Retinal tears and detachment
Rhegmatogenous detachment with one or more retinal breaks. Limited local detachment or tear where laser barricade or external buckle is being considered.
About the service
Retinal detachment requires urgent vitreoretinal assessment. Surgery is chosen according to the detachment type and extent, retinal breaks and other eye characteristics.
Who the service is for
Proliferative changes
Tractional detachment, including proliferative diabetic retinopathy.
Traction and membranes
Combined tractional-rhegmatogenous detachment.
Retreatment
Recurrent detachment after previous surgery.
The macular area
Detachment with vitreous haemorrhage, PVR, multiple breaks or macular involvement.
Assessment before treatment
Exudative detachment requiring investigation and treatment of the underlying cause.
Recovery after treatment
Retinal detachment is not treated with eye drops, vitamins or vascular-support courses. In established rhegmatogenous or tractional detachment, external laser alone does not replace vitreoretinal surgery. Even after successful anatomic reattachment, visual recovery may be incomplete, particularly after prolonged macular detachment, ischaemia or advanced PVR.
Fundus examination
Sudden flashes, a marked increase in floaters, a dark shadow or curtain, field loss or rapid visual decline require urgent dilated retinal examination rather than waiting for a routine visit. Bring records of previous eye surgery, IOLs, silicone oil or prior retinal tears. Do not stop anticoagulants, antiplatelets or systemic medicines on your own.
Limitations and safety
Retinal detachment is not treated with eye drops, vitamins or vascular-support courses. In established rhegmatogenous or tractional detachment, external laser alone does not replace vitreoretinal surgery. Even after successful anatomic reattachment, visual recovery may be incomplete, particularly after prolonged macular detachment, ischaemia or advanced PVR. With intraocular gas, air travel and major altitude exposure are prohibited until the gas is fully absorbed; any anaesthetist must be told about the gas bubble.
Book a consultation
Stages
Stage 1
Urgent examination.
Visual acuity, pressure, biomicroscopy and dilated fundus examination.
Stage 2
Clarifying anatomy
Tear location, detachment extent, macular status, PVR and vitreous; ultrasound for opaque media and macular OCT when informative.
Stage 3
Method and timing selection
Laser, external buckling, vitrectomy or a combination; discussion of tamponade and anaesthesia.
Stage 4
Preoperative preparation
Preoperative preparation under the KazRIED protocol and assessment of systemic risk.
Stage 5
Surgery
Closing the tear or releasing traction, flattening the retina, retinopexy and gas, silicone or perfluorocarbon liquid tamponade when needed.
Stage 6
Early review
Retinal position, pressure, inflammation, macular and tamponade status.
Stage 7
Further follow-up
Monitoring recurrence, new tears and the fellow eye; separate silicone removal when required.
Service benefits
Restoring retinal position
Surgery aims to return the detached retina to its correct anatomical position.
Preserving useful vision
Timely treatment aims to preserve available visual function and reduce the risk of further deterioration.
Care for complex conditions
Vitreoretinal surgery makes it possible to treat changes that cannot be addressed with drops or external laser alone.
Monitoring changes
Follow-up examinations help assess the retinal response to treatment and identify the need for further stages in time.
Methods comparison
Colour applies only to the individual criterion: green = more favourable; yellow = situation-dependent; red = limitation; grey = neutral/not directly comparable. It is not an overall ranking.
Criterion
Laser barricade
Circumferential/local scleral indentation
Vitrectomy
Combined surgery
Main goal
Demarcate a small tear/local detachment
Support the break externally and reduce traction
Release traction and work inside the eye
Address several mechanisms at once
Typical scenario
Limited safely demarcated case
Suitable rhegmatogenous detachment with peripheral break
Extensive/complex detachment, PVR, vitreous haemorrhage
Complex PVR, recurrence, multiple mechanisms
Vitreous removal
No
No or limited
Yes
Yes plus external component
Gas/silicone tamponade
Usually no
Sometimes adjunct gas
Often when indicated
Often when indicated
Refractive change
Low
Myopic shift can occur
Changes possible, especially with cataract
Depends on extent
Main limitation
Not for established extensive detachment
Less suitable for marked PVR/posterior complex pathology
Intraocular surgery and related risks
Larger surgical volume
Laser barricade
Main goal
Typical scenario
Vitreous removal
Gas/silicone tamponade
Refractive change
Main limitation
Demarcate a small tear/local detachment
Limited safely demarcated case
No
Usually no
Low
Not for established extensive detachment
Support the break externally and reduce traction
Suitable rhegmatogenous detachment with peripheral break
No or limited
Sometimes adjunct gas
Myopic shift can occur
Less suitable for marked PVR/posterior complex pathology
Release traction and work inside the eye
Extensive/complex detachment, PVR, vitreous haemorrhage
Yes
Often when indicated
Changes possible, especially with cataract
Intraocular surgery and related risks
Address several mechanisms at once
Complex PVR, recurrence, multiple mechanisms
Yes plus external component
Often when indicated
Depends on extent
Larger surgical volume
Clinical situations
Colour applies only to the individual criterion: green = more favourable; yellow = situation-dependent; red = limitation; grey = neutral/not directly comparable. It is not an overall ranking.
