How are Retinal Tears Treated?
The most common way a retinal specialist will treat a retinal tear is with laser. Cryotherapy and vitrectomy are alternative possibilities and all 3 methods achieve the same goal…to prevent a retinal detachment.
The illustration is demonstrating vitrectomy eye surgery with endolaser to treat a retinal tear.
These outstanding anatomic illustrations of the eye are created by JirehDesign.com.
Retinal Tears
A retinal tear can develop into a retinal detachment. Retinal detachments are potentially vision threatening and can lead to blindness if not surgically repaired.
The goal of treatment of retinal tears is to prevent a retinal detachment.
The most common way a retinal tear develops is from a posterior vitreous detachment (PVD).
Retinal holes, caused by other conditions such as lattice degeneration, can also lead to a retinal detachment and are treated similarly to retinal tears.
Laser Photocoagulation
Laser photocoagulation is the medical term for laser treatment. The laser is used to encircle the retinal tear. This induces the retina to scar to the underlying tissue and prevents fluid from migrating underneath the retina and cause a retinal detachment.
Laser photocoagulation is non-invasive and is performed in the office setting. There is little or no pain and does not require pre-operative fasting or after care.
Not all tears can be treated with laser. In order for successful treatment to occur, the retina specialist must be able to have a clear view of the entire tear. Here are some conditions or situations where laser treatment may be difficult to perform:
- Vitreous hemorrhage – too much blood in the eye blocks the laser light
- Cataract – if too dense, surgeon either can not see well and/or the cataract absorbs the laser
- Intraocular implants – the edges of the implant may make direct visualization difficult
- Location – tears located in the extreme anterior portion of the retina are difficult to see without special instruments and techniques
Cryotherapy
Cryotherapy, or freezing, is an older technique and was a common way to treat retinal tears before laser. Freezing the retina from the outside of the eye yields the exact same results. The retina scars to the underlying tissue and fluid can not get underneath the retina.
Cryotherapy involves a technique called scleral depression. The eye is manipulated with the cryotherapy instrument which pushes the retinal tear into view. There is more inflammation and swelling associated cryotherapy.
Vitrectomy for Retinal Tears
Vitrectomy can also be used if the other modalities are not feasible. Vitrectomy is the basic intraocular surgery performed by retina specialists. During the procedure a laser probe can be introduced into the eye to treat the retinal tear.
Regardless of the method, all three techniques achieve the same results.