The retina is the sensitive membrane of the eye, in which light flows are converted into nerve impulses that enter the cerebral cortex. It is the brain that already forms a unified picture of what is happening. The retina is a very thin membrane. If it is injured, it leads to loss of the ability to see. Surgery for retinal detachment should be carried out as quickly as possible. This will help maintain good vision and avoid serious complications.

Causes of retinal detachment

The main cause of retinal detachment is retinal breaks. Such damage can be caused by:

• Prolonged inflammation of the iris or choroid.
• Severe myopia.
• Atrophic changes in the fundus of the eye.
• Injuries to the visual organ.
• Physical activity - jumping from heights or lifting weights.
• Other systemic diseases - diabetes mellitus, hemorrhages and various neoplasms in the eye.

Retinal detachment is not always diagnosed in a timely manner, since at first the symptoms may not be very pronounced. You should be wary of:

• Deterioration in the quality of vision.
• Deterioration of lateral vision.
• Flashing spots, flies and veils before the eyes.
• Fluctuation of objects around and their blurriness.

In many cases, patients note that their vision improves after waking up. This happens because the retina in a horizontal position fits in the right place, and when it takes a vertical position, it moves away again and all the symptoms appear again.

Retinal ruptures occur during retinal dystrophy. Large ruptures are observed with serious eye injuries.

Indications for surgery

It must be remembered that it is impossible to cure retinal detachment with drops, injections or physiotherapeutic procedures. In this case, only surgery can help. Moreover, the sooner it is done, the greater the chance a person has of maintaining his vision.

Only an ophthalmologist can make a correct diagnosis. This requires a series of examinations. The visual field is determined, the fundus and internal structures of the eyeball are examined. In addition, optical coherence tomography of the retina is performed.

Indications for surgical intervention are all characteristic symptoms of detachment, as well as a confirmed diagnosis during the examination. If a pregnant woman experiences retinal detachment, spontaneous childbirth is impossible.

Types of operations

Treatment for retinal detachment can be surgery or laser. The latter type of treatment is more preferable, as it is less traumatic. Laser treatment in most cases does not require hospitalization of the patient. The patient spends no more than 2-3 hours in the clinic.

Laser coagulation

During laser treatment, the areas treated with a laser beam are soldered to the vascular film. This is due to the high temperature at which the tissues coagulate. This treatment is completely bloodless, the patient feels only a light touch to the mucous membrane and observes glare. The operation is carried out in several successive stages:

The entire course of the operation is controlled by a microsurgeon through a special microscope. Typically, surgery on one eye lasts no more than 20 minutes. All manipulations are performed with the patient sitting.

Laser surgery is well tolerated by children. Unpleasant sensations after surgery disappear in just a day.

Extrascleral filling

Even during the diagnostic process, the location, size and shape of the problem area of ​​the retina are determined. Taking this data into account, a specific filling is made from spongy silicone. The doctor cuts the conjunctiva, through this incision the filling is placed on the sclera and secured with sutures. To correctly place such a filling, sometimes an expanding gas or air is injected into the eye.

If there is an accumulation of intraocular fluid in the eye, then at the final stage of the operation it is removed. Only after this the conjunctiva is sutured.

After such an operation, vision is not restored immediately, but after a couple of months. For some patients, the recovery period lasts up to six months. And if the detachment was caused by myopia, then the process of complete recovery is even more delayed.

The effectiveness of such treatment is partial, since complete restoration of vision after surgery is not observed.

Vitrectomy

This is a surgical procedure that is used to treat a number of ophthalmological diseases. During the operation, scars, blood and pathologically altered tissues are removed from the vitreous. The vacated space is replaced with a saline solution or special polymers. These substances expand, due to which the retina is pressed tightly against the choroid from the inside.

Most often, the operation is performed under local anesthesia and general anesthesia. Hospitalization is not required, the operation lasts about an hour, the patient does not experience any discomfort.

Ballooning of the sclera

This operation is indicated for uncomplicated retinal detachment. Ballooning is performed on the surface of the sclera. The goal of such treatment is to ensure a tight fit of the retina to the choroid.

The operation consists of inserting a special balloon with a catheter behind the eye. As the pressure in the balloon gradually increases, it increases in size and puts pressure on the sclera.

