Vitrectomy & later cataract surgery (also post-LASIK)

[LKNmermaid]

Be thankful this technology and surgical expertise exists..
Being able to help restore a persons vision/window to the world has been a heartfelt blessing.

I am one of the ones who gives the "I don't care" medicines.

 

[Katsmeow]

Be thankful this technology and surgical expertise exists..
Being able to help restore a persons vision/window to the world has been a heartfelt blessing.

Oh, I am extremely thankful. As I was watching the forceps and the peeling I thought about how amazing it all was. As difficult as this all is, I am really glad to have the option to go through the recovery.

 

[W2R]

Oh, I am extremely thankful. As I was watching the forceps and the peeling I thought about how amazing it all was. As difficult as this all is, I am really glad to have the option to go through the recovery.

Having to sleep on the left side only sounds like a nightmare to me! Not to mention a week of face down, and not being able to drive and so on. You are going through a much more difficult recovery regimen than I did for just simple cataract surgery. I hope the recovery time flies quickly and that your vision turns out to be all you hoped.

 

[Katsmeow]

Having to sleep on the left side only sounds like a nightmare to me! Not to mention a week of face down, and not being able to drive and so on. You are going through a much more difficult recovery regimen than I did for just simple cataract surgery. I hope the recovery time flies quickly and that your vision turns out to be all you hoped.

Maybe that means that when I have cataract surgery it will seem like no big deal. Of course, I don't like the restrictions that I have. On the other hand, it is truly amazing that this kind of surgery exists where they can literally use forceps to peel tissue at the retina and restore vision that once would have been lost for good. It is worth it to do everything I can to get the best outcome possible. Improvement isn't guaranteed but it won't be for me for not doing my part in this.

 

[eytonxav]

Sorry I did not see this post or would have responded here, but hopefully our messaging gave you some additional assurance of a good outcome. Dr also discovered a small tear during my procedure and that is why I got the longer lasting gas which in hindsight I appreciated his conservative approach as that will help achieve a better long term outcome. I did have to sleep on my side as you were instructed, and believe was told to keep my head tilted down for a while. While I hate to say it, and my memory may be off, that two month period may have been more like 2.5 months till my bubble went completely away. Living with the bubble for so long was the hardest part, as it kept me from my normal activities of going to the gym and playing softball. Nevertheless, be confident in a good outcome, you used one of the best Drs around.

 

[Katsmeow]

Sorry I did not see this post or would have responded here, but hopefully our messaging gave you some additional assurance of a good outcome. Dr also discovered a small tear during my procedure and that is why I got the longer lasting gas which in hindsight I appreciated his conservative approach as that will help achieve a better long term outcome. I did have to sleep on my side as you were instructed, and believe was told to keep my head tilted down for a while. While I hate to say it, and my memory may be off, that two month period may have been more like 2.5 months till my bubble went completely away. Living with the bubble for so long was the hardest part, as it kept me from my normal activities of going to the gym and playing softball. Nevertheless, be confident in a good outcome, you used one of the best Drs around.

Yes, thank you both for this and your message. Very helpful! Your original problem and then a tear needing the longer acting gas was my exact situation so I read your old posts from when you were going through it. (This is why it is often so helpful for people to post experiences. It may help others even years later).

 

[Dreamer]

I am going to go back and read the old posts about people's cataract surgeries. It is helpful to go back and read them. I am having my first surgery on 09/02/21.

I hope that the time goes quickly for you and that you have a very good outcome.

 

[eytonxav]

(This is why it is often so helpful for people to post experiences. It may help others even years later).

Absolutely, I remember reading W2Rs cataract post very carefully before getting my procedure. It was very helpful.

 

[Katsmeow]

OK. So something interesting about the gas bubble. The bubble makes you super myopic. Mine is starting to come down a little where if I am upright I see a line across my left eye if I look up. But, everything is still very myopic and at least 80% to 85% of my eye still has the bubble.

So sitting upright if I put my hands out straight in front of me and spread my fingers, I can't see the fingers. I can sort of see the hand itself, but no fingers. If I move my fingers I can see the light shifting. Again, not surprising. I can't yet see much "above" the bubble but it is still very blurry.

Well, I was sitting and was looking downward (i.e. eyes parallel to ground) and my hand happened to be stretched out. I realize in that position I could see much better. I could see and count my fingers. In that position the bubble is against the back of the eye but not against the lens. I could even bring my watch close to my eye and read it with my head down. But, with my head up looking straight in front of me, I couldn't even see what was on the watch face (Apple Watch). This was not what expected. I expected as the bubble goes down to be able to see better "above" it. But what I see now is that I can see better if the bubble is not touching my lens. Things are still very blurred compared with normal, of course, but still much better.

