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The most commonly performed retinal detachment surgery is a procedure called vitrectomy. In this procedure, the vitreous or the gel inside the eye is removed with a cutter and replaced with silicone oil or gas.
3 ports are made in the sclera of the eye and instruments are inserted into the eye to complete the procedure. One port is used for the infusion cannula. The continuous infusion of balanced salt solution helps to maintain the intraocular pressure inside the eye while vitreous is being removed. One port is used for the light pipe which throws light on the retina and one port is used for the cutter.
After complete removal of the vitreous, especially from over the retinal break, subretinal fluid is drained from the break and the retina is flattened. After this laser treatment or cryotherapy is done to the breaks. Finally the fluid is replaced with silicone oil or gas depending on the position of the breaks.
Finally the trocars inserted into the 3 ports are removed and the eye is closed. A patch is applied and the patient is given a position to sleep in for the next 24 hours.
No sutures are applied making it extremely comfortable for the patient. Patients usually do not have any discomfort from the 1st post-op day. However, operative positioning is extremely important to hold the retina in place.
Older procedures like scleral buckling and pneumatic retinopexy have very few indications today and are not discussed here.
The overall success rate of retinal detachment surgery has increased considerably over the years. If operated early the prognosis is much better than delayed surgery.