This type of surgery is performed by experienced European surgeons-Professors, who have more than 25 years of surgical experience, which gives the highest guarantee to the patient that the surgical outcome will be successful!
Retinal detachment is treated solely by surgical way. The goal of the treatment is closing of the rupture, that is performed by inducing adhesions between retina and choroid, by cryo-treatment at the locus of rupture or by means of laser. To achieve that, rupture must be in close proximity with choroidal tissue either from outside of the bulbus utilizing cerclage with scleral buckle with puncture of scleral tissue and evacuation of subretinal liquid (old-standard way of surgery), or from within by application of expansive gas. Prior to instillation of expansive gas vitreous body must be removed.
This surgery is called VITRECTOMY and is increasingly used in comparison to old style surgery with buckle and puncture. The reason for this is that by removing the vitreous body the chances for genesis of new ruptures are eliminated, as well as new detachments, and that is not the case with application of cerclage and buckle.
In case of shallow detachments and in case of younger patients, usually the classic method is used. In 30% of cases there will be need to operate again, by method of vitrectomy.
Vitrectomy is nevertheless choice number one in cases of detachments occurred from presence of membranes on retina, in cases of long-lasting retinal detachments, diabetes mellitus, detachments resulted from trauma, or because of high myopia. During the surgery those masses are completely removed, which enables permanent adhesion of retina.
In place of vitreous body expansive gas is instilled as tamponade, or silicone oil.
Gas will remain in the eye for some time, 2 – 4 weeks, or 6-8 (depending on gas used as a tamponade) then it is resorbed. Patient is informed that because of gas, he will not be able to see for several days, and then upon receding of gas bubble, the vision is coming back. With the gas in the eye, after the surgery, one should avoid altitudes higher than 1000m and airplane flights until resorption of gas, because there is a possibility of sudden increase of intraocular pressure resulting from gas expansion.
In cases of more complicated and longer lasting detachments, it is practice to use silicone oil as tamponade. It has advantage over gas because patient will see immediately after the surgery and it is always used if it is a case of only one functional eye, multiple ruptures, highly myopic eye, diabetes, but it demands additional surgery, evacuation of silicone oil, approximately two-three months after the first surgery.
In cases of complicated retinal detachments often occurs appearance of scar processes, i.e. genesis of new membranes, even after their complete removal, requiring one or more additional surgeries. This is a case with advanced, long-lasting, non-treated processes, proliferative diabetic changes, traumatic retinal detachments etc.
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.