Surgical treatment of retinal detachment

The most frequent presentation is the rhegmatogenous form, associated with a retinal tear that allows fluid to pass into the subretinal space. Symptoms such as a sudden increase in floaters, flashes of light and loss of peripheral visual field warrant immediate evaluation.

Dilated fundus examination, complemented by photographic documentation and, when the media do not allow adequate visualization, ocular ultrasonography, defines the extent of the detachment and macular involvement.

The surgical approaches described in the literature include pneumatic retinopexy, scleral buckling and pars plana vitrectomy, used alone or in combination. The choice takes into account the type and location of the tears, the status of the lens and the presence of proliferative vitreoretinopathy.

The vitreoretinal literature describes variable primary reattachment rates depending on technique and case complexity, with the possibility of reoperation in a proportion of patients.

Macular involvement prior to surgery is the principal determinant of visual recovery described in the studies, which underscores the value of early diagnosis.