Why Do I Need An Operation?
If treatment of retinal detachment is not sought, you have a very high chance of going blind in this eye. The eye may also become painful later.
Retinal detachment surgery is aimed firstly at preventing any worsening of your vision and secondly at recovering as much sight as possible. If you have a macula-on retinal detachment, successful surgery should help you keep good vision for the rest of your life.
If you have a macula-off retinal detachment, successful surgery should help you recover much, but not all, of your central vision, as well as practically normal peripheral vision. The central vision may also be distorted after retinal detachment surgery, but this usually gets better over the detached retina recovery period.
What Does Cryo-buckle Surgery Involve?
This surgery is usually performed under general anaesthetic as a day case. That is, you will be asleep and under the care of the specialist anaesthetist for the duration of surgery. You will be lying on your back throughout the anaesthetic and surgery.
After you have been anaesthetised, an iodine solution will be used to clean around your eye. After this, a plastic sheet (drape) will be used to cover your eye and face. A hole will then be cut in the drape over your eye, with a special clip used to hold it open for the duration of your retinal detachment treatment.
The time taken for this surgery takes an hour on average, the time taken is no indication of how well the operation has gone. At the end of the operation, you will have a pad and shield placed over your eye. The nurses will arrange for an appointment for you to return to the clinic in two or three weeks after your retinal detachment surgery.
When Should I Have My Operation?
Surgery for a macula-on retinal detachment is usually more urgent than for macula-off retinal detachments. However, there can be many different types of retinal detachment, with varying levels of urgency. Dr. Chauhan will advise you of when you should have your surgery.
If treatment of retinal detachment is not carried out within the recommended time period, the final vision is more likely to be worse, the surgery is less likely to work, and there is more chance of complications and further surgery being necessary.
How Is The Surgery Done?
This surgery consists of stitching a band of solid silicone rubber to the surface of the white of the eye (sclera) under the conjunctiva, which is the thin transparent layer covering the sclera. This material ‘buckles’ the sclera (wall) of the eye inwards. This pushes the retinal pigment epithelium (RPE) on the inside of the eye towards the detached retina within. Freezing treatment (cryo) is applied to set up a scar reaction, sticking the retina to the RPE around each tear.
The buckle is usually not seen after surgery, as it lies further back than expected, beyond the back of the base of the eyelids.
What Should I Expect After Surgery?
After receiving retinal detachment treatment, the operated eye may be uncomfortable. If necessary, you may take painkillers as you would for a headache. The eye is also likely to ache, especially when it is moved far off centre. Occasionally, stronger medication is required.
Stitches used during surgery can cause surface irritation (feeling like something is in the eye) and bright lights may be a little uncomfortable (wearing sunglasses is often helpful).
The eyelids may be swollen for a matter of days to a few weeks, and the upper eyelid may be a little droopy too.
The eye will be red and sometimes a pinkish watery discharge may be noticed on bedclothes. This is caused by tears mixing with some blood on the surface of the eye and is not dangerous.
How Long Will Detached Retina Recovery Take?
Detached retina recovery varies between patients and may depend on the many factors to do with the original detachment. Fluid under the retina may take several weeks to be absorbed and visual recovery may be slow, but can continue for a year or so. During this time, you will be reviewed at the clinic periodically.
What Should I Be Concerned About After Retinal Detachment Surgery?
If any of the following occur after you’ve received retinal detachment treatment, or if you’re concerned about any another matter after an operation on your eye, you should get in touch your surgeon urgently.
- Pain, particularly aching, deep pain.
- If your eye becomes more uncomfortable or painful than when your surgeon last saw you.
- If your vision worsens since your last appointment. In particular, if the top part of your vision, which slowly improves in normal circumstances, gets worse, you ought to be seen urgently.
- If a pus-like discharge develops at any time after the surgery, this requires urgent attention.
- If you become aware of new floaters, flashes of light or a shadow in your peripheral vision during the detached retina recovery period.
- Not all problems fit neatly into descriptions in a list like this. Dr. Chauhan and his staff prefer that his patients call with any questions they have rather than wait until their next appointment, even if they might seem minor or ‘silly’.
If Dr. Chauhan is the surgeon for your retinal detachment surgery, please call Vision Retinal Institute Eastern on (03) 9890 4333 during office hours. You will also have been given his mobile phone number to call; he will attempt to contact or see you as soon as possible. If he is unable to see you, he will make alternative arrangements for you to be seen by another retinal specialist.