Retinopexy

Retinopexy is a medical procedure used to treat a retinal tear or help repair a retinal detachment. Its main goal is to prevent vision loss by sealing the retina back against the wall of the eye.

Purpose

The retina is the thin layer of light-sensitive tissue at the back of the eye. If there is a tear, fluid in the eye can pass underneath it, leading to a retinal detachment. This is a serious condition that can cause permanent vision loss.

Hence, retinopexy is performed with the aim to:

• Seal a retinal tear or hole

• Prevent progression to retinal detachment

• Reattach the retina (in certain types of detachment)

• Preserve vision and reduce the risk of permanent vision loss

Common Symptoms Leading to Treatment

• Sudden flashes of light

• New floaters

• A shadow or curtain in peripheral vision

The above symptoms are indicative of a retinal tear, which when diagnosed, will call for a retinopexy procedure. Early treatment is very important, because if the retina fully detaches, surgery becomes more complex and vision recovery less predictable. Hence, retinopexy aims to halt this condition and preserve vision.

The laser equipment.

Types of Retinopexy Procedures

There are two main approaches:

1. Laser Retinopexy (Laser Photocoagulation)

• A laser is used to create small localised burns around the retinal tear.

• These burns form scar tissue.

• The scar tissue seals and attaches the retina to the underlying tissue.

• Cryoretinopexy, or Freezing Treatment, uses a freezing probe applied to the outer wall of the eye to create a scar similar to laser, and may be used if the tear is difficult to reach with laser.

2. Pneumatic Retinopexy

• A small gas bubble is injected into the eye.

• The bubble presses the retina back into place.

• Laser or freezing treatment (cryotherapy) is then used to seal the tear.

• The patient must keep their head in a specific position for several days so the bubble stays against the tear, pushing and holding the retina in place.

What Happens During the Procedure

1. Your eye is numbed with drops or a local anesthetic, and eye drops are use to dilate your pupils in order to get a good view of the retina using instruments.

2. The laser, freezing probe, or gas bubble is applied.

3. You may see lights, or feel a pricking sensation (not everyone feels this)

4. The procedure itself usually takes 15 to 30 minutes.

5. You are disrcharged on the same day.

6. After the procedure, on the same day, you will have to report to our clinic for a photograph of the retina to be taken (no additional cost, no consultation).

Common Symptoms After Retinopexy

Normal symptoms:

• Mild redness

• Mild pain or irritation

• Blurred vision

• Seeing the gas bubble (if this technique is used)

Call your doctor urgently if you experience:

• Sudden increase in floaters

• Flashes of light

• A dark curtain or shadow over vision

• Severe pain

• Sudden decrease in vision

Expected Recovery

Recovery depends on the type of retinopexy:

After Laser Retinopexy

• Mild eye discomfort or aching for 1–2 days

• Blurred vision temporarily

• Light sensitivity

• Small floaters

• Most people resume normal activities within a few days.

• Avoid lifting heavy objects or strenous activities for a week.

After Pneumatic Retinopexy

• Blurry vision while the gas bubble is present (this may last for weeks)

• You will see a moving line or bubble in your vision

• Strict head positioning is needed for several days

• No flying or high altitude travel until the bubble dissolves

  
  

It is important to keep with the necessary follow ups with your ophthalmologist, in order to check if the retinal tear or hole has been fully sealed.

Got Questions?

Q&A:

I still see floaters after the retinopexy laser - is this normal?

• Yes, the purpose of the laser is to seal up the retina tear or hole, with the objective of preventing a retinal detachment later on. However, the laser does not remove the floaters. When there is a retinal tear, there is also a possibility that the blood vessels would leak blood into the space in front of the retina (the vitreous), causing the symptoms of floaters. In some cases, these floaters may get lesser over time. However, as the vitreous gel inside the eye degenerates as we age and move around, the number of floaters may also increase or change over time. If there is a sudden large increase of floaters, shadow in the vision, significant drop in vision or any loss of vision, seek medical attention immediately.

Can I do sports after the procedure?

• After laser retinopexy, avoid high impact or streneous activities, or actions that cause sudden or violent movement for the next two weeks to a month, until further advised by the eye doctor. This is because should there already be a tear, any trauma or impact could cause the retina to detach. Even after a retinopexy laser, it can take about two weeks for the scar tissue to form and seal the retina.

Can I fly after the procedure?

• If pneumatic retinopexy (gas bubble) is done, depending on the type of gas used, it can take up to about 2 months for it to be absorbed. You should atend the follow-up appointments with the eye doctor who will best be able to check if the gas bubble has been fully absorbed.

What are some complications of this procedure?

• Retinopexy is generally safe, but no procedure is risk-free. Common complications like discomfort and mild blur vision typically go away gradually and quickly. Less common complications include new retinal tears, incomplete sealing of the retina, and progression to retinal detachment despite the treatment.

• Other rare but serious complications include macular involvement affecting central vision, formation of epiretinal membrane, increase in eye pressure and inflammation, and bleeding or infection.

• Retinopexy does not guarantee that retinal detachment or future retinal tears will not occur, which is why regular follow-up visits are necessary.

Retinopexy is a preventive procedure. We do it not because vision is already lost, but to protect it. A small tear treated early is a minor problem. A detachment treated late can be life-changing.

Concerns? Talk to us!

A quick note on Cryotherapy (Cryopexy)

Cryotherapy (often referred to as cryopexy) is chosen over laser retinopexy in specific scenarios, primarily because it can be applied to areas of the retina that are difficult to reach with a laser or when the view into the eye is obscured. While both procedures aim to create a scar that seals retinal tears or holes, cryotherapy may be done when the retinal tear is too periphery (too much to the side) to be easily visualised for a laser retinopexy to be done.

In certain cases, we may try for laser retinopexy and then switch to cryotherapy if it is determined that laser retinopexy may not be reasonably possible.