Treatment of Retinal Detachment in the Aphakic

Abstract

Detachment of the retina in the aphakic has a multiple genesis, the common denominator of which is constituted by the extraction of the cyrstalline lens and by the anterior dislocation of the vitreous body. We can distinguish on the one hand an idiopathic detachment, in which extraction of the lens acts to trigger a phenomenon which was already ‘in fieri’ due to retinovitreal ‘meyoprofic’ (retino-vitreal degenerations of the myopic or senile type). On the other hand, a secondary retinal detachment, in which the pathogenesis of the cataract (trauma, perforating wound) or its extraction (vitreous loss, presence of posterior synechiae) leads to pre-, or post-operative complications such as to constitute the direct cause of the retinal detachment. In particular, we can distinguish between ‘aphakic type’ detachments where numerous small holes at the base of the vitreous are found, anterior to the ora serrata, with circumferential traction on the retina in several quadrants, and ‘phakic type’ detachments, with continuous ruptures of greater dimensions and varied forms, localized more posteriorly than the first, on the equatorial level; and, yet again, retinal detachments complicated by inflammatory and/or traumatic reactions with bands of vitreo-retinal traction responsible for the retinal lesion.