Special Surgical Procedures II
LESSON 1: Eye, Ear, Nose, and Throat (EENT) Surgery
Section I: EYE SURGERY
1-13
1-13. PROCEDURES FOR REPAIR OF DETACHED RETINA
a. General. A retinal detachment is a separation of the portion of the retina that contains the rods and cones from the portion of the retina called the pigment epithelium. As a result, the rods and cones lose nutrition and cease to function. Thus, the visual defect will vary with the extent and location of the detachment.
(1) There are many causes for a retinal detachment. These include trauma, high myopia (causing a thin retina), degeneration, diabetes, infections, and tumors. The danger of a small retinal detachment is that eventually the entire retina will separate and the eye will lose all vision.
(2) Blood or fluid may be present as a result of direct or indirect trauma, severe inflammation, or certain diseases.
b. Operative Procedures.
(1) If the retina is detached as a result of tumor, enucleation may be the operation indicated.
(2) Retinal detachment due to the presence of blood or fluid offers a choice of several operative procedures to the surgeon. All operations are based on the principle of sealing off the area in which the tear has been located, of draining off sub-retinal fluid, and of creating a watertight adhesion between the choroid and the retina. A frequently used operation involves the use of electrocautery. The surgery may be performed using general or local anesthesia.
