Retinal detachment is a peeling away of the retina from the wall of the eye and is usually associated with high degrees of short sight. It can be associated with trauma and other, more unusual, injuries in the eye. Patients will often notice a shadow coming into the vision as, unfortunately, the retina peels away and function is lost.
We do have very successful techniques for surgical repair. In recent years, vitrectomy surgery has become the gold standard for the vast majority of retinal detachments.
What is the procedure for vitrectomy surgery?
Vitrectomy is carried out by making incisions in the eye as the patient is lying down in the theatre. The eye is not taken out of the eye socket but three small incisions are made in the whites of the eye (the sclera). This allows the surgeon to have access to space behind the lens where the jelly is removed from the eye. This then gives access to the retina itself where the surgeon can apply laser treatment, freezing treatment, suck out fluid from behind the retina and usually insert a bubble of gas to hold the retina in place.
The hole in the retina is the cause of the detachment. I may ask patients to lie in a certain position so that the bubble floats and presses on different parts of the retina, holding it in place while the freezing and laser treatment work and provide a long-term secure seal for the retina.
Unfortunately, without treatment, the majority of acute retinal detachment will result in complete loss of vision and surgery is fairly urgent. Therefore, if you do have any symptoms consistent with retinal detachment, which would include flashing lights, floaters, or a shadow in the vision, you must contact an optician or ideally an eye surgeon on an urgent basis, within a day.
What’s the success rate of vitrectomy surgery?
The success rate of vitrectomy surgery very much depends on the initial pathology, which determines the reason for removing the jelly. A simple vitrectomy because of, for example, vitreous floaters and debris with no other retinal pathology would have around a 98-99% chance of a very successful outcome with no complications.
Vitrectomy itself is now very much safer than it was 10-20 years ago. Additional complications, of course, arise when one has to do additional things to the retina. A retinal detachment is generally considered to have around 90% chance of successful reattachment on procedure. Macular hole surgery has around a 95% chance of a successful outcome with no significant problems.