After the balloon is in place, it is strengthened using a laser beam. The canister is removed approximately a week after laser treatment. This operation is considered low-traumatic and effective; it lasts no more than an hour.

With timely ballooning of the sclera, the effectiveness of treatment reaches 98%.

Contraindications to surgery and risk groups

Each type of surgical intervention has a number of contraindications. Vitrectomy cannot be done in the following cases:

• If there is clouding of the cornea.
• If there are pronounced pathological changes in the tissues of the visual organ.

The filling operation can also not be performed in all cases. It is not done if there is clouding of the vitreous body or protrusion of the sclera.

There are also a number of contraindications to laser treatment. Laser operations cannot be performed in the following cases:

• If the retina is detached over a large area.
• If certain tissues of the eye are opaque.
• If pathologies of the iris vessels are diagnosed.

Any types of surgical interventions are contraindicated if a person is intolerant to painkillers or does not tolerate anesthesia well. It is unacceptable to perform operations for infectious and inflammatory diseases of any etiology in the acute stage.

Before choosing a treatment method and surgery, the doctor carefully studies the patient’s medical record and conducts a detailed examination.

Complications and consequences

Complications after surgery are rare, but they do occur. This is mainly due to a violation of the technique of the operation. The most common consequences include:

Some time after the operation there may be a relapse. This is due to incorrect surgical technique or incorrect suturing. After surgery, patients are registered with an ophthalmologist and are examined every 2-3 months.

What not to do after surgery

• Avoid excessive physical activity. Do not play sports or go to the gym.
• Don't lean forward.
• Avoid respiratory and infectious diseases.
• Avoid any procedures that involve sudden temperature changes. You should refrain from visiting baths and saunas.
• Take medications prescribed by your doctor.
• In sunny weather, wear sunglasses.

In addition, a patient who has undergone surgery for retinal detachment should avoid excessive physical activity and intoxication of the body for a long time. Any situations in which visual injury may occur should be avoided.

Walking and swimming are not contraindicated. It is advisable to walk in the shade, and do not strain too much when swimming. During the postoperative period, it is recommended to sleep on your back.

Prices

Surgeries to repair retinal detachment are offered by various ophthalmology clinics. They differ in cost, which depends on the following factors:

• Localization of the detachment site and area.
• Method of treatment.
• Clinic locations. In domestic hospitals, surgery costs an order of magnitude cheaper than in foreign clinics.
• Qualifications of doctors who perform the operation.
• To what extent is the clinic equipped with modern equipment?

In addition, the complexity of the case is taken into account. In some cases, the patient requires not only surgery to strengthen the retina, but also simultaneous replacement of the lens with an IOL. It is logical that in this case the cost increases noticeably.

The cost of surgery on one eye ranges from 5 thousand rubles to 135 thousand. Filling small areas of the retina costs about 25 thousand rubles. In foreign clinics, prices are much higher. There, just the initial examination by an ophthalmologist reaches $600.

The patient has the right to choose which clinic is suitable for him. The ophthalmologist gives only his recommendations. Before performing an operation, you should look for reviews about the microsurgeon who will perform it.

Retinal detachment is a dangerous condition that requires immediate treatment. It must be remembered that the sooner the operation was performed, the better the prognosis. Doctors prefer laser treatment. This method is the least traumatic.

Retinal detachment is one of the dangerous ophthalmological diseases. If surgery is not performed in a timely manner, complete loss of vision is guaranteed. Many people ask the question: what is surgery for retinal detachment and what are they?

We will tell you in detail in the article about modern microsurgery in ophthalmology and look at other methods of surgical treatment of the disease. How does the early postoperative period go and what should not be done during the recovery period.

Indications and contraindications for treatment

Indications for surgical treatment depend on many factors: the cause of the disease, how long ago the first symptoms appeared and the presence of concomitant pathology.

We list the main reasons for the occurrence of detachments:

Any medical intervention must be justified. The attending physician individually selects treatment tactics only after conducting a sufficient number of medical studies.

Reference! In Germany, emergency intervention is regulated by a strict time frame (the first twenty-four hours from the moment of injury).

There are also contraindications for operations to return the retina to its anatomically correct location:

• acute inflammatory eye diseases;
• severe general condition of the patient, when questions about ophthalmological treatment fade into the background;
• irreversible dystrophic changes in the lens;
• chronic retinal detachment (more than a week has passed since the first signs appeared);
• pathological formations on the sclera that interfere with surgical interventions;
• pregnancy and others.

