina. Cryopexy may then be used to repair a break in the retina. Fluid under the retina is absorbed and the retina can then adhere to the wall as it formerly did. Patients usually need to hold their head in a certain position to keep the gas bubble in the proper position; this may be required for a period of several days.
- Scleral buckling — In this method, Dr. Besirli sutures a piece of silicone material to the white of your eye (the sclera) over the affected area. This procedure indents the wall of the eye and relieves some of the force caused by the vitreous tugging on the retina. If you have several holes or tears, Dr. Besirli may place silicone around the entire eye, similar to a belt. This doesn’t affect vision and is usually placed permanently.
- Vitrectomy — In a vitrectomy, Dr. Besirli removes the vitreous along with any tissue that is tugging on the retina. Air, gas, or silicone oil is then injected into the vitreous space to help flatten the retina back against the wall. Eventually, the air, gas, or liquid will be absorbed, and the vitreous space will refill with body fluid.
How long is recovery after retinal detachment surgery?
Your recovery depends upon the method of surgery used. Each of the three procedures for a detached retina has different timelines, but the overall range for recovery is from two to six weeks.
- For pneumatic retinopexy, the recovery time is approximately three weeks. The most difficult part of this recovery is the need to maintain a specific head position for several days to keep the bubble in place long enough to repair the detachment.
- For scleral buckling, it is approximately two to four weeks. You’ll need antibiotic eyedrops to reduce the risk of infection, and you’ll likely wear an eye patch for a short period of time.
- For vitrectomy, recovery time is approximately four to six weeks. These procedures have the least involved recovery from a standpoint of what you need to do.
During your consultation, we will discuss your recovery in detail.
Does Retinal Detachment Happen Suddenly?
The retina may detach suddenly or gradually. It is important to know the signs of this condition so you can obtain care in an appropriate timeframe. Retinal detachment that occurs suddenly may present as an immediate, strong onset of floaters and flashes that appear in your field of vision. If floaters and flashes are something you experience occasionally, a marked increase in them could indicate retinal detachment. Additional signs of this condition include shadowing that occurs in your peripheral vision, distorted vision, or the sensation of having a curtain pulled over your eyes. If you experience any of these symptoms, contact your ophthalmologist right away.
What Causes Retinal Detachment?
The retina is a small piece of tissue that attaches to the back of the eye. There are two reasons that this tissue may pull away from its normal position. One is that there is a tear or hole in the retina that allows vitreous fluid to leak into the area behind the tissue. Another cause is tugging on the retina due to age-related changes in the vitreous fluid at the center of the eye. Now, while age is one factor that influences the risk of retinal tears, holes, and detachment, there are other causes that may instigate this separation. The most common include diabetes, macular degeneration, and an injury to the eye.
What Type of Anesthetics Will Be Used During the Procedure?
Thanks to advances in surgical techniques over the years, the surgical treatments for retinal detachment are now performed on an outpatient basis. Before the procedure, the doctor will administer anesthetic eye drops that numb the eye. This makes the procedure pain-free. In the vast majority of cases, the use of this topical anesthesia is sufficient for complete comfort for the duration of the short procedure. If you are concerned about how you will feel for your retinal repair, talk to the doctor. It is important to us that you have peace of mind as your treatment day approaches.
How Long Can Retinal Detachment Go Untreated Before I Need Surgery?
The best way to view retinal detachment is as an emergency condition that requires immediate attention. The consequence of retinal detachment could be irreversible vision loss. This can happen in days or weeks. We cannot know the answer to this question until we have examined your eye thoroughly and can measure the extent of detachment that has occurred.
How Will My Eye Look and Feel After Retinal Detachment Surgery?
Your eye may be covered with a shield or patch of some sort after your procedure is done. When you remove the patch to clean the area as directed by the doctor, you can expect to see bruising and swelling. Your eyelid may look puffy and droopy. The white of your eye may look very red and you may notice some blood if you wipe your eyelid. Additional surgical side effects can include a runny nose and watery eyes. Discomfort should also be expected after the anesthetic wears off. It is beneficial to take your pain reliever strictly as directed on the label to maintain an optimal comfort level. Your bruising and puffiness will improve gradually over one to two weeks.
What Can I Expect in Regards to My Vision After Retinal Detachment Surgery?
Retinal detachment causes damage to your vision. After surgery, it can take weeks or months for distortion and blurriness to resolve. Until that time, it is nearly impossible to predict the full outcome of your retinal detachment surgery. The vision in your treated eye should not affect vision in your other eye. However, relying solely on one eye for some time, you may feel slight strain now and then. It is important to rest when needed so your good eye does not get overly fatigued.
How long before I can return to normal activities after retinal detachment surgery?
Expect at least 4 to 6 weeks for most normal activities, although there can be wide variation with the patient. The key is to avoid increasing blood pressure to the face and eyes through strenuous exercise or activity or heavy lifting. Dr. Besirli will clear you for activities as he follows your recovery.
When is retinal detachment surgery needed?
If you have a detached retina, you’ll likely need surgery right away to raise the odds of saving your sight in that eye. This isn’t usually an optional procedure, as delaying any decision will likely lead to permanent damage to your vision.
If you only have a retinal hole or tear, but your retina has not detached, you may avoid surgery with the two methods discussed above, photocoagulation or cryopexy.
What are the risks involved with retinal detachment surgery?
These are surgical procedures, so there are some of the risks involved with any surgery, such as excessive bleeding or infection. Specific to retinal detachment surgery, these are the risks:
- Your vision may not be fully returned.
- The detached retina may not properly adhere, requiring further surgery.
- You may have an increase in intraocular pressure inside your eye, which can eventually damage the optical nerve.
Call Wilkinson Eye Center For Retinal Detachment Surgery
If you’re interested in learning more about retinal detachment surgery please contact us for a consultation at (248) 334-4931 or fill out our contact us form. We will discuss your needs and concerns, and determine your best course of action.