PostOp Eyes

Retinal Detachment Surgery Recovery: What to Expect

Illustration for retinal detachment surgery recovery

General information about typical recovery, not medical advice. Every eye and every surgery is different, and your surgeon's instructions override anything on this page. Read our full disclaimer.

Retinal detachment happens when the retina, the light-sensing layer at the back of the eye, pulls away from the wall of the eye. NEI calls it a medical emergency and warns that delayed treatment raises the risk of permanent vision loss or blindness. The good news on the other side is real: ASRS reports that retinal detachment repairs succeed in about 9 out of 10 cases, though sometimes more than one procedure is needed, and NEI gives the same roughly 9 in 10 figure.

There is no single retinal detachment surgery. ASRS describes three main repairs. A scleral buckle places a silicone band on the outside of the eye to push the eye wall closer to the tear so it can close. Pneumatic retinopexy injects a gas bubble into the eye in the office, and the patient holds a specific head posture so the bubble sits over the tear. A vitrectomy removes the gel from inside the eye and fills it with a gas bubble. Some people get a combination. This page focuses on scleral buckle and pneumatic retinopexy recovery. If your repair was a vitrectomy, the vitrectomy page on this site goes deeper on gas bubble life and face-down positioning.

Recovery feels very different depending on which repair you had. A scleral buckle usually means a sore, red, swollen eye for a couple of weeks and sometimes double vision or a change in your glasses prescription. Pneumatic retinopexy usually means much less soreness but strict head positioning and a gas bubble in your vision, plus every gas restriction that comes with it.

One rule applies to every repair that used gas, in the office or in the operating room. AAO states you cannot fly in an airplane, travel to high altitudes, or scuba dive with an air or gas bubble in the eye. Nitrous oxide anesthesia must also be avoided while gas is present. Beyond that, your surgeon's instructions override everything on this page, because they saw exactly where your tear was and what they used to fix it.

The typical timeline

Typical full recovery: Vision often starts improving around 4 to 6 weeks, with months to settle. Ranges below are what published guidance describes for most people; your surgeon may set different limits for your eye.

StageWhat to expectRestrictions
Surgery or procedure dayDay 0Pneumatic retinopexy is an office-based procedure, described by ASRS as injecting a gas bubble into the eye after sealing the tear with freezing treatment or laser. Scleral buckling is done in an operating room, where ASRS says a silicone band is placed outside the eye wall to push the wall of the eye closer to the retinal tear, with freezing treatment to seal the tear. Expect an eye patch afterward and an aching, sore eye if you had a buckle.Arrange a ride. If gas was used, head positioning starts immediately, and the no-flying, no-altitude, no-diving, and no-nitrous-oxide rules apply from that moment.
First few daysDay 0-3The eye is typically red, watery, and light sensitive. StatPearls describes lid swelling, conjunctival swelling, and corneal swelling with associated inflammation as early effects after scleral buckle surgery, and a buckle is generally the sorer of the two repairs. If a gas bubble was placed, vision through the operated eye is very poor because you are looking through the bubble.AAO advises wearing an eye patch for as long as your doctor recommends. Hold your assigned head position exactly. Take the prescribed drops. No flying, altitude, diving, or nitrous oxide while gas is present.
Positioning periodRoughly day 1 through week 1-2If a gas bubble was used, this is the demanding stretch. ASRS says the pneumatic retinopexy patient maintains a specific head posture to position the gas bubble over the retinal tear. AAO says the position must be held very specifically as the doctor recommends for a few days, and elsewhere describes keeping the head in one position for a length of time such as 1 to 2 weeks. AAO explains gas-bubble patients should stay face-down or sideways when they stand, sit, eat, walk, and sleep unless told otherwise.AAO warns that the surgery may not work if you do not recover in the recommended position. Continue all restrictions on gas and altitude. Scleral buckle patients without gas usually do not have positioning rules, but should confirm that with their surgeon.
Settling inWeek 2 through week 6Soreness and redness fade over these weeks. If a gas bubble was used, it keeps shrinking on a schedule set by the gas: StatPearls reports about 5 to 7 days for air, 1 to 2 weeks for SF6, and 6 to 8 weeks for C3F8, and AAO's EyeNet review reports about two weeks for nonexpansile SF6, three weeks for C2F6, and eight weeks for C3F8. AAO notes floaters and flashing lights may persist for weeks. Buckle patients may notice their glasses no longer work well, since StatPearls describes surgery-induced myopic shift and astigmatism as documented effects of scleral buckling.AAO advises limited activity for several weeks after retinal detachment surgery, and says the ophthalmologist gives specific guidance on returning to normal activities. Any gas restriction continues until your surgeon confirms the bubble is gone.
Vision recovery and follow-upWeek 6 through month 6 and beyondAAO says vision improvement typically begins 4 to 6 weeks after surgery, though complete stabilization may take months. How much vision returns depends largely on whether the macula, the central retina, was detached before surgery. StatPearls reports that 83 percent of patients whose macula was still attached achieved best-corrected vision of 20/40 or better, while around 50 percent of macula-off patients recover to 6/15 or better after surgery in the first week. StatPearls also notes that after buckle surgery, remaining fluid under the retina can persist for up to 3 months and can be observed safely, and that epiretinal membrane, seen in roughly 7.7 to 18.0 percent of cases, is the most common cause of vision loss after otherwise successful buckle surgery.New glasses are usually postponed until the eye is stable. Lifelong awareness of detachment warning signs matters, because a new tear can happen later or in the other eye.

