Retinal Detachment Surgery: Key Questions Answered

Q: Retinal Detachment Surgery: Key Questions Answered

Hello： <br>1. <br>Isn't this an emergency surgery? Why can't it be performed immediately? Retinal detachment is an ophthalmic emergency, but the definition and timing of emergency treatment can vary depending on the situation. <br>Generally, if the retinal detachment has not affe

Retinal detachment surgery

Hello, Doctor.
Last Friday afternoon, I noticed a shadow in the eye where I had a lens replacement.
On Monday, I returned for a follow-up and was diagnosed with retinal detachment.
On Tuesday, I was referred to a major hospital, where they confirmed the retinal detachment without affecting the macula.
I need to undergo a vitrectomy with gas injection, but the scheduled surgery date is Friday.
I am hesitant to go to work on Wednesday and Thursday for fear of worsening the detachment, but it seems the shadow has increased.
I have a few questions: 1.
Isn't this an emergency surgery? Why can't it be performed immediately? 2.
If the condition of the detachment changes between the diagnosis on Tuesday and the surgery on Friday, will that affect the surgical outcome? 3.
The doctor mentioned that I should lie face down for 2 weeks, and that the gas will dissipate after 2 weeks, with more time spent face down being unhelpful.
However, I read on a reputable website that I should lie face down for 4 to 6 weeks.
Should I follow the doctor's advice?

Tian Xiansheng, 50~59 year old female. Ask Date: 2024/06/13

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
Isn't this an emergency surgery? Why can't it be performed immediately? Retinal detachment is an ophthalmic emergency, but the definition and timing of emergency treatment can vary depending on the situation.
Generally, if the retinal detachment has not affected the macula, there may be more leeway to schedule the surgery.
The surgical schedule depends on the availability of the operating room and the schedules of the relevant physicians.
Your surgery is scheduled for Friday, which indicates that the physician has assessed the risks of performing the surgery during this time as manageable.
2.
If the condition changes between the diagnosis on Tuesday and the surgery on Friday, will that affect the surgical outcome? The physician will conduct a detailed examination again before the surgery on Friday to confirm the current status.
Even if there are changes, the surgical plan will be adjusted based on the latest examination results to ensure the best surgical outcome.
3.
The physician mentioned to lie face down for 2 weeks, and that the gas will dissipate after 2 weeks, with additional face-down time being unhelpful.
However, I read on a reputable website that it should be for 4 to 6 weeks.
Should I follow the physician's advice? The recommended face-down time after surgery is primarily to ensure that the gas effectively presses against the retina, promoting its reattachment.
Different patients, surgical techniques, and types of gas may influence the required face-down duration.
The physician will provide the best advice based on your specific situation.
Therefore, you should follow the physician's instructions, and if you have any questions, you can confirm with the physician.
Wishing you a successful surgery and a speedy recovery.

Reply Date: 2024/06/13

More Info

Understanding retinal detachment surgery is crucial for patients facing this serious condition. Your concerns are valid, and it's important to address them comprehensively.

1. Isn't this an emergency surgery? Why can't it be done immediately?
Retinal detachment is indeed considered an ocular emergency, especially when the macula (the central part of the retina responsible for sharp vision) is involved. However, the urgency of surgery can vary based on the specific circumstances of each case. If the detachment has not yet affected the macula, as in your situation, there may be a window of time that allows for scheduling the surgery without immediate risk of vision loss. The scheduling of surgeries often depends on the availability of operating rooms and the surgical team. Your healthcare providers likely assessed that your condition was stable enough to wait a few days for the surgery without significant risk of deterioration.

2. If the condition changes between the diagnosis and the surgery, will that affect the outcome?
Yes, any changes in the condition of the retina between the initial diagnosis and the surgery can potentially impact the surgical outcome. Surgeons typically perform a thorough examination right before the procedure to assess the current state of the retina. If there are significant changes, they may adjust the surgical approach accordingly. It’s essential to communicate any changes you notice, such as an increase in the size of the black shadow or any new symptoms, to your healthcare team before the surgery.

3. The doctor advised two weeks of face-down positioning post-surgery, but I read online that it should be for 4-6 weeks. Should I follow my doctor’s advice?
Post-operative positioning is critical in retinal detachment surgery, especially when gas is used to help reattach the retina. The purpose of face-down positioning is to ensure that the gas bubble exerts pressure on the retina, promoting its reattachment. The duration of this positioning can vary based on several factors, including the type of gas used, the extent of the detachment, and the surgeon's preference based on their experience. While some sources may suggest longer periods of positioning, it’s essential to follow your surgeon’s specific instructions, as they are tailored to your individual case. If you have concerns about the recommended duration, it’s perfectly acceptable to discuss this with your surgeon for clarification.

In summary, while retinal detachment is a serious condition requiring prompt attention, the timing and approach to surgery can vary based on individual circumstances. It’s crucial to maintain open communication with your healthcare team, report any changes in your symptoms, and adhere to their post-operative instructions for the best possible outcome. Remember, your surgeon has the expertise to guide you through this process, and their recommendations are based on your specific situation. Wishing you a successful surgery and a smooth recovery!

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