Some situations are emergencies and require immediate surgery. Severe eye infections, eye injuries, and retinal detachments that do not include the macula, all fall into this emergency category.
Almost all retina surgery is performed in a doctor’s office or an ambulatory surgery center.
Anesthesia for Retina Surgery?
Local anesthetic and mild sedation are all that are necessary to ensure a pain-free procedure for most patients. Sedatives are given through an IV to make you semi-conscious, but in a very relaxed state, you will be given a numbing injection around your eye. The numbing injection blocks pain and keeps your eye from moving.
Because most retina surgeries are completed in an hour or less, a local anesthetic and mild sedation will keep you comfortable during the entire procedure.
There are times when general anesthesia is preferred. Young children, patients with dementia, or anxiety are usually given a general anesthesia. This is generally a group decision between the retina specialist and anesthesiologist taking into account age and health of the patient.
Intraocular Air or Short Acting Gas Bubble?
Intraocular air or a gas bubble will be placed in your eye to cover the problem area such as a macular hole, retinal tear, or detached retina. The bubble prevents fluid from reaching the retinal tear or hole, or the reattached retina while it heals.
A short acting gas bubble will disappear in 2 to 3 weeks and be replaced by natural fluid.
The gas bubble makes your vision extremely out-of-focus, but the gas bubble will disappear. When the gas bubble is down to half size you will see a line across your vision where the gas meets the fluid which is gradually replacing it. Day-by-day the line will move lower and your field of vision will enlarge as natural fluid replaces the gas bubble.
If there is any of the gas bubble in your eye you must not fly in an airplane or engage in any travel at higher altitudes (i.e. mountains). The pressure in an aircraft cabin or higher altitudes is lower than the atmospheric pressure at sea level on Earth. The intraocular gas can expand in lower atmospheric conditions and increase the eye pressure. This would cause severe pain and possible loss of sight.
An injection of air into the eye will produce an “air bubble” that can serve the same protective purpose as a “gas bubble”.
Talk with your retina specialist about which is right for your specific retinal repair.
You will have eye drops to prevent infection and you will have to wear an eye patch or shield for a day or two following surgery. Depending on the type of repair your recovery could be days or two to four weeks. If you had a complete retinal detachment repaired it could take a few months for your eye to heal before you will know how much vision was restored.