Retinal Detachment

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Retinal Detachment


A transparent and viscoelastic substance called vitreous fills in the eyeball. This substance gives the eye a spherical shape and brings it elasticity. The vitreous gel exhibits tight attachments to the retinal layer in some areas.

As a result of advanced age, high myopia, some impacts to the eye or head trauma, the vitreous gel begins to liquefy and detach from the retina. During this separation, tears or hemorrhages may occur where the vitreous attaches to the retina. As a result of genetic predisposition, thinned degenerated areas sensitive to tearing may be present in the retina (lattice, tuft). Retinal tears can also form as a result of some traumas, cataract surgery or other eye surgeries.

Liquefied vitreous passing through these tears in the retina causes the retinal layers to detach from each other. Detachment and/or fluctuations together with degeneration of the vitreous in the retina, which is a nervous tissue, causes symptoms such as flashes of light, flying flies or spider webs. A curtain over the eye is mentioned when the retina, under which the fluid accumulates, is detached from the eye wall. As this detachment affects the macula, vision decreases to the sense of light.

If retinal detachment is not treated almost immediately, the fluid may advance through the retinal layers, causing detachment of the entire retina and permanent vision loss.

Retinal detachment may directly give symptoms such as rapid closure of vision without flying flies, flashes of light, loss in visual field, or any of these.

Flying flies, flashes of light, and the feeling of floaters may sometimes occur only in the presence of retinal tears without detachment. At this stage, the development of detachment can be prevented by attaching the periphery of the tear with a barrage laser without any fluid entering between the tear.

If retinal detachment has developed due to detachment of the retina from the eye wall; depending on the condition of the eye and the decision of the ophthalmologist, either standard retinal detachment surgery or vitreoretinal surgery (pars plana vitrectomy) surgery is decided. These surgeries are usually performed with general anesthesia. During the surgery, it is decided by the physician to perform intraocular tamponade with medical silicone oil or special medical gases. In the postoperative period, it may be necessary to maintain a certain position and lie down in that way for 7-10 days, which will be determined by the physician.

Repair of retinal detachment and tear with pars plana vitrectomy surgery

Until the tear can attach completely, sterile gas or air is injected into the eye and pressure is applied on the tear. After the operation, the patient is provided with a head and lying position so that the buffer gas can come over the tear.

In some cases, it may be necessary to apply compression to the (sclera with special materials for complete closure of the tear.
Retinal detachment most commonly occurs as a tear retinal detachment.
Tractional retinal detachment may also develop as a result of fibrotic bands pulling the retina from the inside, after retinal vascular diseases or some trauma-intraocular foreign bodies in diabetic retinopathy.
Exudative retinal detachments may develop in malignant and some benign intraocular tumors, intraocular inflammations called uveitis, eclampsia during pregnancy, renal failure and high systemic hypertension.
Anatomical success rate is very high after retinal detachment surgeries. The earlier the intervention, the higher the chance of success.
If the retina is damaged, growth factor injections outside the eyeball or monovision support can be applied after the surgery.