I am going to go back and read the old posts about people's cataract surgeries. It is helpful to go back and read them. I am having my first surgery on 09/02/21.

I hope that the time goes quickly for you and that you have a very good outcome.

Thanks. Please do a thread when you have your cataract surgery. I know I have that in my not too distant future.

 

[eytonxav]

You might be lucky and have the bubble dissipate sooner if you can see a line by this point in time. I guess it is a function of your eye cavity and how much gas he administered. I think with me the line took quite a while to show up although the Dr said to expect it at any time after my initial checkup.

 

[Katsmeow]

You might be lucky and have the bubble dissipate sooner if you can see a line by this point in time. I guess it is a function of your eye cavity and how much gas he administered. I think with me the line took quite a while to show up although the Dr said to expect it at any time after my initial checkup.

I can only hope! I can see the line but it is pretty high up. Tomorrow is 2 weeks after surgery. I have a followup appointment next week and will ask him what he thinks based upon where the line is then. I also want to ask if it is typical that you can see better looking down parallel to the floor rather than when upright.

 

[Katsmeow]

Doctor visit

I went in on Monday for a 2 1/2 week visit. Things seemed to be going smoothly.

He explained about being able to see better when I look down (gas bubble not against my lens) versus looking upright (bubble mostly covering lens). It is apparently a matter of focus. When you have the bubble in your eye and you are looking through it, your eye can't focus. So when I look upright I am always trying to focus through the lens and I can't. Even the part above the line (ie the part where the gas is gone) isn't clear since I have to look through the bubble to see above the line. When I put my head down I don't have the bubble right against the lens so I can focus better. He asked me if I could see his fingers when he had me look down and I could. Therefore, my retina is actually functioning. Things are still blurred even so since I do still have gas in my eye.

Basically until the gas bubble is no longer covering the central part of my eye, I won't be able to see well.

I do think I am moving along fairly well on the bubble going away. The long acting gas he used C3F8 (I said E3 in a prior post which was a typo) typically lasts about 2 months. But it can go away a little faster or last a little longer. I know from DFW_M5's posts that his lasted about 10 weeks.

The doctor said mine was about 45% gone at 2 1/2 weeks. If it goes away in a linear fashion, then, mine might be gone by 6 weeks! Of course...it may not go away in a linear fashion. Still, I am glad to be where I am on it. I think by 4 weeks it might be at a point where I am no longer looking through it and my vision will be better.

I asked him all kinds of things on when I could do them. Most of them was after 4 weeks although swimming in the pool was a 2 month thing (I can go in the spa with my head totally above water at 4 weeks).

Oh -- he also cleared me to sleep on my right side as well as left side. While I am a side sleeper having to sleep on one side was tough. I noticed that I was starting to hurt when I walked and it was my left hip area getting sore from being in one position at night. My retinal tear laser repair (which is what caused the need for the long acting gas) looks healed enough that I can sleep on either side.

We did have a discussion about whether I will be able to tell when my vision starts improving from the peel he did. The bottom line is I may be able to. But, if my cataract progresses rapidly I may not. That is the improvement I get from this surgery may be masked by the cataract getting worse. Basically I may need to do the cataract surgery to see all the improvement from the peel. However, from a cataract standpoint in terms of my lens and the power of it, the best thing would be for me to know how much improvement I will get from the surgery. I do plan to get the light adjustable lens where the power can be adjusted after the cataract surgery. Still, it would be ideal to get as much improvement as possible from the peel before doing the cataract surgery. But -- if the cataract gets worse there is a point where I really need to get it done and shouldn't wait. Crabby Mike said his cataract was noticeably worse in 2 to 3 months.

Ideally I would like to be able to wait 6 months to do the cataract but that may not possible. From what I've read using long acting gas increases the likelihood the cataract will get worse.

I asked the doctor when I could expect my vision to be like it was right before the vitrectomy. That is, just getting back to where I was then without even having any improvement yet from the surgery. He said that if my cataract progresses rapidly I may not get back to that point. If I didn't have the cataract complication, he said that he would normally expect me to be back to pre-surgical vision when the gas totally went away. The improvement from the surgery would mostly occur in the first 6 months (perhaps starting as early as a month after surgery) although it can continue for 2 years. But -- I do have a cataract so I may not get back to the pre-surgical state until I have the cataract surgery.

