Pneumatic retinopexy is one type of procedure to reattach the retina. After numbing the eye with a local anesthesia, the surgeon injects a small gas bubble into the vitreous cavity. The bubble presses against the retina, flattening it against the back wall of the eye. Since the gas rises, this treatment is most effective for detachments located in the upper portion of the eye. In order to manipulate the bubble into the ideal location, the surgeon may ask the patient to keep his or her head in a specific position.
The gas bubble slowly absorbs over the next 1-2 weeks. At that time, an additional procedure is usually performed to “tack down” the retina. This can be done either with cryotherapy, a procedure that uses nitrous oxide to freeze the retina, sealing it in place, or with laser. Local anesthesia is used for both procedures.
Some types of retinal detachments, because of their location or size, are best treated with a procedure called a scleral buckle. With this technique, a tiny sponge or band made of silicone is attached to the outside of the eye, pressing inward and holding the retina in position. After removing the vitreous gel from the eye with a procedure called a vitrectomy, the surgeon usually seals a few areas of the retina into position with laser or cryotherapy. The scleral buckle is not visible and remains permanently attached to the eye. This technique of reattaching the retina may elongate the eye, causing nearsightedness.
In rare cases where other types of retinal detachment surgeries are either inappropriate or unsuccessful, silicone oil may be used to reattach the retina. The vitreous gel is removed and replaced with silicone oil, which presses the retina into place. While the oil is inside the eye, the vision is extremely poor. After the retina has resealed itself against the back of the eye, a second procedure may be performed to remove the oil.