LASIK After Retinal Detachment Surgery

Can LASIK be done after retinal detachment surgery? Retinal detachment (also known as detached retina and retinal tear) is a relatively rare but very serious problem. Each year approximately one out of 10,000 people develops a retinal detachment. When the retina detaches, it is lifted or pulled from its normal position. The retina cannot function when it detaches and, unless it is reattached soon, permanent vision loss may result. Therefore, if the retina has become detached and the detachment is too large for laser treatment alone, surgery is necessary to "reattach" the retina.

What is the retina?
Retina is the thin, light-sensitive tissue that covers the back of the eye and works like film in a camera to register the images we see.

What is retinal detachment and what causes it?
Retinal detachment is a serious problem that usually affects middle-aged or older people. However, nearsightedness, infection or injury such as a hard solid blow to the eye, can also make the vitreous separate. It is more common in people with a family history of retinal detachment. If it isn't treated immediately, it will lead to vision problems or even vision loss. The retina detaches because of small tears or holes. These may occur as the retina thins with age. More often, they happen because the vitreous partially separates from the retina. When there is a hole in the retina, fluid from the vitreous space may pass through the hole and flow between the retina and the back wall of the eye. This can separate the retina from the back of the eye and cause it to detach. Once the detachment begins, you may notice that spots or flashes of light have suddenly appeared in your vision. Your vision may seem wavy or watery, or you may have a shadow in your side (peripheral) vision. As the retina detaches further, central vision gets blurry. This can lead to serious vision loss unless it is fixed.

What is retinal detachment surgery?
If the retina is detached, you will need surgery to fix it. Fortunately, in over 90% of cases, retinal detachment can be fixed successfully. Occasionally, more than one operation is needed. About 40% of people who have their detachment successfully repaired have excellent vision within 6 months of surgery. The results are not usually as good when the retina has been detached for a long time or when there is a fibrous growth on the surface of the retina.

Scleral buckling surgery
This is the most common surgery used to treat a retinal detachment. In this procedure, the surgeon places a soft silicone band around the eye, which indents the outside of the eye toward the detached retina. The band is sutured against the tough outer white coating of the eye (the sclera). The surgeon then drains any fluid between the retina and its support tissue, and reattaches the retina with laser photocoagulation or cryopexy.

LASIK after retinal detachment surgery
One of the recent published clinical trials compared the safety and effectiveness of laser in situ keratomileusis (LASIK) in eyes with and without previous retinal detachment surgery. The study involved seven myopic (nearsighted) patients who had previously undergone scleral buckling surgery ( a type of traditional retinal detachment surgery) in one eye and then had successful conventional LASIK surgery in both eyes. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction and vision quality were recorded before and 1, 3, 6 and 12 months after LASIK surgery. The eyes were divided into two groups. The group 1 consisted of eyes that had undergone previous surgery for retinal detachment, and group 2 consisted of the fellow eyes of the same patients, which had not undergone any previous ocular surgery.

At the end of the study, it was shown that the UCVA improved in all eyes in both groups. Hence based on these results, researchers concluded that LASIK can be a safe and effective choice for the treatment of myopia in eyes that have had previous surgery for retinal detachment. However, it was also assumed that the risk of regression may be higher in such eyes than in eyes with no previous scleral buckling surgery (retinal detachment surgery).

Did you have retinal detachment and Lasik surgery? Has your vision improved? Let us know in the box below.

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