Well, I will just have to see how it develops....

 

[eytonxav]

The improvement from the surgery would mostly occur in the first 6 months (perhaps starting as early as a month after surgery) although it can continue for 2 years. But -- I do have a cataract so I may not get back to the pre-surgical state until I have the cataract surgery.

Well, I will just have to see how it develops....

I know my vision improved over a 2 year period, but I had cataract surgery before the peel. After the bubble disappeared, he was able to see and show me how the inflammation from the surgery gradually diminished at each check up and I did see a gradual and progressive improvement in my vision over that time period. I also have type 2 diabetes, not sure how much that can affect one's vision with changing blood sugar levels, so in my case that might have been an additional factor.

 

[Katsmeow]

I know my vision improved over a 2 year period, but I had cataract surgery before the peel. After the bubble disappeared, he was able to see and show me how the inflammation from the surgery gradually diminished at each check up and I did see a gradual and progressive improvement in my vision over that time period. I also have type 2 diabetes, not sure how much that can affect one's vision with changing blood sugar levels, so in my case that might have been an additional factor.

Yes, he said that once the bubble is gone he can scan my eye and see how the peeled area looks and that should give me some idea of how much improvement he would expect to see at that point. If I am not seeing that improvement and the cataract seems to be getting worse, then that implies it is the cataract that is the problem.

I just hope that I will start seeing some improvement before the cataract worsens too much! I hope that bubble will gone closer to 6 weeks than 8 weeks. Tomorrow I am 3 weeks post-surgery and the line is right in the middle of my eye (which is a very disorienting feeling). So maybe that means I am trending to the lower length of time. Of course I don't know that the bubble dissolving will be linear.

 

[eytonxav]

Tomorrow I am 3 weeks post-surgery and the line is right in the middle of my eye (which is a very disorienting feeling). So maybe that means I am trending to the lower length of time. Of course I don't know that the bubble dissolving will be linear.

Sounds like you are making great progress, much faster than my situation. Keep it up and you will get your wish.

 

[Katsmeow]

It is now 4 weeks since my vitrectomy. There has been a lot of progress the last week. I finished all my eye drops today which is great. It was just time consuming to have to do them several times a day.

As of a couple of days ago, I now see "above" the gas bubble. The bubble itself is no longer a straight line across the middle of my eye. It is a little lower than the center and is a curved line (higher in the middle). As a result I can now focus to look above it. It is nice to know that I can actually see above it. I think at 4 weeks I am a bit ahead of the 2 months forecast for the long acting gas bubble. It is clearly more than 50% gone, so I hope it will be gone by 6 or 7 weeks.

The good news also is that at 4 weeks most of my restrictions are gone. The main ones left are to not lay on my back and not to put my head underwater in the pool.

But I am cleared to exercise, including weights and can wear makeup and can sit in the pool spa. That said, I think my exercise will be limited for a few weeks. The bubble does slosh every time I move. It is even sloshing as I type that. And the left lower quadrant of my vision which is most affected by the gas bubble is still very poor. Also, the right and left eyes are working together better but my depth perception is still not like it was before.

So I think I can do things like using the exercise bike but not too sure I would want to chance the treadmill or an exercise video where I had to move around much.

That said, I do feel I am starting to get more back to normal.

 

[eytonxav]

If I recall correctly, when I got to the point you are describing above, my progress speeded up, so you may not have to deal with the bubble for too much longer.

 

[Katsmeow]

My first real complication after my vitrectomy. Thursday (4 weeks after surgery) I completed my 2 eyedrops. I had a steroid drop that I took 4 times a day the first week, then 3 the next, then 2 and then 1. I followed this schedule precisely. When I completed the last drop on Thursday, I still had little in the bottle but I put the bottle in the box and then tossed it in a small bathroom trash can.

I also completed my antibiotic drops on the same day (4x a day until bottle was empty.

Well -- Saturday I noticed my eye was aching a little. It wasn't extreme. Just a persistent ache that would occasionally go away or feel a little worse. I haven't had pain in my eye for several weeks.

Today I woke up and even before I got up I could tell that the pain was much worse. I looked in the mirror and my eye was extremely red and angry looking.