Factor
What the surgeon assesses
Why it matters
Practical impact
Macula attached
Central retina is still on
Progression threatens central vision
Very high urgency
Macula detached
Duration and height
The photoreceptors have already lost contact with the nourishing layer
Visual prognosis is more guarded
PVR
Scar membranes and folds
Prevents easy retinal flattening
Often complex vitrectomy/combined repair
Vitreous haemorrhage
Retinal visibility and bleeding source
May hide tears and prevent laser
Ultrasound and often intraocular surgery
Lens/IOL
Phakic/pseudophakic status and cataract
Affects access, cataract risk and technique
Sometimes combined phaco + vitrectomy
Fellow eye
Tears, retinal degenerations and risk syndromes
Some patients have bilateral risk
Fellow-eye examination is required when clinically indicated
What the surgeon assesses
Macula attached
Macula detached
PVR
Vitreous haemorrhage
Lens/IOL
Fellow eye
Central retina is still on
Duration and height
Scar membranes and folds
Retinal visibility and bleeding source
Phakic/pseudophakic status and cataract
Tears, retinal degenerations and risk syndromes
Progression threatens central vision
The photoreceptors have already lost contact with the nourishing layer
Prevents easy retinal flattening
May hide tears and prevent laser
Affects access, cataract risk and technique
Some patients have bilateral risk
Very high urgency
Visual prognosis is more guarded
Often complex vitrectomy/combined repair
Ultrasound and often intraocular surgery
Sometimes combined phaco + vitrectomy
Fellow-eye examination is required when clinically indicated
Book an appointment
If retinal detachment is suspected, arrange an urgent KazRIED vitreoretinal surgeon examination. After imaging and retinal examination, the surgeon determines urgency and whether laser, scleral indentation, vitrectomy or combined surgery is appropriate.
Procedure prices
Service name
Price
36/1-P Circumferential scleral indentation (per eye)
from 828 000 ₸
128/1-P Closed vitrectomy (per eye)
from 736 000 ₸
128-P Vitrectomy + perfluorodecalin + silicone (per eye)
from 869 000 ₸
167-P Vitrectomy + silicone or perfluorodecalin (per eye)
from 840 000 ₸
166-P Vitreous cavity revision + tamponade (per eye)
from 776 000 ₸
121-P Silicone oil removal (per eye)
from 288 000 ₸
184-P Silicone removal + re-tamponade (per eye)
from 385 000 ₸
157-P PFCL to silicone exchange (per eye)
from 362 000 ₸
158-P Removal of retinal detachment buckle (per eye)
from 253 000 ₸
168/1-P Phaco + IOL + vitrectomy (per eye)
from 960 000 ₸
168-P Phaco + IOL + vitrectomy + silicone/PFCL (per eye)
from 1 075 000 ₸
Our doctors
A team of experienced doctors across specialties.
Experience: 34 years
Head Doctor
Kanafyanova Elmira Gazizovna
Doctor of Medical Sciences; Highest-category ophthalmologist
Experience: 22 years
Head
Orazbekov Lukpan Nurlanovich
Candidate of Medical Sciences, Associate Professor; Highest-category ophthalmologist
Experience: 8 years
Head
Ruslanuly Qayrat
Doctor of Philosophy (PhD)
Experience: 13 years
Ophthalmologist
Kalshabekov Alibi Sembaevich
Highest-category ophthalmologist
Experience: 12 years
Ophthalmologist
Tadzhimetov Murat Mikhaylovich
Highest-category ophthalmologist
Experience: 9 years
Ophthalmologist
Dautalieva Aqbala Zhomartqyzy
First-category ophthalmologist
Experience: 10 years
Ophthalmologist
Qyryqbaev Dastan Rakhmetollauly
First-category ophthalmologist
Experience: 7 years
Ophthalmologist
Oteulieva Marfugha Amanzhanqyzy
Second-category ophthalmologist; PhD Degree Candidate
Experience: 14 years
Ophthalmologist
Botabekov Rustem Makhamadalievich
Experience: 10 years
Ophthalmologist
Kazankapov Gumarzhan Kuanyshevich
Retinal detachment: types, treatment, and postoperative follow-up
Retinal detachment is the separation of the neurosensory retina from the underlying retinal pigment epithelium. Treatment depends on the type of detachment and the condition of the individual eye.
