If the retina becomes detached, it must be repaired surgically. Reattachment of the retina involves closing the retinal tear and preventing the retina from pulling away from the back of the eye again. Several surgical procedures can be used, but in each the surgery is designed to repair the tears or breaks to prevent fluid from getting under the retina. The surgical procedure used depends upon the severity of the detachment.
Laser photocoagulation: When there are small retinal tears, with little or no nearby retinal detachment, the tears are generally repaired with a laser. The surgeon uses a laser to make small burns around the edges of the tears. These produce scars that seal down the edges of the tears, thereby preventing fluid from passing through and collecting under the retina.
Cryotherapy: Freezing the back wall of the eye behind a retinal tear functions much like laser photocoagulation. It stimulates the formation of scar tissue and seals down the edges of the tear, so that fluid cannot pass through and collect under the retina.
Surgical repair: Once a significant amount of liquid has collected under the retina and separates it from the back of the eye, surgery is necessary to repair the detachment. The surgeon may need to drain the liquid from beneath the retina to allow the retina to settle back onto the wall of the eye. Laser photocoagulation or freezing may be used to seal the retinal tear. Sometimes a band or pad (scleral buckle) is used to keep the retina and the eye wall together until scarring seals the tears. In complex retinal detachments, it may be necessary to have a procedure called vitrectomy.
Most detached retinas can be reattached by modern surgical techniques. Occasionally more than one operation may be necessary. By reattaching the retina, blindness is prevented and some degree of vision is retained. The degree of vision that returns depends on several factors including the duration of the detachment and the condition of the retina.
