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The treatment of retinal detachment is surgical. Sometimes it could be the classic approach (scleral buckling) or vitrectomy, depending on the size and number of the holes, the place, duration, age etc. The aim is to cover the rupture on retina, from outside, by making the ‘’scar’’(scleral buckling), or inside by removing vitreous with gas or silicon oil tamponade (vitrectomy).
Vitrectomy is more often used than scleral buckling. Today, vitrectomy is miniinvasive, small incision surgery, like cataract surgery. With this ‘’inside’’ surgery, better visualization and control is achieved. Removing of vitreous body reduces possibility of new traction and rupture, and there are no changes in the axial length, which is not the case in scleral buckling approach.
In young patients and shallow retinal detachment, sometimes is possible to do classical, scleral buckling approach. However, in 30% it is still necessary to reoperate by vitrectomy.
In tractional retinal detachment, long-lasting, traumatic or high-myopic retinal detachment, vitrectomy is used. After removing vitreous body, gas or silicon oil is used as a tamponade (SF6 or C3F8).
The gas will stay 2 and 8 weeks, respectively, until it has been resorbed. The patient is informed that he would not see in a few days until the resorption starts and is not allowed to fly over 1000m altitude high, because of a danger of gas expansion.
In complicated and long-lasting, high-myopic, great rupture or more ruptures, silicon oil as a tamponade is used. The advantage is that the patient can see after the operation. Disadvantage – another operation is needed. It is used in monoculus cases, as well, when the other eye is damaged.
In advanced cases, with a lot of scars already and new membranes forming, in traumatic cases, patient is informed that even one more surgery might be necessary.
Special hospital SVETI VID is devoted to high level of contemporary surgery, in cooperation with most eminent European Universities.
For the first time in this country, vitreoretinal surgery with the use of gas tamponade started here, more than 20 years ago. Among leading eye hospitals in the world, SVETI VID is the place where vitrectomy with small incision, sutureless, using 25 and 23 gauge instrumentation, became miniinvasive surgery, the same as anterior segment surgery. With the perfect visualization pre- and during operation, it is possible to reach every single detail of retina, which enables more precise and subtle surgery with complete solving of retinal situation with long-lasting effects. In SVETI VID special attention is drawn to macular surgery (macular hole, macular pucker). Great possibilities of new diagnostic procedures (OCT, OCT angio, fundus camera) enable us to see almost histological structures and damages of macula.
In SVETI VID, the frontiers of operability are moved toward greater possibilities.