There are several techniques used in retinal surgery such as:

• Vitrectomy
• Scleral Buckle
• Retinopexy
• MacularTranslocation
• Retinectomy

Additionally, several adjuncts can be used to help maximize postoperative results. Some of these are the following:

• Air Injection
• Heavy Gas Injection
• Silicone Oil Injection
• Perfluorocarbon Liquids
• Laser Photocoagulation

The surgical technique and adjuncts used will depend on the particular case of every patient depending on severity, disease and the experience of the surgeon.

Retina surgery is one of the more complicated ocular surgeries performed within ophthalmology. The results after surgery vary widely according to disease severity and surgeon experience.

There are several reasons that a retinal surgery may be necessary. The following is a short list of the most common indications for surgery:

• Retinal Detachment
• Vitreous Hemorrhage
• Diabetic Retinopathy
• Epiretinal Membrane
• Macular Hole

A retinal detachment occurs as the result of a hole or tear in the retina through which vitreous passes and causes de retina to detach. As the retina is a membrane and extremely thin, it cannot be sutured directly and must be approximated to the wall (indented) of the eye (or sclera) and laser pulses, cautery or cryotherapy is applied around the tear to form scar tissue and healing of the tear. The vitreous gel that is behind the retina is drained through a small incision. An adjunct such as gas, air or silicone oil can be used to help reapply the retina.

These procedures are effective in 90% of cases. If the macula was involved in the retinal detachment, it may be possible that the vision will not recover completely. It is imperative that surgery be done as quickly as possible to recover as much vision as possible.

Scleral buckle surgery is the most frequently performed procedure for retinal detachment. It is generally done in an operating room under local or general anesthesia. It is usually performed for uncomplicated cases as an outpatient procedure.

The surgeon will first open the conjunctiva, locate the area with the retinal tear, place a scleral band over the area, approximating the sclera to the retinal tear, and cryotherapy is used to close the tear. The scleral band is sutured to the surface of the sclera. A small incision will be performed to drain the liquid beneath the retina so that it may reattach to its proper place.

This procedure is successful in over 90 percent of cases, although some cases may require a second procedure. A reattached retina does not guarantee normal vision after the surgery. Vision will depend on several factors: if the macula was involved in the retinal detachment, how long after the detachment was the surgery was performed, underlying diseases that may affect the retina.

If the surgery fails, the retinal surgeon can reapply the retina with other more invasive surgical techniques.

If scarring over the surface of the retina forms after successful surgery, this can lead to a new retinal detachment. This can occur one to two month after surgery. This can be resolved with a procedure called pars plana vitrectomy assisted by injection of air, water, gas or silicone oil.

Pneumatic retinopexy is popular technique which consists in injecting a bubble of gas inside the eye. Once inside it will expand and reapply the retina. Once the retina reattaches, the retinal tear is treated with laser photocoagulation or cryotherapy.

This technique is performed in cases with small superior retinal tears with a small retinal detachment.