Retina Surgery

By Omar Ahmad, MD

Many retinal diseases require a surgical correction. These conditions can include retinal detachment, macular holes, diabetic retinopathy, scar tissue on the retina, dislocated intra-ocular lenses and other conditions where office based procedures are not possible or effective.

The surgery is performed at the hospital. Most retinal surgeries are more involved than other types of ocular surgery, so it is rare that they are performed at a surgery center.

Usually the surgery is outpatient, meaning a stay at the hospital after surgery is not required. Surgery on the retina involves the second half of the eye or posterior segment. This is behind the areas that are involved in cataract surgery or glaucoma surgery (anterior segment). As such, the view to the retina has to be clear enough to operate and cataract surgery or other anterior segment surgery may be required prior to the retina surgery.

Also some retinal problems arise from anterior segment surgery. Adequate healing of the anterior segment surgery may be needed before operating on the retina. Most retinal surgeries tend to be emergent and permanently sight threatening. Therefore, your retinal surgeon may tell you surgery is required within a certain time frame, which is unlike many other types of surgery that can be scheduled electively.

One of the largest differences between retinal surgery and other types of surgery is the unpredictability of the visual result. Unlike laser vision correction or cataract surgery, where the visual potential is usually known before the surgery, visual results of retinal surgery depend a great deal on how serious the original problem was and how that particular patient's eye heals. Surgery can go very well and be successful and the vision recovers fully, or the same successful surgery may not recover all the vision lost. This varies a great deal with the type of retinal problem and the type of surgery required, but one of the most consistent factors in visual success is not waiting too long to address the problem.

The recovery period for retinal surgery is also much longer than other types of ocular surgery. There are two aspects to healing here. One is the physical recovery of the eye. This involves watching for infection, inflammation, pressure of the eye, bleeding and other complications. The second aspect is visual recovery. More time (in some cases up to a year after surgery) is required to know the visual outcome. This can mean loss of independence during the recovery.

The types of retinal diseases that require surgical intervention are varied and complex. A full description of all types of surgery is not possible in this article. The thought of having emergent or urgent surgery can be very frightening. It is vital that you are informed and comfortable. The tests that are performed are interpreted with you and explained and the surgery is explained to you in detail. Plain language explanations can help alleviate anxiety. The more knowledge you have, the more comfortable you will feel.