Last updated: 02/17/2009

Alternatives to laser photocoagulation as a treatment for RD depend on the location and size of the retinal detachment. Photocoagulation treatment works best on small tears in the retina. One alternative for the treatment of small areas of detachment...

is cryopexy, which is performed as an outpatient procedure under local anesthesia. In cryopexy, the ophthalmologist uses nitrous oxide to freeze the tissue underneath the retinal tear. This procedure leads to the formation of scar tissue that seals the edges of the tear in place.

Pneumatic retinopexy is a procedure that can be used if the RD is located in the upper part of the eye. After numbing the patient's eye with a local anesthetic, the ophthalmologist injects a small bubble of gas into the vitreous body. The gas bubble rises and presses the torn part of the retina back against the underlying choroid. The bubble is slowly absorbed over the next two weeks. The ophthalmologist then uses either photocoagulation or cryopexy to complete the reattachment of the retina.

If the RD is large, the doctor may decide to perform a scleral buckle treatment or a vitrectomy. These procedures are more invasive than laser photocoagulation or cryopexy; however, they are still usually done as outpatient procedures. In a scleral buckle procedure, the doctor attaches a tiny silicon band to the sclera. The buckle, which remains in the eye permanently, puts pressure on the retina to hold it in place.

In a vitrectomy, the ophthalmologist removes the vitreous body and replaces it with air or a saline solution that puts pressure on the retina to hold it in place. Vitrectomies are usually performed if there is a very large tear in the retina; if the macula is involved; or if blood that has leaked into the vitreous body is interfering with diagnosis or treatment.