Retinal Detachment Surgical Strategies
Summary
Retinal detachment is a sight-threatening condition in which the neurosensory retina separates from the underlying retinal pigment epithelium. Surgical repair aims to locate and seal retinal breaks, flatten the detached retina and maintain long-term apposition. The principal techniques comprise scleral buckling, pars plana vitrectomy and pneumatic retinopexy, each selected according to detachment configuration, break morphology and patient-specific factors such as lens status and proliferative vitreoretinopathy. Scleral buckling involves an external indentation of the globe to close retinal tears, while vitrectomy achieves internal relief of traction and removal of vitreous opacities. Pneumatic retinopexy uses an intravitreal gas bubble to tamponade superior breaks in selected cases. Recent advances include small-gauge instrumentation, wide-angle endoillumination, real-time optical coherence tomography guidance and refined gas and silicone oil tamponade options. These innovations have improved primary success rates and visual outcomes, extending applicability to complex and giant retinal tears. Training in multiple modalities remains essential to ensure global accessibility of optimal care and to balance risks of postoperative complications such as cataract progression and intraocular pressure elevations.
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Retinal Detachment Surgical Strategies publication trend
The graph below shows the total number of articles in retinal detachment surgical strategies across all publications each year (not limited to Nature Index journals).
Technical terms
Rhegmatogenous retinal detachment: Separation of the neurosensory retina from underlying tissue due to full-thickness retinal breaks allowing fluid ingress.
Scleral buckling: External procedure applying an indent to the sclera to close retinal tears and appose the neurosensory retina.
Pars plana vitrectomy: Internal surgical removal of vitreous gel via the pars plana to relieve traction and facilitate subretinal fluid drainage.
Pneumatic retinopexy: Injection of a gas bubble into the vitreous cavity to tamponade superior retinal breaks and promote reattachment.
Gas tamponade: Use of intraocular expansile gases or air to press the detached retina against the pigment epithelium.
References
- Rhegmatogenous retinal detachment surgery: A review. Clinical and Experimental Ophthalmology (2023).
- A Review of Innovations in Rhegmatogenous Retinal Detachment Surgical Techniques. Journal of Ophthalmology (2017).
- Functional and morphological results of treatment of macula-on and macula-off rhegmatogenous retinal detachment with pars plana vitrectomy and sulfur hexafluoride gas tamponade. BMC Ophthalmology (2019).
- Exclusive Use of Air as Gas Tamponade in Rhegmatogenous Retinal Detachment. Journal of Ophthalmology (2017).
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