Issues of contraindications are quite abstract. Taking into account the level of development of ophthalmology and the sufficient variety of surgical treatment methods, it is possible to select the optimal surgical intervention for which there will be no contraindications.

What determines the choice of method

The choice of treatment method is made taking into account existing indications and contraindications. General somatic chronic diseases should not be neglected. A variety of surgical methods to repair retinal tears and detachments increases the number of patients cured.

When choosing a surgical treatment method, they rely on the following factors:

Considering that the most common cause of eye detachment is trauma, they try to carry out treatment at the place of initial treatment or the patient is redirected to a hospital where it is possible to perform surgery. The urgency and urgency of this condition forces the patient to agree to treatment in municipal hospitals.

However, if your condition gradually worsens and you have time, you can choose the most suitable private clinic. The cost of surgical treatment certainly increases, but no one can guarantee a 100% cure.

Important! Who to contact, where to have the operation and with whom is the personal choice of the patient who has reached the age of majority!

If you have an ophthalmological pathology for which you have been seeing a certain specialist for a long time, you may need to contact him for prompt help. Nobody canceled personal preferences in choosing a surgeon. Do not forget about the constitutional right to freely choose the treating doctor.

Examination and preparation

During hospitalization, the following tests will be required:

The research data must be recent and less than a month old. In case of emergency admission to the hospital, all laboratory tests will be carried out in the hospital.

On the patient's part, preparation for surgery consists of strictly following the doctor's instructions and observing the general hospital regime. A couple of hours before the intervention, you will be asked to take sedatives. In an hour, a drug is dropped into the eyes that dilates the pupil (most often it is atropine).

Operations are performed under local or general anesthesia. The choice of pain relief method is directly related to the type of operation and the presence of chronic diseases.

Types of surgery

Independent

Sclerosis(Retinal filling). The operation can be carried out both in an outpatient clinic and in a hospital (if it is necessary to monitor the patient). During the operation, the doctor places a piece of plastic or silicone to the outer membranes of the eye. It is produced with the aim of creating external compression on the tissue of the eyeball, resulting in the formation of close contact at the site of ruptures or detachments.

Complications include the development of proliferative vitreoretinopathy, detachment of the vascular fundus, increased intraocular pressure (dangerous for patients with glaucoma), infections and bleeding. In the postoperative period, it is recommended to wear an aseptic dressing for 7 - 10 days, antibiotic drops and painkillers. Full restoration of vision is possible in 1 - 2 months.

Vitrectomy- a microsurgical method performed primarily in a hospital setting. The first stage of the operation is the implementation of surgical access. The second stage is removal of the vitreous body using a vitreotome.

The third is aspiration of subretinal fluid and formation of chorioretinal adhesions (carried out using laser or cryotherapy). The fourth stage is intraocular tamponade, for this purpose a gas-air mixture or silicone oil is used.

If silicone is used, a second operation will be required to remove it. The gas-air mixture is gradually replaced by normal intraocular fluid.

Complications of vitrectomy include postoperative bleeding, increased intraocular pressure, degenerative processes in the lens body and infectious processes. The recovery period usually takes at least two months, but it can be extended by using silicone oil.

Combined

Laser coagulation- a safe and less traumatic method of treatment. Not contraindicated for pregnant women and persons with chronic diseases. The procedure is performed in an outpatient setting. Using a laser, pinpoint burns are applied to the edges of the detachment, which causes the formation of a scar. Such scars subsequently fix the detached retina.

Complications include corneal edema, accumulation of exudative fluid in the cavities between scars, repeated detachments, surges in intraocular pressure, the appearance of cataracts or microscopic hemorrhages. In the postoperative period, you should adhere to restrictions in physical work and not overstrain your eyesight. Only fourteen days after laser coagulation can one judge its effectiveness.

Pneumatic retinopexy. It is not an independent method of surgical treatment. Performed in inpatient and outpatient settings. The essence of the procedure is the formation of a gas bubble in the eye cavity, which will put pressure on the detachment site. Complications - infections, pain in the postoperative period. The recovery period depends on the type of main intervention.

Reference! Combined surgical interventions require simultaneous exposure to different methods of restoring the normal layering of the eye.