What are the types of retinal detachment?
- Rhegmatogenous: fluid passes through a retinal break and accumulates beneath the retina.
- Tractional: fibrovascular membranes pull on the retina, often in association with diabetic retinopathy.
- Exudative: fluid accumulates without a retinal break because of inflammatory, vascular, or tumor-related processes. Treatment must address the underlying cause.
How is treatment selected?
Treatment planning considers:
- the type of detachment and whether the macula remains attached or is already detached;
- the number and location of retinal breaks;
- the extent of traction and proliferative vitreoretinopathy (PVR);
- the presence of vitreous hemorrhage and cataract;
- previous operations;
- the condition of the other eye.
KazRIED uses vitrectomy, scleral buckling, and laser methods in selected, limited situations.
The goal is to restore anatomical retinal attachment, address the cause of detachment, and preserve as much visual function as possible. In rhegmatogenous detachment, the source of fluid entering beneath the retina must be sealed.
What determines treatment urgency?
Urgency depends primarily on the risk of macular involvement and the duration of detachment.
Patients should not try to judge the stage by symptom severity: a peripheral detachment can progress rapidly, while symptoms of tractional or exudative detachment may develop gradually.
Postoperative follow-up
After surgery, monitoring includes retinal attachment, intraocular pressure, macular condition, and the tamponade agent.
If gas is used, the clinician may prescribe a specific head position and prohibit air travel. Silicone oil may need to be removed in a separate procedure after the retina has stabilized.
The timing of return to work, driving, and physical activity is determined individually.
Facts and offers
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Related services
Frequently asked questions
What is retinal detachment?
Retinal detachment occurs when the neurosensory retina separates from the underlying tissues and can no longer function normally. Some types can rapidly cause irreversible visual loss and require urgent ophthalmic assessment.
Which symptoms require urgent assessment?
A sudden increase in new floaters, flashes of light, a dark shadow or curtain in the visual field, loss of part of the visual field or rapidly worsening vision requires urgent ophthalmic assessment.
Is retinal detachment painful?
Rhegmatogenous retinal detachment is usually painless. The absence of pain does not make the condition less urgent when characteristic visual symptoms develop.
Can retinal detachment be treated with eye drops?
No. Rhegmatogenous detachment generally requires treatment to close the retinal break and restore retinal attachment. Tractional detachment also often requires surgery. Exudative detachment is primarily managed by treating the underlying cause of subretinal fluid accumulation.
Is vitrectomy always required for retinal detachment?
No. Depending on the type of detachment, location and number of retinal breaks, vitreous and lens status and other factors, treatment may involve vitrectomy, scleral buckling, pneumatic retinopexy or a combination of methods.
When can laser treatment help with retinal detachment?
Laser can be used to seal selected retinal tears before substantial detachment develops, to demarcate certain small localized areas and as part of retinal-detachment surgery. Laser alone is generally insufficient for an established extensive detachment.
What is scleral buckling?
It is surgery in which a silicone element is placed on the outside of the sclera. It indents the eye wall toward the retina and helps relieve traction around the retinal break.
What does vitrectomy do in retinal detachment?
Vitrectomy removes the vitreous and relieves traction contributing to the detachment. The surgeon may drain subretinal fluid, flatten the retina, treat retinal breaks with laser or cryotherapy and use gas or silicone oil for internal tamponade.
What is proliferative vitreoretinopathy?
Proliferative vitreoretinopathy, or PVR, involves formation of cellular membranes and scar tissue on or beneath the retina. Their contraction causes traction, makes retinal reattachment more difficult and increases the risk of recurrent detachment.
Why does macular status matter in retinal detachment?
The macula provides detailed central vision. If it is still attached, rapid assessment and treatment planning are important to reduce the risk of macular involvement. If the macula is already detached, the central visual prognosis is generally less predictable.