Rhegmatogenous retinal detachment affects 1 in every 10,000 people each year, and both eyes can be affected in about 10% of cases. Retinal detachment is characterized by the presence of a peripheral retinal rupture that is kept open by the traction of the internal gel of the eye, which allows for the accumulation of fluid under the retina and the subsequent retinal detachment
More than 40% of all retinal detachments occur in patients with myopia. The risk is inversely proportional to the prescription, meaning that patients with higher myopia have a greater risk of retinal detachment. Before a retinal detachment, these patients may present with lesions such as tears or holes in the retina that can only be diagnosed during a consultation with a specialist.
Photo: “Retinal Tear”.
Myopic patients that have had corrective surgery are still at risk of a retinal detachment because this type of refractive surgery only modifies the cornea or lens that is found in the front of the eye (whereas the retina is located in the back of eye).
The main symptoms described by 60% of patients with retinal detachment are floaters and flashes (lights). As time goes by, the patient begins to notice blurred vision or a black curtain, until the patient loses all vision.
Photo: “Traumatic Retinal Detachment, Superior tears.”
The main procedures to treat problems affected the retina include: pneumatic retinopexy, scleral buckle, and vitrectomy.
Pneumatic retinopexy or pneumopexy is an outpatient procedure in which a gas bubble is used that expands inside the eye to close a retinal rupture and adhere the retina without opening the eye. It can be performed in the office and is minimally invasive but the success rate is lower than scleral buckling or a vitrectomy (described below). This procedure is usually reserved for the treatment of uncomplicated detachments with a small superior retinal rupture.
Photo: “Dr. Moreno perfoming a scleral buckle procedure”.
The scleral buckle is a surgical procedure in which a sponge or band is sutured to the walls of the eye creating an indentation or internal depression. The purpose of this procedure is to close retinal breaks by positioning the wall of the eyeball to the retina and to reduce the traction of the internal gel that caused the break. The scleral buckle is placed around the entire circumference of the eye to create a 360 degree closure.
Although the majority of retinal detachments are simple and can be satisfactorily treated with a scleral buckle, a vitrectomy offers a greatly improved prognosis for more complex detachments. A vitrectomy is a surgery performed inside of the eye using ports through which light, cut, and suction probes enter. A vitrecomy is suggested in cases where the retinal breaks can not be visualized, and in cases of retinal detachments in which the retinal breaks can not be treated with a scleral explant in a single procedure (which are usually detachments involving giant tears or posterior tears).
Photo: "Retinal detachment during vitrectomy."
Photo: "Three weeks after vitrectomy."
MAKE SURE TO VISIT A RETINA SPECIALIST IF YOU A HISTORY OF ANY OF THE FOLLOWING CONDITIONS: