EYE SURGERY
Retina Surgery
The retina is the light-sensitive layer at the very back of the eye that converts what you see into electrical signals sent to the brain. It is, in essence, the film in your camera. When the retina is damaged, torn, detached or affected by disease, vision deteriorates rapidly and, if left untreated, can be lost permanently. Retinal conditions are among the most urgent emergencies in ophthalmology and require prompt specialist surgical intervention.
Retina surgery, most commonly performed as vitrectomy, is a group of advanced surgical procedures that allow the retinal surgeon to access, repair and treat the retina directly. With modern small-gauge vitrectomy techniques, retinal surgery is minimally invasive, highly effective and performed as a day procedure or with a short hospital stay.
At Royal Eye & Ear Hospital, our specialist surgeons perform SICS using the most precise manual techniques available, giving patients in Nairobi and across Kenya access to world-class cataract care close to home.
Conditions Treated with Retina Surgery
Retinal Detachment — The most urgent retinal surgical emergency. The retina separates from the underlying supportive tissue, causing progressive vision loss. Without prompt surgical repair, total and permanent blindness in the affected eye can result.
Vitreous Haemorrhage — Bleeding into the vitreous gel, most commonly from diabetic retinopathy, causes sudden severe vision loss. Vitrectomy removes the blood and treats the underlying cause.
Diabetic Retinopathy (Advanced) — Tractional retinal detachment and dense vitreous haemorrhage from advanced proliferative diabetic retinopathy require surgical intervention when laser and injection treatments are no longer sufficient.
Macular Hole — A small break in the macula, the central part of the retina responsible for fine detail vision, causing central vision distortion and loss. Vitrectomy with membrane peeling and gas tamponade closes the hole in most cases.
Types of Retinal Surgery:
Pars Plana Vitrectomy (PPV) — The most widely performed retinal surgical procedure. Three tiny incisions less than 1mm wide are made in the sclera. The vitreous is removed and the retina is treated directly through these ports.
Scleral Buckling — A silicone band is sutured around the outside of the eye to relieve vitreous traction on the detached retina. Often combined with vitrectomy for complex cases.
Pneumatic Retinopexy — A gas bubble is injected into the eye to push the detached retina back into position. Used for selected uncomplicated retinal detachments.
Laser Retinopexy — Laser burns are placed around a retinal tear to create a seal, preventing detachment. Used for retinal tears before detachment occurs.
Membrane Peeling — Fine microsurgical forceps peel scar tissue from the retinal surface during vitrectomy for macular hole or macular pucker.
How It Works
Vitrectomy involves Six precise steps:
- Anaesthesia — performed under local anaesthesia with sedation or general anaesthesia. You are comfortable throughout.
- Small-gauge incisions — three tiny incisions less than 1mm wide are made in the sclera, self-sealing and requiring no sutures.
- Vitreous removal — the vitreous cutter removes the vitreous gel while infusion fluid maintains the eye’s shape.
- Retinal treatment — the surgeon treats the retina directly, reattaching detached areas, peeling membranes, sealing tears with laser or removing blood and scar tissue.
- Tamponade — the vitreous cavity is filled with sterile saline, a gas bubble or silicone oil to support the retina while it heals.
- Closure — the small incisions are checked and sealed. The eye is covered with a protective pad.
Most vitrectomy procedures take 1-3 hours depending on complexity.
Why Choose Royal Eye & Ear Hospital for Retinal Surgery?
- Expert Vitreoretinal Surgeon with Exceptional Experience — Dr. Mostafa El Rayes is a Fellowship-trained Consultant Vitreoretinal Surgeon who has performed over 5,000 vitreoretinal surgeries across Egypt, Yemen, Djibouti, Chad, Somalia and Kenya. This breadth and volume of surgical experience is among the highest available in East Africa.
- Aravind Eye Hospital Collaboration — Our clinical collaboration with Aravind Eye Hospital, India, one of the world leading centres for vitreoretinal surgery, ensures our protocols and surgical techniques reflect the very best in global ophthalmic surgical practice.
- Dedicated Eye & Ear Specialists — We are a specialist eye and ear hospital. Vitreoretinal surgery is a core part of our advanced surgical programme.
- Comprehensive Retinal Assessment — Detailed retinal imaging including OCT, fundus photography and ultrasound B-scan guides the surgical plan before every procedure.
- Post-Operative Monitoring — Careful post-operative monitoring confirms anatomical success, manages tamponade and detects complications early.
Benefits of retina Surgery
Saves Vision
For conditions such as retinal detachment and vitreous haemorrhage, surgery is the only treatment that can prevent permanent and total vision loss.
Minimally Invasive
Modern small-gauge vitrectomy uses incisions less than 1mm wide, offering shorter recovery times, reduced discomfort and minimal scarring.
Restores Vision
Successful reattachment of the retina restores functional vision in the majority of cases, particularly when surgery is performed promptly before the macula becomes involved.
Treats Multiple Conditions
Vitrectomy allows the surgeon to address multiple retinal problems simultaneously in a single procedure.
Definitive Treatment for Macular Hole
Vitrectomy with membrane peeling and gas tamponade achieves macular hole closure in the large majority of cases.
Essential for Diabetic Complications
For advanced diabetic retinopathy with tractional retinal detachment or dense vitreous haemorrhage, vitrectomy is the only surgical option.
What to Expect After SICS Cataract Surgery
Timeline:
Day 1-3 — Eye will be sore, red and vision significantly blurred. A protective eye shield is worn. If a gas bubble was used, vision may be almost completely blocked initially.
Week 1-2 — Redness and discomfort gradually improve. Positioning requirements must be maintained. Frequent follow-up appointments monitor the retina and eye pressure.
Weeks 2-6 — If a gas bubble was used, it gradually absorbs and vision slowly improves. For silicone oil cases, vision remains affected until the oil is removed in a second procedure.
Months 2-6 — Vision continues to improve gradually as the retina heals.
Long-term — Regular retinal monitoring continues with OCT imaging and fundus examination at each follow-up.
Recovery Do's and Dont's:
✅ Maintain prescribed head position precisely if a gas bubble was used
✅ Use all prescribed eye drops exactly as directed
✅ Attend every post-operative follow-up appointment without exception
✅ Protect the eye from injury at all times
✅ Report any sudden worsening of vision or severe pain immediately
❌ Do not fly by aeroplane if a gas bubble has been used
❌ Do not rub or press on the eye at any time after surgery
❌ Do not swim or use hot tubs until your surgeon confirms it is safe
❌ Do not stop eye drops without consulting your surgeon
❌ Do not miss positioning requirements if a gas bubble was placed
RESULTS
What Results Can You Expect?
1
Retinal Reattachment
Modern vitrectomy techniques achieve successful reattachment in the large majority of primary retinal detachment cases, with an overall re-detachment rate of approximately 10% in large series.
2
Vision Recovery
Visual recovery after retinal detachment surgery depends critically on whether the macula was detached before surgery. Macula-on detachments typically recover excellent vision. Macula-off detachments recover more limited central vision even after successful reattachment.
3
Macular Hole Closure
Vitrectomy with membrane peeling achieves macular hole closure in the large majority of cases, with many patients experiencing significant improvement in central vision.
4
Time is Critical
For retinal detachment, the urgency of surgery directly determines the visual outcome. Surgery performed before the macula detaches gives the best chance of functional vision recovery.
Risks & Considerations of Retinal Surgery⚠️
1
Cataract Formation
One of the most common complications following vitrectomy, occurring in up to 80% of patients over 50 within two years. Treatable with routine cataract surgery.
2
Re-Detachment
The retina can re-detach after initially successful surgery, particularly in cases with proliferative vitreoretinopathy. Overall re-detachment rate is approximately 10%. Repeat surgery may be required.
3
Endophthalmitis
Intraocular infection reported in approximately 1 in 5,000 vitrectomy procedures. Strict sterile technique minimises this risk.
Patient outcome note: Individual results vary depending on the density of the cataract, the patient’s overall eye health, and adherence to post-operative care. Your surgeon will give you a personalised expectation at your pre-operative consultation.
Frequently Asked Questions About Retinal Surgery
Sudden increase in floaters, flashes of light and a dark curtain or shadow spreading across your visual field. These require urgent same-day assessment. Do not wait for a routine appointment.
Yes. The longer the retina remains detached, the greater the permanent damage. If the detachment reaches the macula before surgery, central vision recovery is significantly compromised even after successful reattachment.
If a gas bubble was used, yes. You will need to maintain a specific head position for several days to weeks to keep the bubble pressing against the repaired retina. Not maintaining the correct position significantly reduces the chance of a successful outcome.
Not if a gas bubble was placed. The change in pressure during flight causes the gas to expand dangerously. Your surgeon will confirm when it is safe to fly, typically 4-8 weeks depending on the gas type used.
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