glaucoma Marbella
glaucoma Marbella

Retinal detachment

desprendimiento retina ojo
 

Retinal detachment is one of the most serious eye diseases. Without preferential surgical treatment, vision can be completely and irreversibly lost.

 

It occurs when the neuroretina separates from the retinal pigment epithelium due to an accumulation of fluid between the two structures.

 
 

retina

There are three types:

  • Rhegmatogenous retinal detachment. This is the most common and occurs when a break in the peripheral retina serves as a gateway for intraocular fluid which, as it accumulates, causes the neuroretina to detach. Although less frequently, the tear may also occur in the macula or closer to the posterior pole.
  •  

  • Exudative retinal detachment, which occurs when there is no rupture but rather filtration of the liquid due to inflammatory processes or diseases such as uveitis, infections, tumours, etc.
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  • Tractional retinal detachment, cuando la separación es debida a una tracción física ejercida desde el interior del ojo. El origen suele estar en la existencia previa de una enfermedad, como la diabetes.

 
 

 
 

moscas volantes

Retinal detachment is a very serious eye pathology that requires rapid attention. It is very important to see an ophthalmologist as soon as the first symptoms appear.

 

  • Sudden appearance of floaters (myodesopsia) or an increase in the number of existing floaters
  • Flashes of light (photopsia)
  • The appearance of a kind of curtain or black area in the field of vision, which extends towards its centre.
  • Undulating vision
  • Decrease in visual acuity.
  • Loss of central vision (indicative of macular lesion)
  • It does not cause pain, which may lead the patient to mistakenly think that the condition is not very serious.

factores de riesgo oculares

  • High myopia
  • Previous eye surgery
  • First-degree relative with retinal detachment
  • Severe trauma

Vitrectomía Pars Plana

 
The treatment of retinal detachment is surgical and should be performed as early as possible.

 

There are three techniques, and they can be used separately or in combination:

 

Extrascleral surgery

 

Which consists of causing a deformity in the eye wall towards the inside of the globe to bring it closer to the tear caused by the detached retina, thus hindering the passage of fluid to the subretinal space. This deformity is created by means of a silicone band or silicone sponge explants. To achieve better results, this technique can be combined with others such as intraocular gas injection, cryopexy, laser therapy (which acts as a „glue“ around the tear) and/or subretinal fluid drainage.

 
 

Pars Plana Vitrectomy

 

In this technique the approach is from the inside of the eye, which is accessed through 3 microincisions in the sclera. The first step is to remove the vitreous gel and its tractions and then treat the tears and reposition the retina. The intervention is performed by visualising through the pupil with a surgical microscope combined with special lenses. To repair the tears, laser or cryopexy procedures are used, and in the most complicated cases, intraocular gas or silicone oil as well.

 
 

Pneumatic retinopexy

 

This may be combined with cryopexy or laser procedures, and consists of the injection of intraocular gas to adhere and suture the retina. If cryopexy was not performed during gas insertion, laser treatment must be carried out. It is a simple technique, but not all patients are candidates.

 

Ärzte-Team

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