Our Summary

This study looked at the best ways to perform surgery on patients who had retinal detachment, a condition where the retina at the back of the eye pulls away from its normal position, due to Familial Exudative Vitreoretinopathy (FEVR), a genetic eye disorder. The study looked back at patients who were diagnosed with FEVR and had surgery for retinal detachment between 2004 and 2017.

They found that 44 eyes from 38 patients were treated for this condition. The patients were on average around 15 years old and about 58% were male. Of these, around 80% had a specific type of retinal detachment called rhegmatogenous retinal detachment, and the rest had tractional retinal detachment.

Two types of surgery were performed: scleral buckle, where a flexible band is placed around the eye to counteract the force pulling the retina out of place, and pars plana vitrectomy, where the vitreous gel that is pulling on the retina is removed and replaced with a bubble that pushes the retina back into place.

Scleral buckle was performed on about 32% of the eyes, with around 79% having a successful reattachment of the retina after one surgery, and 86% after multiple surgeries. Pars plana vitrectomy was performed on about 68% of the eyes, with around 73% having a successful reattachment after one surgery and 84% after multiple surgeries.

The study found that poor vision before surgery, the presence of tractional retinal detachment, and the presence of falciform folds (a type of eye tissue abnormality) were related to worse outcomes.

In conclusion, these surgeries can be successful, but sometimes more than one surgery is needed.

FAQs

  1. What is the difference between rhegmatogenous retinal detachment and tractional retinal detachment?
  2. What are the two types of surgeries for retinal detachment and how successful are they?
  3. What factors could potentially affect the outcome of retinal detachment surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about retinal detachment surgery is to follow all post-operative instructions carefully to ensure the best possible outcome. This may include avoiding strenuous activities, taking prescribed medications as directed, attending follow-up appointments, and reporting any changes in vision or discomfort to your healthcare provider immediately. It’s also important to protect your eyes from injury and to avoid rubbing or putting pressure on the eye during the healing process. By following these guidelines, you can help promote successful healing and recovery after retinal detachment surgery.

Suitable For

Patients with retinal detachment due to Familial Exudative Vitreoretinopathy (FEVR) are typically recommended for retinal detachment surgery. This study specifically looked at patients with FEVR who underwent surgery for retinal detachment, but the findings may also apply to patients with other causes of retinal detachment.

The study found that patients with rhegmatogenous retinal detachment had better outcomes compared to those with tractional retinal detachment. Additionally, patients with falciform folds or poor vision before surgery were more likely to have worse outcomes.

Overall, both scleral buckle and pars plana vitrectomy surgeries were found to be effective in reattaching the retina in patients with FEVR-related retinal detachment. Multiple surgeries may be required in some cases to achieve successful reattachment.

It is important for patients with retinal detachment to seek prompt medical attention and discuss treatment options with their ophthalmologist to prevent permanent vision loss.

Timeline

  • Before surgery: The patient may experience symptoms such as sudden flashes of light, floaters in their vision, a curtain-like shadow over their field of vision, or a sudden decrease in vision. They will undergo a comprehensive eye examination to diagnose retinal detachment.
  • Day of surgery: The patient will undergo either scleral buckle or pars plana vitrectomy surgery to reattach the retina.
  • After surgery: The patient will need to follow post-operative care instructions, which may include wearing an eye patch, using eye drops, avoiding strenuous activities, and attending follow-up appointments with their ophthalmologist. The success of the surgery in reattaching the retina will be monitored, and additional surgeries may be needed for some patients.

What to Ask Your Doctor

Some questions a patient should ask their doctor about retinal detachment surgery include:

  1. What type of retinal detachment surgery do you recommend for my specific condition?
  2. How many surgeries do you anticipate I will need to successfully reattach my retina?
  3. What are the potential risks and complications associated with retinal detachment surgery?
  4. How long is the recovery process after retinal detachment surgery?
  5. Will I need to follow any specific post-operative care instructions or attend follow-up appointments?
  6. What is the success rate of retinal detachment surgery for patients with Familial Exudative Vitreoretinopathy?
  7. Are there any alternative treatment options for my condition?
  8. How will retinal detachment surgery affect my vision and overall eye health in the long term?
  9. Will I need to make any lifestyle changes or adjustments after retinal detachment surgery?
  10. Are there any specific factors related to my condition that may impact the outcome of the surgery?

Reference

Authors: Sen P, Singh N, Rishi E, Bhende P, Rao C, Rishi P, Bhende M, Sharma T, Gopal L. Journal: Can J Ophthalmol. 2020 Jun;55(3):253-262. doi: 10.1016/j.jcjo.2019.11.001. Epub 2020 Jan 13. PMID: 31941588