What is retinal surgery?

Retinal surgery treats a range of conditions that affect the retina of the eye and can reduce your vision. Read on to learn which eye diseases retinal operations can treat and what you can expect from retinal surgery.

What is the retina?

The retina forms the curved back wall of the eye and contains cells that detect light. These cells relay light signals to the brain, allowing us to see.
Key parts of the eye that are relevant to the retina include the macula – which is the central point of the retina that is responsible for central vision and most colour vision – and the vitreous, which is a jelly-like fluid in front of the retina. Retinal conditions can affect the retina, macula or vitreous.

What conditions can retinal surgery treat?

Some conditions can cause damage to your retina, and a retinal operation may be required to treat the condition. These retinal conditions include:

• Macular degeneration
• Diabetic retinopathy
• Retinal vein occlusion
• Retinal detachment
• Retinal tear
• Macular hole
• Epiretinal membrane (macular pucker)
• Eye floaters

What are the types of retinal surgery?

Retinal laser surgery

Retinal laser surgery, which includes laser retinopexy, photodynamic therapy and laser photocoagulation, uses a precision laser to treat the affected area of the retina to treat disease. Laser photocoagulation can be used to manage disease progression in diabetic retinopathy by treating leaking or abnormal blood vessels in the retina. It can also treat retinal vein occlusion and macular oedema. Laser retinopexy can be used to treat retinal tears.¹

Photodynamic therapy is a retinal surgery that treats a kind of macular degeneration called wet age-related macular degeneration. During photodynamic therapy, a light-sensitive medicine is injected into the bloodstream. Next, a laser is pointed at the macula to activate the medicine and slow the progression of macular degeneration.

Unlike other types of retinal surgery that take place in day hospitals, retinal laser procedures may be performed in the ophthalmology clinic.

Vitrectomy

A vitrectomy is a keyhole retinal operation where some or all of the vitreous (a gel-like fluid inside the eye) is removed and replaced with a bubble of gas, sterile saline or silicone oil. Generally, vitrectomy can be performed as a day surgery procedure that takes 30–45 minutes.

Vitrectomy can be an effective treatment for:

• Retinal detachment
• Macular hole
• Epiretinal membrane (macular pucker)
• Severe eye floaters.

Pneumatic retinopexy

A pneumatic retinopexy is a two-part retinal surgical procedure that can treat retinal tears and retinal detachment.² During the pneumatic stage, a gas bubble is injected into the vitreous of the eye to press the retina against the back wall of the eye. During the retinopexy stage, a focused laser or freezing treatment is used to seal the retina against the retinal wall.

Scleral buckling

Scleral buckling (also known as scleral buckle surgery or cryo-buckle surgery) is a surgery used to treat retinal detachment. During scleral buckle surgery, a sterile band of silicone rubber is wrapped around the outer surface of the eye and stitched into place where it cannot be seen. This silicone ‘buckle’ creates pressure within the eye that pushes the detached retina against the back wall of the eye.³ A freezing (cryo) treatment may then be administered to bind the retina to the back of the eye.

How serious is retinal surgery?

The seriousness of a retinal operation varies depending on the condition the retinal surgery is treating and its severity. In the case of a sudden retinal detachment that has caused complete vision loss, the retinal operation would be an immediate, emergency surgery to save vision. Some retinal surgeries may be administered urgently or semi-urgently, such as retinal laser surgery for a retinal tear. For many other retinal conditions, retinal surgery is a routine and planned treatment.

When providing recommendations for retinal surgery, your doctor will advise you of the seriousness and urgency of the retinal operation.

What happens during retinal surgery?

There are multiple types of retinal operations available and what happens during your surgery will vary based on the specific retinal operation you have. Before surgery, your ophthalmologist will inform you of what is involved in the procedure and any specific risks, benefits or alternatives to consider.

What are the risks of retinal surgery?

As with any surgical procedure, there is a small risk of infection. You can help minimise this risk by attending your post-operative appointments and following the recommendations of your doctor. There is also a risk that your retina may heal slowly or that the operation was not fully effective – this may require further treatment or surgery.

What is the recovery time for retinal surgery?

Your recovery from a retinal operation varies depending on the condition your retinal surgery is treating and the type of retinal procedure. Generally, most patients can resume their daily activities within a few days of their surgery – however, your ophthalmologist will provide you with more specific information.

What is posturing and why is it needed after retinal surgery?

Posturing involves keeping your head and body in a specific position to help your eyes heal. It is required following retinal surgeries that leave a gas or silicone oil bubble in the eye, such as some retinal detachment surgeries and macular hole surgery. Posturing positions the bubble correctly within your eye to help close the affected areas of your retina, giving your eyes the best chance of recovering well. The specific position you will need to adopt depends on which areas of your retina are affected.

Your retinal surgeon may recommend posturing for 7 to 10 days following retinal surgery. Although it can be challenging, posturing is a vital part of recovery. Your surgeon will give you detailed instructions on how to posture and answer any questions you may have.

When will your vision return after retinal surgery?

The return of your vision after retinal surgery is dependent on which retinal condition you have, the type of retinal operation and the goal of the surgery. While some retinal surgeries can treat a retinal disease to improve your vision, others aim to prevent disease progression and preserve your existing vision.

For more information

There is a wide range of retinal surgeries available, and it can be helpful to discuss your options with a specialist in retinal surgery. Vision Hospital Group’s expert vitreoretinal surgeons (a vitreoretinal surgeon is an ophthalmologist who has specialised in surgery of the retina and vitreous) can provide an experienced opinion about your treatment options, answer your questions and support you to make the best decision for your vision.

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