Emergency vitreoretinal surgery · UK
Retinal detachment - theatre today, not next week.
Sudden flashes, floaters or a shadow across your vision is an emergency. A consultant vitreoretinal surgeon, dilated exam within hours, and theatre the same or next day for macula-on detachments - the window that saves central vision.
Why patients choose us
- 01
A vitreoretinal surgeon, on call
A named consultant vitreoretinal (VR) surgeon - not a general ophthalmologist - with routine detachment volume and access to theatre within 24 hours.
- 02
Macula-on triage taken seriously
If your macula is still attached, every hour matters. We aim for same-day theatre because central vision is what is at stake.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - and whether an NHS eye emergency route is the right fit - is impartial and costs you nothing.
Indicative pricing
What private retinal detachment surgery costs in the UK.
Indicative ranges across our vitreoretinal network. Emergency triage is done within hours; theatre booking within the day for macula-on cases.
In short
Vitrectomy for a straightforward detachment: £6,500–£11,000, home day-case.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Emergency dilated VR consultation | £320–£550 | 45–60 min | Same day |
| Pneumatic retinopexy (office-based) | £2,800–£4,500 | 30 min | Day-case |
| Scleral buckle surgery | £5,500–£9,500 | 60–90 min | Day-case or 1 night |
| Pars plana vitrectomy (rhegmatogenous) | £6,500–£11,000 | 60–120 min | Day-case |
| Combined phacovitrectomy (with cataract) | £8,500–£14,000 | 90–150 min | Day-case |
| Silicone-oil removal (secondary procedure) | £3,500–£6,500 | 30–60 min | Day-case |
| Complex re-detachment or giant tear | £10,000–£18,000 | 2–3 h | Day-case or 1 night |
Prices vary by surgeon, by lens status (phakic vs pseudophakic), by whether combined cataract surgery is done, and by tamponade (gas vs silicone oil). Complex re-detachments and giant tears sit at the top of the range. We come back with a firm quote within one working day.
The problem
Macula-on is a race. Macula-off is a plan. Both are surgery, not an outpatient wait.
Retinal detachment is where triage quietly under-delivers - general ophthalmology lists, no vitreoretinal cover overnight, and macula-on cases lost because the window closed.
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Vitreoretinal surgeon or nothing
A general ophthalmologist reduces cataracts and treats glaucoma. Detachment needs a VR sub-specialist with routine volume.
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Speed matters if the macula is on
A macula-on detachment where the central vision is still intact should be in theatre in under 24 hours - every hour compounds risk.
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The technique fits the tear
Superior tears in a phakic eye may suit pneumatic retinopexy; young phakic patients often do best with a buckle; older or pseudophakic eyes typically vitrectomy. One size does not fit.
The journey
From enquiry to recovery - what happens, in order.
One team from first call through same-day theatre, posturing and one-year vision review.
Phase 1 · Before
Assessment, imaging, planning
Phase 2 · On the day
Procedure and recovery
Phase 3 · After
Follow-up and rehab
- 01
Before
You call us with symptoms
Sudden flashes, a shower of floaters or a curtain across vision. We triage in minutes, not hours.
- 02
Before
Dilated exam within hours
A consultant vitreoretinal surgeon sees you the same day for a dilated fundus examination, OCT and B-scan ultrasound if needed.
- 03
Before
Diagnosis and technique decision
Rhegmatogenous, tractional or exudative - and macula-on or macula-off. Pneumatic retinopexy, scleral buckle or vitrectomy chosen accordingly.
- 04
Before
Consent and theatre booking
Same or next-day theatre for macula-on. Within 3–5 days for macula-off. Anaesthetic reviewed, gas or oil tamponade discussed.
- 05
On the day
Surgery
Local anaesthetic with sedation for most. Pneumatic retinopexy in the office (30 min), scleral buckle 60–90 min, vitrectomy 60–120 min.
- 06
On the day
Posture, patch and discharge
Face-down or side-posturing schedule started immediately for gas or oil tamponade. Home the same day with written aftercare.
- 07
After
Reviews and vision recovery
Follow-up at 24 hours, one week, one month and three months. Silicone-oil removal at 3–6 months if used. Vision keeps improving for up to a year.
