Surgery for Retinal Detachments
Dr. Patricia Smith, one of the four board-certified veterinary ophthalmologists at Animal Eye Care, is a pioneer in the surgical management of retinal detachment in veterinary patients. She has performed surgery for rhegmatogenous retinal detachments since joining the team in 1997. Either another veterinary ophthalmologist or your general practice veterinarian, may refer you to Dr. Smith for a retina consult to discuss options for your pet. Laser retinopexy and retinal reattachment surgery are the most common procedures performed.
Retinal detachment is a typically a non-painful condition, but it is usually sight-threatening and often blinding eye problem in any species. The retina is like the “film” in a camera; a thin layer of tissue at the back of the eye which receives light information. This information is transmitted to the brain, via the optic nerve, where it is interpreted as an image. Most cases of retinal detachment are due to inflammation inside the eye. However, another kind of retinal detachment, termed rhegmatogenous, occurs due to the formation of retinal holes or tears in this delicate tissue.
Rhegmatogenous retinal detachments (due to holes or tears in the retina) most commonly occur due to the following conditions: cataracts, lens displacements or luxations, recent cataract surgery, or severe and abnormal degeneration of the clear vitreous gel that fills the space behind the lens and in front of the retina.
At Animal Eye Care we offer surgical management of pre-existing retinal detachments as well prophylactic laser retinopexy to prevent detachment in a high risk patient. The later procedure is recommended for some animals at the same time as cataract surgery, in order to reduce the risk of retinal detachment.
RETINAL REATTACHMENT SURGERY:
Retinal reattachment surgery is performed when large or complete retinal detachments are present. At the initial examination, if retinal reattachment surgery is being considered, Dr. Smith will assess whether or not there is the potential for recovery of vision. The surgery used to reattach the retina, called a pars plana vitrectomy, has a lot of potential complications, and requires a long anesthesia. In addition to the health of the retina, the health and temperment of the pet is also evaluated. We always want to make sure there is the best chance for a successful outcome: return of vision. In some cases, even if we are able to reattach the retina surgically, the patient might not recover much vision due to either preexisting retinal disease or post-operative complications.
LASER TREATMENT OF RETINAL DETACHMENT:
Animal Eye Care also offers laser treatment of the retina. Barrier laser retinopexy can be performed in animals with partial retinal detachments with the goal of preventing the detachment from becoming complete and thus blinding the eye. In addition, in high risk eyes (for example the fellow eye of an animal that has developed a complete blinding retinal detachment) a prophylactic laser retinopexy can be performed. Prophylactic laser retinopexy reduces but does not eliminate the risk of retinal detachment.
The left photograph is a normal dog retina. The right photograph is of a dog with a complete retinal detachment. The retina (the gray membrane like tissue) is torn from the back of the eye and folded over the optic nerve (the roun pink structure).
This picture of the dog retina shows a row of white laser treatments. The laser creates little areas of inflammation which then scar and act like “spot welds” making the retinal attachment stronger. Laser retinopexy is used to prevent retinal detachment (prophylactic), to contain retinal detachments (a barrier retinopexy), and in retinal reattachment surgery to help keep the retina attached.