Retinal Detachment Surgery

Retinal detachment leads to the separation of the retinal cells from the blood vessels that provide nourishment and oxygen to the eye. 
Retinal detachment requires prompt treatment. The longer retinal detachment stays untreated, the more the risk of permanent loss of vision in the affected eye.

Causes and types:

The different causes and types of retinal detachments include:

1. Rhegmatogenous: This is the most common cause of retinal detachment that occurs when there is a small tear in the retina. The eye fluid, known as the vitreous, can travel through the tear to collect behind the retina. This causes the retina to push away and detach from the back of the eye. This type of detachment usually occurs as a patient gets older. As the vitreous thins and shrinks with age, it will pull on the retina and tear it.
2. Tractional: The scar tissue on the retina will pull it away from the back of the eye. It commonly occurs due to prolonged high blood sugar (diabetes) that can damage the blood vessels in the eye and result in the formation of scar tissue. The scars and traction areas may get bigger to pull and detach the retina from the back of the eye.
3. Exudative: The fluid will build up behind the retina even if there is no tear in the retina. As the fluid will collect, the retina will be pushed away. The different causes of fluid buildup include leakage of blood vessels or swelling behind the eye that could develop due to uveitis (eye inflammation).

Risk factors:

The following factors increase the risk of developing retinal detachment:

1. Age above 50 years
2. History of retinal detachment in one eye
3. Family history of retinal detachment
4. Myopia (nearsightedness)
5. History of severe eye injury
6. History of eye surgery, like cataract removal
7. History of eye disorders like lattice degeneration (thinning of the retina)

Symptoms

The symptoms of retinal detachment are:

1. Sudden appearance of floaters (small specks that drift through the vision field)
2. Photopsia (flashes of light in one or both eyes)
3. Blurred vision
4. Decreased peripheral (side) vision
5. Curtain-like shadow over the field of vision 

Diagnosis

1. Fluorescein angiography: The doctor uses a special dye and a camera to view the blood flow in the retina.
2. Tonometry: The pressure inside the eye can be checked using this test.
3. Ophthalmoscopy or retinal examination: The back part of the eye, including the retina, is examined by the doctor using an instrument with a bright light and special lenses. Retinal holes, detachment, or tears can be viewed by the doctor using this test.
4. Refraction test: The eyeglass prescription can be checked using this test.
5. Visual acuity: The doctor will check the smallest letters that the patient can read using this test.
6. Slit-lamp examination: The structures at the front of the eye can be evaluated using this test.
7. Ultrasound of the eye:  This test is performed if there is bleeding in the eye, making it difficult for the doctor to view the retina.

Treatment

Depending on the severity of the condition present, the doctor may recommend the following different types of retinal detachment treatments, which may include the following:

1. Laser surgery or photocoagulation:
2. This procedure is recommended if the patient has a tear or hole in the retina, but the retina is still attached.
3. The laser used will burn the tear site.
4. This results in scarring and fixation of the retina to the back of the eye.

Cryopexy:

• This method is also used to repair retinal tears.
• A freezing probe is used to close the retinal tears and hold the retina in place.

Pneumatic retinopexy:

• This procedure is preferred in patients having minor but multiple detachments.
• It is a surgical procedure involving the extraction of a small amount of fluid from the eye and the injection of air to form small bubbles.
• The bubble will push the retina back into its proper place to close the holes using laser photocoagulation or cryopexy.

Scleral buckling:

• This procedure is performed in severe cases of retinal detachment.
• The doctor will place a small, flexible band around the sclera.
• The band will gently push the sides of the eye towards the retina.
• This will reattach the retina and the band will permanently be left around the eye.
• A laser or cryopexy is then used to repair the tears and holes.

Vitrectomy:

• This type of surgery is used for larger retinal tears.
• It involves making a small incision in the sclera of the eye and inserting a microscope to obtain a clear view of the eye.
• The various abnormalities in the eye, like cataracts, scar tissues, or vitreous, will be carefully removed by the surgeon.
• The retina is then placed back in its position by using a gas bubble.
• The tears or holes are then frozen or burned.

Risks

The possible complications of retinal detachment surgery are:

1. Eye infection
2. Bleeding in the eye
3. Need for revision surgery
4. Increased eye pressure
5. Possible retinal detachment in the future
6. Incorrect retinal reattachment

After Procedure

1. Most patients can go home on the same day after retinal detachment surgery.
2. It is normal to have some discomfort after the procedure. 
3. The doctor will prescribe pain-relieving medications to relieve your discomfort.
4. You will need to wear an eye patch to protect your eyes for as long as the doctor recommends.
5. If a bubble is put in your eye, follow your doctor’s instructions on which position your head should be kept in and for how long to keep it in that position to help in healing the eye.
6. Your doctor will recommend using certain eye drops to clean the eyes and prevent infection.
7. About four to six weeks after surgery, you will start noticing improvement in your eyesight. It may take a couple of months before you recover completely.

Home remedies:

There are no home remedies to treat retinal detachment and it is important that you visit your doctor immediately if you notice any symptoms associated with retinal detachment.

Prevention:

Retinal detachment cannot be prevented. However, the following steps may be taken to lower the risk of retinal detachment:

1. Get regular eye checkups and dilated eye exams
2. Wear safety goggles or other eye protection wear while playing contact sports or doing other risky activities
3. Keep your blood sugar levels under control if you have diabetes
4. Get prompt eye treatment if you notice any retinal detachment symptoms 

Cost of Retinal Detachment Treatment in India- 

The cost of retinal detachment treatment using laser surgery or cryopexy is between INR 3,000 to INR 5,000 per eye.
The cost of retinal detachment treatment using other surgical methods in Mumbai is between INR 50,000 to INR 70,000.
The cost of retinal detachment treatment using other surgical methods in Delhi is between INR 45,000 to INR 65,000.
The cost of retinal detachment treatment using other surgical methods in Bangalore is between INR 45,000 to INR 65,000.
The cost of retinal detachment treatment using other surgical methods in Chennai is between INR 40,000 to INR 60,000.