Day by day

When can I...

Is this normal?

Common questions

Can I fly after pneumatic retinopexy or scleral buckle surgery?
If gas was used, no, not until your surgeon confirms the bubble is completely gone. Pneumatic retinopexy always uses gas, since ASRS describes it as injecting a gas bubble into the eye. AAO states that with an air or gas bubble you cannot fly in an airplane, travel to high altitudes, or scuba dive, and StatPearls warns that air travel with intraocular gas can cause bubble expansion and an extreme rise in intraocular pressure with possible permanent optic nerve injury and vision loss. A scleral buckle by itself, with no gas, does not carry the altitude problem, but many buckles are combined with gas, so confirm with your surgeon before booking anything.
How long do I have to hold my head in position after pneumatic retinopexy?
ASRS says the patient maintains a specific head posture to position the gas bubble over the retinal tear. AAO says you must keep a very specific position as your doctor recommends for a few days, and its detachment guidance describes keeping the head in one position for a length of time such as 1 to 2 weeks depending on the case. The position is not always face down, because the bubble floats up and has to sit on your particular tear, so ask which position and how many hours per day. AAO warns the surgery may not work if you do not recover in the recommended position.
Will my glasses prescription change after a scleral buckle?
It often does. StatPearls describes surgery-induced myopia and astigmatism as documented complications of scleral buckling, with myopic shift linked mainly to circumferential buckle elements and astigmatism to radial elements. AAO's EyeNet review also lists refractive changes among notable postoperative issues. Most surgeons wait until the eye is stable before checking a new prescription, and AAO notes vision improvement typically begins 4 to 6 weeks after surgery with stabilization taking months.
How likely is retinal detachment surgery to work?
Quite likely, though not guaranteed on the first try. ASRS reports that retinal detachment repairs succeed in about 9 out of 10 cases, though sometimes more than one procedure is required, and NEI gives a similar roughly 9 in 10 figure. AAO's EyeNet review reports about 80 percent single-procedure success for pneumatic retinopexy rising to about 98 percent with one or more procedures, 80 to 90 percent for scleral buckle in suitable cases, and 64 to 96 percent for vitrectomy depending on complexity. StatPearls notes that proliferative vitreoretinopathy is the most common cause of failure, occurring in roughly 8 to 10 percent of primary repairs. How much vision returns is a separate question that depends largely on whether your macula was detached.

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