Retinal ballooning. To be carried out strictly in stationary conditions. The first stage of the operation involves inserting a catheter with a balloon behind the eye. Subsequently, the balloon is filled with liquid or gas, which helps to create external pressure on all membranes of the eye. The second stage is the removal of the bloated balloon, which is carried out no earlier than after 7-10 days. Complications - infections, re-detachment, bleeding, increased intraocular pressure. The recovery period varies from person to person and takes one month on average.

Cryopexy. Surgical treatment using low temperatures. It is carried out on an outpatient basis, but it can also be performed on an inpatient basis. Defects at attachment sites are exposed to negative temperatures, which promotes the formation of adhesive bonds. Possible complications are lens clouding, glaucoma, microbleeding. In the first week after surgery, bed rest is required.

Video about surgical treatment of retinal detachment:

Possible complications and prognosis

Complications can arise both during surgical treatment and in the postoperative period. In the first case, the reasons may be technical difficulties in performing the operation, anatomical features of the patient’s eye structure, insufficient skills of the operating surgeon, or incorrectly selected anesthesia.

The use of blood thinning drugs must be stopped a week before surgery, otherwise bleeding during surgery cannot be avoided. If the intervention is carried out on an emergency basis, then it is necessary to warn the doctor about what medications you use on an ongoing basis.

Postoperative complications can arise due to exacerbation of a chronic disease (glaucoma, diabetes mellitus, arterial hypertension), non-compliance with medical recommendations, or the addition of an infectious process. The most common complications include retinal detachment, scar formation (the reason for their appearance lies in the development of proliferative vitreoretinopathy) and the development of endophthalmitis (an inflammatory disease of the eye).

Important! If you experience unbearable pain in the operated eye, pathological discharge, swelling of the periocular tissues and an increase in body temperature, you should immediately consult a doctor!

If the operation is performed correctly and medical recommendations regarding body position or physical activity are followed, the prognosis for recovery from retinal detachment is favorable. Visual acuity can be restored to 98%.

Considering the method of treatment, the duration of the period of vision recovery may vary in patients with similar clinical situations. For example, if a patient had pneumonic retinopexy, then clarity of vision is restored only after 14 to 18 days. Patients note the disappearance of the “curtain” in the field of vision, but blurred images still persist.

And when performing a vitrectomy followed by filling the eye cavity with silicone oil, vision will be reduced until a second operation in which the silicone is removed. Patients are usually advised to change the lenses in their glasses before the oil runs out.

Postoperative period

For the early recovery period after surgical treatment, there are general recommendations:

Many patients are interested in the question of banning plane travel in the first three to four months after surgery. This issue is resolved individually with the treating doctor. From a scientific point of view, the flight ban is justified after microsurgical surgery performed using gas mixtures. The procedure causes an increase in intraocular pressure, and additional changes in atmospheric pressure can lead to a shift in the position of the gas bubble, which will contribute to re-detachment of the retina.

The postoperative and recovery periods are especially difficult for professional athletes and weightlifters. The ban on intense physical activity concerns them to the same extent as ordinary people. Permission to visit sports and gyms must be obtained from an ophthalmologist. It is most likely that you will need to leave the sport due to deteriorating health for three or more months.

To improve vision, patients are recommended to do eye exercises, take vitamin complexes, reduce the consumption of alcoholic beverages (it is advisable to completely eliminate them from your life during the recovery period), avoid psycho-emotional stress, perform a light massage of the eyeballs through closed eyelids, and it is imperative for hypertensive patients to regulate blood pressure with medication.

Final part

It is almost impossible to protect yourself from all the causes of retinal detachment. However, an annual visit to an ophthalmologist, rational distribution of time for work and rest, preventive use of vitamin complexes and medical monitoring of chronic diseases (arterial hypertension, diabetes mellitus) will help reduce the risk of developing retinal detachments. Remember to practice workplace safety and protect your eyes from injury with safety glasses. Take care of yourself and your eyes!

14.06.2017

Retinal detachment is a pathological condition in which it separates from the underlying tissues of the eyeball. This disease in ophthalmology always receives a lot of attention from specialists, since the role of the region in the formation of visual images is difficult to overestimate. Treatment for retinal detachment should begin immediately after diagnosis, since even a short delay will seriously impair visual acuity or even lead to blindness.

Retinal detachment can occur at any age, but reaches its highest prevalence in people aged 60 to 70 years. This pathology usually affects more men than women.