Typical end-to-end: theatre within 24 hours for macula-on. Final vision review: 3–12 months.
When it helps
When retinal detachment surgery is the right step.
The presentations we see most, plus the mimic that needs bloods and steroids - not the theatre list.
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Sudden flashes and floaters
A shower of new floaters and flashes - posterior vitreous detachment, which can tear the retina in 10–15 percent of cases.
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A shadow or curtain across vision
Peripheral field loss that expands over hours - a rhegmatogenous detachment until proven otherwise.
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Macula-on rhegmatogenous detachment
Central vision still intact - the surgical emergency where speed determines the final acuity.
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Macula-off rhegmatogenous detachment
Central vision already involved - still repaired urgently, but timing is measured in days rather than hours.
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Giant retinal tear
A tear ≥90 degrees - usually needs vitrectomy with heavy liquid and silicone-oil tamponade.
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Tractional detachment (diabetic)
Diabetic proliferative retinopathy - vitrectomy with delamination of fibrovascular tissue, often combined with panretinal photocoagulation.
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Re-detachment after prior surgery
Recurrent detachment or PVR - complex vitrectomy, membrane peel, retinectomy and long-acting tamponade.
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Red flag: new field loss with eye pain or headache
Sudden painful vision loss with headache, jaw claudication or new visual disturbance in a person over 50 can be giant cell arteritis - urgent bloods and steroids, alongside eye care.
Procedure options
Three main techniques, chosen by the tear and the lens.
What each option involves - success rates, tamponade choice, and where each fits by patient anatomy.
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Pneumatic retinopexy
Office-based expansile gas bubble (C3F8 or SF6) plus cryotherapy or laser. Success 70–80 percent in well-selected superior tears in a phakic eye. Fastest and cheapest option.
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Scleral buckle
Silicone band or sponge sutured to the sclera to indent the wall and close the break. Preferred in young phakic patients - avoids inducing cataract. Success 85–90 percent primary.
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Pars plana vitrectomy (PPV)
23, 25 or 27-gauge sutureless surgery. Vitreous removed, retina reattached with fluid-air exchange, breaks treated with endolaser, gas or silicone-oil tamponade. Success 85–95 percent primary.
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Combined phaco-vitrectomy
Cataract removed at the same sitting in pseudophakic-appropriate patients - avoids the near-certain post-vitrectomy cataract in older eyes.
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Silicone oil tamponade
For complex, inferior, giant-tear or PVR detachments. Requires a second operation to remove at 3–6 months. Better long-term view than gas.
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Gas tamponade (SF6, C3F8)
Absorbs over 2–6 weeks. No air travel or general anaesthetic while the bubble is present - pressure change ruptures the eye.
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Complex vitreoretinal surgery
PVR peel, retinectomy, heavy liquid, endolaser - the sub-specialist end of the spectrum, high stakes and long theatre lists.
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Barrier laser for a tear without detachment
A discrete retinal tear caught before detachment is treated with laser (retinopexy) in the clinic - 5-minute procedure, huge upside.
Our vetted UK network
A small panel of vitreoretinal surgeons, we picked them.
Consultant VR surgeons across London and the major UK cities with emergency cover and dedicated detachment lists.
Selection criteria
How we choose every vitreoretinal surgeon in our network.
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Consultant vitreoretinal surgeons with dedicated detachment lists, not general ophthalmology
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24/7 emergency VR cover with same-day dilated examination
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Same or next-day theatre for macula-on detachments
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Combined phaco-vitrectomy and complex re-detachment expertise across the panel
Safety and recovery
What to expect afterwards - honestly.
Retinal detachment surgery is a high-stakes, technique-dependent operation. The single biggest determinant of vision is how fast the macula-on eye reaches theatre.
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Local anaesthetic for most, GA for some
Peribulbar or sub-Tenon block with sedation is standard. GA reserved for children, very anxious patients or long complex cases.
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Cataract after vitrectomy is near-certain in older eyes
Around 60–95 percent of phakic patients over 50 develop a visually significant cataract within 2 years - often best combined at surgery.
