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Home Patients' Zone Patient Leaflets Retinal Detachment Surgery

Retinal Detachment Surgery

Vitrectomy, gas bubbles and head positioning

A retinal detachment happens when the light-sensitive layer at the back of the eye peels away. It usually starts with flashes, new floaters and then a shadow or curtain spreading across the vision. It is an emergency: the sooner it is repaired, especially before the centre of the retina (macula) detaches, the better the vision afterwards.

Types of surgery

  • Vitrectomy: the vitreous jelly is removed through tiny openings, the retina is flattened, the tear is sealed with laser or freezing, and the eye is filled with a gas bubble or silicone oil to hold the retina in place while it heals.
  • Scleral buckle: a silicone band is stitched to the outside wall of the eye to push it against the tear; common in younger patients.
  • Pneumatic retinopexy: for some small detachments, a gas bubble is injected in the clinic and the tear sealed with laser or freezing.

Head positioning (posturing)

If a gas bubble is used, it floats upwards. Your surgeon will tell you exactly how to hold your head (face down, or on one side) so the bubble presses on the tear. This is usually for about 50 minutes in every hour for 5 to 10 days, including sleeping on the correct side. Correct positioning makes a real difference to success. Ask family to help with meals and support pillows, and get up to walk around regularly to avoid stiffness and clots.

Gas bubble rules

  • No flying, mountain travel or hill stations above about 600 m until your surgeon confirms the gas has gone (usually 2 to 8 weeks). Expansion of the gas can raise eye pressure dangerously.
  • If you ever need an anaesthetic, tell the anaesthetist: nitrous oxide must not be used while gas is in the eye. You may be given a wristband as a reminder.
  • Vision is very blurred until the bubble shrinks; you may see a wobbly line that moves down as it absorbs.

Silicone oil

Silicone oil does not shrink, so it does not limit flying. It usually needs a second operation to remove it after a few months. Vision is blurred while it is in place, and glasses may need changing.

Recovery

  • Use the drops exactly as prescribed; do not rub the eye.
  • Avoid heavy lifting and swimming for 2 to 4 weeks.
  • Time off work varies from 2 to 6 weeks, depending on your job and the bubble.
  • Cataract often develops within a year or two after vitrectomy in people who still have their natural lens.

Contact the surgical team urgently if

  • Increasing pain, vomiting or headache in the first days (possible high pressure)
  • Vision getting worse, or a new shadow
  • Increasing redness or discharge

Frequently asked questions

How successful is retinal detachment surgery?

Most detachments (about 85 to 90%) are repaired with one operation; some need more than one.

Will my vision go back to normal?

If the macula was still attached, vision often returns close to normal. If it had detached, some blur or distortion may remain.

Why can't I fly with a gas bubble?

At altitude the gas expands and can cause a sudden, painful and sight-threatening rise in eye pressure.

How do I sleep while posturing?

Your surgeon will tell you which side to lie on. Face-down pillows or a massage-table style support can help.

Related: Retinal Detachment: Types, Lincoff Rules and Surgery Choice, Floaters, Retina Treatment in Ahmedabad.

This leaflet gives general information and does not replace advice from your own eye doctor. Reviewed by Dr. Dhaval Patel, MD (Ophthalmology, AIIMS New Delhi), November 2026.

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Sadbhaav Eye & Dental Clinic, Motera, Ahmedabad. Dr. Dhaval Patel, MD (AIIMS New Delhi). Monday to Saturday, 10 am to 1 pm and 5 pm to 8 pm. For a serious eye injury outside clinic hours, go to the nearest eye hospital or emergency department.

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