Classification of retinal detachment

There are three types:

• Rhegmatogenous;
• Traction;
• Exudative.

Rhegmatogenous detachment of the eye– associated with breaks in the retina.

Causes:

• Age;
• Myopia;
• Cataract surgery;
• Injury;
• Degenerative lesions of the retina;
• Stickler syndrome;
• X-linked retinoschisis;
• Marfan syndrome.

Traction retinal detachment- caused by chronic traction from scars on the surface of the retina.

Causes:

• Proliferative diabetic retinopathy;
• Proliferative vitreoretinopathy;
• Retinopathy of prematurity;
• Penetrating eye injury;
• Retinopathy in sickle cell anemia.

Exudative retinal detachment- caused by fluid leakage into the subretinal space.

Causes:

• Inflammatory process (uveitis, scleritis);
• High blood pressure (with malignant hypertension, toxicosis in pregnant women);
• Neoplastic processes (choroidal melanoma, hemangioma, metastases);
• Vascular pathology (retinal macroaneurysm);
• Maculopathy (neovascular macular degeneration, central serous choroidoretinopathy);
• Congenital disorders (microphthalmos).

Why is it important to treat retinal detachment?

The impact of light rays on the retinal area induces a biochemical cascade leading to the formation of an electrical impulse. Sensory endings originating in this anatomical region and forming a nerve transmit signals to the brain. Central neurons perceive and process information, thanks to which a person not only sees, but also becomes aware of visual images. The retina of the eye can be compared to the film of a camera. Only, unlike its artificial counterpart, the images on it are constantly updated, allowing a person to perceive millions of different images of the surrounding world.

Retinal detachment is usually the result of microscopic tears. Traction effects from the vitreous body, a transparent liquid that fills the organ of vision from the inside, lead to micro-tears. The defects serve as a gateway for fluid to penetrate between the layers of the retina, leading to their mechanical separation from each other. This is retinal detachment. The integrity of the nerve endings is disrupted, and the retina can no longer fulfill its main task - to receive and process information. That is why timely treatment of detachment helps prevent many serious consequences.

Many different parameters play a role in the development of this pathology: a retinal detachment in the upper half of the eye with a large Y-shaped hole usually behaves more aggressively than a retinal detachment in the lower hemisphere with small holes.

Symptoms

The most common symptom of retinal detachment is sudden, painless loss of vision or blurred vision in the affected eye. Some patients experience partial visual field loss and describe it as the appearance of a veil or one-sided shadow. Flashes and floaters may occur in the affected eye for several days or weeks before complete loss of visual function in the eye occurs. This pathological symptom of detachment is in most cases associated with vitreous degeneration.

Inferior retinal detachments can be slowly progressive, so that the onset of the pathological process goes unnoticed until it reaches the posterior pole of the eye. Sometimes detachments of the eye are accompanied by mild discomfort and redness of the eyes due to uveitis and hypotony, and this condition can sometimes be misdiagnosed by ophthalmologists as idiopathic anterior uveitis.

When the retina is detached, the visual field defect is located opposite the detachment site due to optical inversion of the images. It is usually described by patients as a dark curtain or shadow, appearing first in the periphery and moving to the center over several hours, days or even weeks. Visual acuity gradually decreases, and the patient may notice distorted images. Without surgical treatment, complete retinal detachment will very quickly lead to blindness.

What are the types of surgeries for retinal detachment?

Ophthalmologists plan surgical treatment of retinal detachment according to the individual situation. In some cases, smoothing of the separated retina can be achieved by strictly positioning the patient on the side of the detachment that has begun, which subsequently facilitates surgical intervention.

Small tears can be treated with surgery such as laser photocoagulation or cold application. But it is not always necessary to act surgically. This depends on their size and location of the detachment; the presence or absence of traction and other risk factors is also taken into account. Treatment for complete retinal detachment is currently only surgical. Below we will consider the possibilities of modern ophthalmic surgery and types of operations.

Vitrectomy

Today, this is the most commonly performed intervention for retinal detachment. It is performed in the clinic under general or local anesthesia. During the operation, small incisions are made on the surface of the sclera in order to place a fiberoptic device or camera, an irrigation system and special small instruments in the eye cavity.

