Introduction
Only through surgery is it possible to effectively treat retinal detachment. Before the operation it is important to keep bed rest and keep the head strictly still to avoid further retinal detachment.
Operation
To maintain and improve vision, the detached retina is reattached during the operation. This procedure is usually performed under local anesthesia with eye drops or injections next to or behind the eyeball (para- or retrobulbar anesthesia), but can be performed under general anesthesia in exceptional cases.
Implementation
During the operation the conjunctiva is cut through and the detached part of the retina is searched for from the outside of the eyeball. Then there are different ways to reattach the retina. One of the procedures is to dent the eyeball from the outside, so that the retina reattaches itself virtually by itself.
This denting is done either with a plastic seal, which is sewn to the sclera from the outside, or with a lacing ring (belt thread, cerclage), which is placed around the eyeball. Another possibility is the introduction of gas (pneumatic retinopexy). Here, a special gas mixture is introduced into the interior of the eye.
Depending on where the detachment is located in the eyeball, the patient must maintain a certain head position after the operation so that the gas can then fix the retina back to the choroid and sclera. The gas is gradually absorbed by the body and thus disappears from the inside of the eye within a few weeks. The two variants mentioned above are carried out in addition to laser treatment or cold treatment (cryocoagulation), with which the retina can be reattached to the base in the detached areas.
If a fluid accumulation has formed under the retina, this fluid must often be sucked out with a fine instrument. When the operation is completed, the conjunctiva that was initially severed is sutured again. Sutures that dissolve by themselves or non-resorbable sutures can be used, which must be removed by the ophthalmologist after the suture has grown together.
