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Postoperative Retinal Detachment Follow-up

  • Author: Lihteh Wu, MD; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Mar 11, 2016

Further Outpatient Care

According to the surgeon's discretion, an intraocular gas bubble may have been used in the repair of the RRD. If this is the case, the patient will have to adopt a certain head position for several weeks.


Further Inpatient Care

Most vitreoretinal procedures are performed as ambulatory outpatient procedures.


Inpatient & Outpatient Medications

Following vitreoretinal surgery, the patient is usually prescribed a topical prophylactic antibiotic, a topical corticosteroid (eg, prednisolone acetate), and a cycloplegic (eg, atropine 1%). The intraocular pressure is monitored during the postoperative period and treated as necessary with beta-blockers, alpha-agonists, carbonic anhydrase inhibitors, and prostaglandin analogs.



It is good clinical practice that the general ophthalmologist dilates the pupil and examines the peripheral retina prior to cataract surgery. If abnormalities are found, the patient should be referred to a vitreoretinal specialist for further management.

If a patient has risk factors for retinal detachment (eg, myopia, fellow eye retinal detachment, family history), a silicone IOL should not be placed. Instead, a foldable acrylic IOL is a better option.



PVR is the most common cause of failure of surgical reattachment surgery.

Elevated intraocular pressure is common after either vitrectomy with intraocular tamponade or scleral buckling procedures. Most cases respond to topical medications. Very seldom does one have to release the buckle or withdraw gas from the vitreous cavity.

Endophthalmitis following vitrectomy is rare. A scleral buckle may become infected and may need to be removed.



Most series indicate that up to 95% of cases are anatomical successes. Of these cases, as many as 50% obtain a visual acuity of 20/50 or better.[1, 14]

In a retrospective longitudinal cohort analysis of 9216 Medicare beneficiaries diagnosed with a rhegmatogenous retinal detachment between 1991-2007, patients who had undergone primary pneumatic retinopexy were 3 times more likely to receive a second retinal detachment operation compared to scleral buckling or pars plana vitrectomy. Risk of additional retinal detachment surgery did not differ significantly between scleral buckling and pars plana vitrectomy. Patients who had a pars plana vitrectomy were 2 times more likely to suffer adverse events as compared with those who had scleral buckling.[30]


Patient Education

Patients should be educated regarding the symptoms, namely floaters and photopsia, of an acute PVD. Patients should be instructed to seek immediate attention if these symptoms occur.

Contributor Information and Disclosures

Lihteh Wu, MD Asociados de Macula Vitreo y Retina de Costa Rica

Lihteh Wu, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Club Jules Gonin, Macula Society, Pan-American Association of Ophthalmology, Retina Society

Disclosure: Received income in an amount equal to or greater than $250 from: Bayer Health; Quantel Medical; Heidelberg Engineering.


Dhariana Acón, MD Ophthalmologist, Caja Costarricense Seguro Social, Hospital de Guapiles, Costa Rica

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

V Al Pakalnis, MD, PhD Professor of Ophthalmology, University of South Carolina School of Medicine; Chief of Ophthalmology, Dorn Veterans Affairs Medical Center

V Al Pakalnis, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, South Carolina Medical Association

Disclosure: Nothing to disclose.


Teodoro Evans, MD Consulting Surgeon, Vitreo-Retinal Section, Clinica de Ojos, Costa Rica

Disclosure: Nothing to disclose.

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