The vitreous is removed to reduce or eliminate tension in the retinal area. Laser or cryotherapy is additionally used to close the tears, and the cavity is filled with a gas-air mixture. The bubble, gradually dissolving, provides good fixation and promotes rapid healing.

Tamponade of retinal tears after surgery can be achieved with long-acting gas or silicone oil. According to physicians, there is no significant difference in clinical outcome between the two agents, and the choice of drug in treatment may be individual for each patient.

Benefits of silicone oil include its clarity, which allows you to see objects and walk immediately after surgery.

Being insoluble, silicone oil also provides long-term tamponade over a large area of ​​the retina. Disadvantages include the need to remove the oil during a second surgery to avoid complications. The oil can be left in place to provide continuous retinal tamponade and avoid recurrent retinal detachment, but this carries the risk of complications.

In the postoperative period, the patient may be required to temporarily position the head face down (in other words, lying on the stomach).

In the past, due to its traumatic nature, vitrectomy was performed only in complicated cases, for example, with giant ruptures or massive hemorrhages. With the development of microsurgery, the indications for this operation have expanded. In serious situations, instead of a gas mixture, sterile silicone is placed into the eye cavity, which must be removed after a certain period of time.

Episcleral filling

For many years, this surgery was the gold standard treatment for retinal detachment. Today it is performed much less frequently, but does not lose its relevance when indicated. First, the surgeon identifies the site of the tear using a microscope or indirect ophthalmoscope. The rupture site is treated with laser or cryotherapy.

During laser coagulation surgery, laser light enters the eye through the pupil. The laser energy is absorbed into the retinal epithelium, resulting in heating (about 60°C) and necrosis with coagulation.

Cryocoagulation as a treatment method involves freezing the eyeball all the way from the outside to the retina using a special instrument - a cryoprobe (about -80 ° C).

As a result of this type of treatment, scar tissue is formed, preventing further spread of the pathological process.

Then the injured area is fixed from the outside, that is, from the side of the sclera, using silicone or sponge filling material. From the outside it looks as if a filling encircles the eye. It promotes better fixation and healing of the detachment site. Such a filling is not visible from the outside, since it is localized at the posterior pole and covered by the conjunctiva. If visualization of the fundus is poor, the procedure is combined with another operation - vitrectomy.

Pneumatic retinopexy

During the operation, the surgeon introduces a gas bubble into the eye cavity. The goal is to press the damaged retina to the posterior pole of the organ for quick and reliable healing. It usually resolves within 2 to 6 weeks. Face-down positioning may be necessary and is appropriate for uncomplicated detachments. A combination with laser photocoagulation or cryotherapy is possible.

The timing of surgery is critical for patients with retinal detachment because the longer the photoreceptors take to separate from the retinal epithelium, the greater the irreversible structural changes in the retina.

The choice of appropriate treatment tactics is within the competence of the attending physician. It is he who, assessing the patient’s condition and the presence of concomitant pathologies, can choose the optimal type of operation.

After surgery, patients should undergo a retinal examination, assessment of visual field changes, and measurement of intraocular pressure.

If intraocular pressure remains normal several days after gas implantation, it usually does not require additional monitoring. If silicone oil is used during vitrectomy, IOP monitoring should continue at least until the oil is removed. The condition of the retina should be monitored for 4 months after surgical treatment, while there is a risk of developing proliferative vitreoretinopathy.

