[Retinal detachments and retinal surgery]

Abstract

The incidence of retinal detachment is approximately 1:10,000. Most retinal detachments occur between the ages of 50 and 65 years. A rhegmatogenous retinal detachment starts with a tear in the peripheral retina. Through this retinal tear liquefied vitreous may enter the subretinal space, resulting in a retinal detachment with progressive visual loss. In 50% prodromal light flashes are observed. Laser coagulation around a tear without subretinal fluid can make surgical intervention unnecessary in approximately 96% of cases. When subretinal fluid is present, conventional scleral buckling surgery is successful in 80-90% of the cases. In more complex retinal detachments or in re-detachment cases, a trans pars plana vitrectomy is indicated. Anatomical success can be achieved in approximately 96% of cases, sometimes after several operations. Functional success depends on preoperative pathology and duration of the detachment. Eyes with retinal detachment of the macula and with larger and complex defects have poorer visual prognosis.