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Re-detachment rate 10–20 percent
Primary anatomical success is 85–95 percent depending on technique and complexity. Proliferative vitreoretinopathy (PVR) is the main cause of re-detachment.
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Raised eye pressure and glaucoma risk
A transient pressure spike after gas or oil is common. A minority need long-term glaucoma medication or surgery.
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Endophthalmitis is rare but serious
Post-vitrectomy endophthalmitis under 1 in 1,000. Sudden pain, redness or vision loss in the first two weeks is a same-day emergency.
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Posturing matters
Face-down or side-posturing for 5–14 days after gas or oil supports the tamponade against the break. Non-compliance drops success rates.
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No flying with a gas bubble
Any air travel, altitude or general anaesthetic while a gas bubble is present risks catastrophic pressure change. Wear a warning bracelet.
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Final vision depends on macula status
Macula-on detachments can regain 20/20. Macula-off detachments usually recover to 20/40–20/60. Time to surgery and duration of detachment matter most.
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Red flags after surgery
New pain, sudden vision loss, spreading redness or discharge in the first two weeks need the same-day VR team or the on-call eye service, not a routine call.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used - pneumatic, buckle or vitrectomy - the note the VR surgeon sends you keeps to the same shape.
A quiet reminder
Clinical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the notes and any results before your review, just ask.
- 01 Header
Diagnosis, macula status, technique
Which eye, rhegmatogenous vs tractional, macula-on vs off, and which technique - pneumatic, buckle or vitrectomy.
- 02 Technique
Instruments, tamponade, adjuncts
Gauge (23/25/27), gas (SF6/C3F8) or silicone-oil tamponade, endolaser, cryotherapy, cataract combined.
- 03 Findings
Number and location of breaks, PVR
Where the tears were, whether all were treated, and whether proliferative vitreoretinopathy was present.
- 04 Impression
Posture plan and follow-up
Read this first: posturing schedule, no-fly restrictions with gas, follow-up dates and expected visual recovery.
Recognised by major UK insurers
Retinal detachment surgery is usually covered as an emergency when medically indicated. Silicone-oil removal and combined phaco-vitrectomy are typically covered too. We confirm cover before booking.
Frequently asked
Everything we get asked about retinal detachment surgery.
Quick answers on urgency, technique, posturing, flying and cost.
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Is retinal detachment an emergency?
Yes. Sudden flashes, a shower of floaters or a curtain across your vision needs same-day dilated examination. If the macula is still attached ("macula-on"), the goal is theatre within 24 hours to preserve central vision. Macula-off detachments are still urgent but the timing is measured in days.
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Which operation will I need?
It depends on the tear location, the number of breaks, your lens status and any prior surgery. Pneumatic retinopexy suits some superior tears in phakic eyes; scleral buckle suits many young phakic patients; vitrectomy is the most versatile and dominant in older or pseudophakic eyes. Your VR surgeon will explain the trade-offs.
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Will my vision fully recover?
Macula-on detachments can regain 20/20 in most cases. Macula-off detachments typically recover to 20/40–20/60, sometimes better with a short off-time. Vision continues to improve for 6–12 months after surgery. The longer the macula was off, the poorer the ceiling.
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How long do I have to lie face-down?
When gas or silicone oil is used, posturing (face-down or side, depending on the tear location) is usually needed for 5–14 days - most active during the first 3–7. Non-compliance meaningfully reduces success. Your surgeon will give you a written schedule.
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Can I fly after surgery?
Not while a gas bubble is in the eye - SF6 lasts about 2 weeks, C3F8 up to 6 weeks. Any air travel, altitude or general anaesthetic during that time risks a catastrophic pressure rise. Wear a warning bracelet. Silicone oil does not carry this restriction.
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How much does private retinal detachment surgery cost in the UK?
Roughly £2,800–£4,500 for pneumatic retinopexy, £5,500–£9,500 for scleral buckle, £6,500–£11,000 for standard vitrectomy, £8,500–£14,000 for combined phaco-vitrectomy, and £10,000–£18,000 for complex or re-detachment cases. Emergency VR consultation £320–£550. We confirm a firm figure within one working day.
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