Cost of operations for retinal detachment

№	Service name	Price in rubles
2011027	Introduction of drugs into the vitreous cavity (Eylea, Lucentis, Ozurdex)	46 000	Sign up
2011072	Introduction of drugs of the 1st degree of complexity into the vitreous cavity	18 500	Sign up
2011073	Introduction of drugs of the 2nd degree of complexity into the vitreous cavity	22 500	Sign up
2011074	Introduction of drugs of the 3rd degree of complexity into the vitreous cavity	65 000	Sign up
2011061	Injection of gas into the vitreous cavity	10 000	Sign up
2011060	Injection of liquid silicone into the vitreous cavity	15 000	Sign up
2011059	Introduction of perfluoroorganic liquids into the vitreous cavity	12 500	Sign up
2011046	Vitreoretinal surgery for complicated conditions (2-stage) of the second category of complexity	99 950	Sign up
2011048	Vitreoretinal surgery for complicated conditions (2-stage) of the highest category	175 050	Sign up
2011045	Vitreoretinal surgery for complicated conditions (2-stage) of the first category of complexity	70 350	Sign up
2011047	Vitreoretinal surgery for complicated conditions (2-stage) of the third category	135 050	Sign up
2011039	Vitrectomy for uncomplicated hemophthalmos or vitreous opacities of the second category	53 750	Sign up
2011038	Vitrectomy for uncomplicated hemophthalmia or vitreous opacities of the first category	45 000	Sign up
2011040	Vitrectomy for uncomplicated hemophthalmia or vitreous opacities of the third category	65500	Sign up
2011042	Vitrectomy for complicated conditions of the second category	75 000	Sign up
2011043	Vitrectomy for complicated conditions of the highest category of complexity	105 900	Sign up
2011041	Vitrectomy for complicated conditions of the first category of complexity	69 500	Sign up
2011044	Vitrectomy for complicated conditions of the third category of complexity	120 750	Sign up
2011052	Unscheduled revision of the vitreal cavity	35 000	Sign up
2011066	Reconstruction of the anterior chamber	6 000	Sign up
2011034	Additional extrascleral filling in case of detachment	24 050	Sign up
2011075	Intraoperative administration	6 000	Sign up
2011033	Combined extrascleral filling for detachment	54 000	Sign up
2011063	Circular retinotomy or retinectomy	14 000

Retinal detachment- a severe eye disease characterized by separation of the retina from the choroid, which can be accompanied not only by a pronounced decrease in visual acuity, but also by the development of irreversible blindness and disability of the patient.

Therefore, retinal detachment requires immediate surgical treatment. Timely surgical treatment carried out early after the onset of retinal detachment allows you to completely restore visual acuity. However, modern surgical technologies and methods make it possible to treat retinal detachment even in very advanced cases, resulting in a high functional result.

At-risk groups

Retinal detachment can develop at any age, but most often occurs in able-bodied people aged 25-65 years. Particular attention should be paid to patients with predisposing factors: moderate and high myopia, peripheral vitreochorioretinal dystrophy of the retina of the “lattice” and “trace of the cochlea” type, after surgical treatment of cataracts, trauma and penetrating wounds of the eyeball, chronic sluggish uveitis and intraocular neoplasms, diabetes diabetes. At the slightest suspicion of retinal detachment, such patients are advised to urgently consult an ophthalmologist.

Using modern high-precision equipment, a specialist from our clinic will conduct all the necessary examinations and prescribe appropriate treatment depending on the type, stage, and extent of retinal detachment.

Laser and surgical treatment of retinal detachment.

Currently, our clinic has a rich arsenal of methods for surgical treatment of retinal detachment. Each of them has its own indications for use, advantages and disadvantages. The goal of surgical treatment of retinal detachment is to bring the detached retina closer to the underlying choroid (choroid) and create a tight chorioretinal adhesion to prevent recurrence of retinal detachment.

Pneumoretinopexy	Combination of cryopexy and pneumoretinopexy

For fresh local retinal detachment with single retinal breaks, pneumoretinopexy, cryoretinopexy, and scleral ballooning, both individually and in combination with each other, give good results. Each of these methods of surgical treatment can subsequently be supplemented with laser coagulation of the retina.

In more severe cases of retinal detachment with multiple peripheral breaks and a large area of ​​detachment, it is preferable to perform surgical treatment using scleral filling surgery. Episcleral filling intraoperatively can be combined with pneumoretinopexy, cryoretinopexy, and in the postoperative period - laser treatment of the retina.

In severe cases of retinal detachment with the development of pathological changes in the vitreous body and on the surface of the detached retina, and the obvious ineffectiveness of other treatment methods, endovitreal surgery is indicated - vitrectomy.

Scleral filling	Vitrectomy

Treatment in our clinic

Surgical treatment for retinal detachment is selected individually, depending on the duration of the disease, the volume of detachment, the number and location of breaks, the condition of the vitreous body and the central zone of the retina. In each specific case, treatment can be performed in one stage or several. Treatment of retinal detachment in our clinic is carried out on an ophthalmic surgical combine CONSTELLATION® Vision System manufactured by Alcon (USA) using modern microinvasive technologies, which eliminates the need to open the eyeball and apply sutures. Thanks to this, it is possible to perform surgical treatment of retinal detachment absolutely painlessly under local anesthesia on an outpatient basis without hospitalization of the patient.

Cost of treatment