Editing Retinal detachment (section)

== Treatment ==
Rhegmatogenous retinal detachment typically requires prompt surgical intervention to preserve vision.<ref name=":2" /><ref name=":1" /><ref name=":6" /><ref name=":7" /> The 3 main options include pneumatic retinopexy, vitrectomy, and scleral buckle.<ref name=":4" /> These are selected based on how the patient presents, including the number, location and size of retinal tears, surgeon preference, and cost.<ref name=":1" /><ref name=":7" /><ref name=":18">{{Cite journal |last1=Sultan |first1=Ziyaad Nabil |last2=Agorogiannis |first2=Eleftherios I. |last3=Iannetta |first3=Danilo |last4=Steel |first4=David |last5=Sandinha |first5=Teresa |date=2020-10-08 |title=Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management |url=https://bmjophth.bmj.com/content/5/1/e000474 |journal=BMJ Open Ophthalmology |language=en |volume=5 |issue=1 |pages=e000474 |doi=10.1136/bmjophth-2020-000474 |issn=2397-3269 |pmid=33083551|pmc=7549457 }}</ref>

=== Pneumatic retinopexy ===
Pneumatic retinopexy is an office-based procedure often used for small and uncomplicated retinal detachments, particularly those involving a single tear in the superior part of the retina.<ref name=":6" /><ref name=":7" /> A gas bubble is injected into the vitreous cavity to push the retina back into place against the back of the eye.<ref name=":4" /><ref name=":6" /><ref name=":17">{{Cite web |title=Surgery for Retinal Detachment {{!}} National Eye Institute |url=https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/surgery-retinal-detachment |access-date=2024-12-08 |website=www.nei.nih.gov}}</ref> Additionally, freezing ([[cryotherapy]]) or [[Laser coagulation|lasers]] are used to seal the retinal tears and prevent further detachment.<ref name=":6" /><ref name=":7" /><ref name=":17" /> Following the procedure, patients are advised to maintain a specific head position to ensure the gas bubble remains in place over the tear and to facilitate proper healing.<ref name=":1" /><ref name=":17" /> Patients must also avoid air travel, high altitudes, and scuba diving until the gas bubble dissolves.<ref name=":17" /> Over time, the gas bubble will be naturally replaced by the eye’s [[Vitreous body|vitreous fluid]].<ref name=":4" />

=== Vitrectomy ===
[[File:Gas bubble (day 8).jpg|alt=Bunch of flowers (close-up), but everything blurred and a dark semi-circle obscuring half the image.|thumb|Visual representation of an eye with a gas bubble looking at a bouquet of flowers (8 days after vitrectomy surgery).]]
[[Vitrectomy]] is a surgical procedure used to treat complicated retinal detachments.<ref name=":1" /> It is especially useful for large retinal tears or tears that are not easily visible.<ref name=":1" /> Vitrectomy is also used for [[proliferative vitreoretinopathy]], which is the growth of scar tissue on the retina that can occur after a retinal detachment.<ref name=":1" /><ref>{{Cite web |title=Complex Retinal Detachment - Patients - The American Society of Retina Specialists |url=https://www.asrs.org/patients/retinal-diseases/34/complex-retinal-detachment |access-date=2024-12-08 |website=www.asrs.org}}</ref><ref>{{Cite journal |last1=Idrees |first1=Sana |last2=Sridhar |first2=Jayanth |last3=Kuriyan |first3=Ajay E. |date=2019 |title=Proliferative Vitreoretinopathy: A Review |journal=International Ophthalmology Clinics |volume=59 |issue=1 |pages=221–240 |doi=10.1097/IIO.0000000000000258 |issn=1536-9617 |pmc=6310037 |pmid=30585928}}</ref> In this technique, the vitreous gel is removed from the eye to relieve the pulling force on the retina.<ref name=":1" /><ref name=":7" /> Any fluid behind the retina is drained, and tears are sealed with freezing or lasers.<ref name=":1" /><ref name=":7" /> The removed vitreous is then replaced with either a gas bubble or [[silicone oil]], which stabilizes the retina.<ref name=":1" /><ref name=":7" /><ref name=":14">{{Cite web |title=Vitrectomy {{!}} National Eye Institute |url=https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/vitrectomy |access-date=2024-12-08 |website=www.nei.nih.gov}}</ref> Patients treated with a gas bubble are advised to maintain a face-down position and refrain from air travel, high altitudes, and scuba diving.<ref name=":1" /><ref name=":7" /><ref name=":14" /><ref name=":15">{{Cite web |date=2024-10-01 |title=What Is Vitrectomy? |url=https://www.aao.org/eye-health/treatments/what-is-vitrectomy |access-date=2024-12-08 |website=American Academy of Ophthalmology |language=en}}</ref> In patients treated with silicone oil, a follow-up surgery is required to remove the oil.<ref name=":1" /><ref name=":7" /><ref name=":15" />  For patients who have not previously undergone [[cataract surgery]], vitrectomy increases the risk of developing a [[cataract]] in the treated eye.<ref name=":1" /><ref name=":7" /><ref name=":15" />

=== Scleral buckle surgery ===
[[Scleral buckle]] surgery is a procedure in which one or more silicone bands are placed around the outer layer of the eye, known as the [[sclera]].<ref name="nhs" /><ref name=":1" /> The procedure typically begins with freezing ([[cryotherapy]]) to seal retinal tears.<ref name=":7" /><ref name=":18" /> Next, the silicone band is placed to create an indentation on the sclera, applying inward pressure that helps reattach the retina to the back of the eye.<ref name="nhs" /><ref name=":4" /><ref name=":1" /><ref name=":6" /> After surgery, the person is often positioned in a prone position to reduce the risk of hemorrhages by preventing blood from reaching the macula.<ref>{{Cite journal |last1=Fallico |first1=Matteo |last2=Alosi |first2=Pietro |last3=Reibaldi |first3=Michele |last4=Longo |first4=Antonio |last5=Bonfiglio |first5=Vincenza |last6=Avitabile |first6=Teresio |last7=Russo |first7=Andrea |date=2022-01-09 |title=Scleral Buckling: A Review of Clinical Aspects and Current Concepts |journal=Journal of Clinical Medicine |language=en |volume=11 |issue=2 |pages=314 |doi=10.3390/jcm11020314 |doi-access=free |pmc=8778378 |pmid=35054009}}</ref> The band typically remains in place permanently unless complications occur.<ref name=":1" /> During the procedure, subretinal fluid may also be drained, though it is sometimes left to reabsorb naturally.<ref name=":1" /><ref name=":6" /> This approach is often preferred for younger patients, those who have not undergone [[cataract surgery]], those without [[Posterior vitreous detachment|posterior vitreous detachment (PVD)]], and those with retinal dialysis, a type of tear commonly caused by trauma.<ref name=":1" /><ref name=":6" /><ref name=":13" /><ref name=":18" /> Possible complications of this procedure include missed retinal breaks, improper positioning of the buckle, infection, inflammation, and [[Diplopia|double vision]] immediately after surgery, which typically resolves on its own.<ref name=":1" /><ref name=":6" /><ref name=":18" /> Scleral buckling can also be combined with [[vitrectomy]] for specific cases.<ref name=":7" /><ref name=":13" />