I called the on call doctor at the surgeon's office. That doctor (not my surgeon but one of the others in the practice) told me that it is probably inflammation. He asked if I had any of the steroid drops out. I was able to fish them out of the trash (the bottle was still in box). He told me do drops 3x today and to call the office in the morning to try to see my doctor on Monday. He said this type of inflammation after completing the drops is not uncommon. (I already have an appointment scheduled for Friday. I could have scheduled that appointment for as early as Monday this week but I set it on Friday to give my gas bubble more time to go down. I was hoping it would be down enough by Friday so they could scan my eye).

I have done one drop so far today and the eye is much better. The pain is more like it was yesterday (very mild) and the red is slightly better. It is still red but not as angry looking.

From looking online I found 2 possible causes for this. Sometimes you can have rebound inflammation if you stop a steroid drop abruptly. I know that I did not do this, as I followed all instructions very carefully.

And sometimes you are just not quite ready to stop the drops. That is, you still have inflammation if you aren't using drops. I didn't have any pain or redness when I was using as little as 1 drop a day. But, going from 1 drop to no drops has seemed to bring it on. I do still have the long acting gas in my eye and perhaps that is why I was subject to inflammation returning.

I will be calling my doctor's office Monday morning. I am hoping that all that needs to happen is that I need to continue the steroid drops for a bit longer.

 

[Marita40]

Is it lotemax? Pretty sure that was the steroid I used and do recall there’s a weaning process. Sometimes too after stopping, your eye might get irritated as it adjusts, but that will resolve itself. Sounds like you are doing great post surgery!

 

[Katsmeow]

I saw the doctor today and it was a great appointment. The pain/redness is inflammation. He said that sometimes it just takes longer to go away than it does for others. I am going back on the prednisolone 3x a day and will taper off it over another 6 weeks. My pressure in that eye has never been high so felt it best to just taper more slowly (before it had been over 4 weeks).

The good news was that my bubble is low enough that they were actually able to scan my eye and to do a vision test.

My vision in the left eye was 20/40. This was an improvement. Pre-surgery it was 20/60 (and had been 20/70 at my first visit when they found the retinal tear). 20/40 is what my uncorrected vision was 2 years ago when I had my last eye exam before this all started (I am a little farsighted in this eye). Unfortunately, I didn't see better with a pinhole today. With the pinhole everything looked very dark which the biggest problem.

Also the scan was great looking. Even I can see the difference in how that area looks. My pseudohole is completely gone and I can see that the retina is smoother.

The best part was that my doctor was really happy with how it looked. He said it really couldn't look better for this stage and was basically everything he wanted it to be.

He expects that most of my improvement will come in the next 5 months. I did ask if it is typical for visual distortion to improve first or if visual acuity typically improves first. My visual distortion (wavy and slanted lines) is not yet better. He said that this varies and there is no set away that things get better. Interestingly, he said that for people whose vision improves first the distortion sometime becomes more noticeable. When vision is blurry people don't notice the distortion as much as they do when vision is clear.

My cataract is continuing to progress and there may be a point where my vision starts getting worse due to the cataract. He is hopeful that I will be able to wait until 6 months after surgery to do the cataract surgery. That would be great if possible.

I go back in 3 weeks and he expects that by then I will be able to lay on my back and the gas bubble will be gone or almost gone.

 

[Katsmeow]

Update - Doctor's visit

I went back for my scheduled appointment last Monday - 7 1/2 weeks after surgery.

On the one hand, everything is sort of fine. The retina looks good. My distorted vision (wave lines) has improved a little bit. I still have my gas bubble which he thinks will be gone next week or the next. Right now it is really small and not much of a problem.

But, there is the other hand.

A week before the appointment I commented to someone that my left eye vision was still very good. Pre-surgery it had gotten down to about 20/60 due to the macular pucker. At my appointment on the 30th it was 20/40 which was great improvement. And, it stayed like that for a couple of weeks.

Then late last week it just cratered. I could tell it was very blurry at a distance. Also, my reading glasses and computer glasses made my left eye vision worse. I could see near better with no glasses than with my reading glasses.

This is apparently all due to the cataract. When they did a scan of my eye on Monday the scan looked "snowy" with little white speckles on it. That wasn't there at the last appointment. Again, that is because the scan is taken through the lens of my eye and my cataract has degraded significantly.

So, even though my vision should continue to improve from my surgery I no longer will be able to see that it is improving due to my cataract. And, the cataract will keep degrading.

I am cleared to have cataract surgery as soon as my bubble disappears. I am going to contact the cataract surgeon's office and make them aware of the situation. With the lens I was planning to use for that eye (light adjustable lens) I had hoped to wait until 6 months out so I would know what kind of improvement I would get from the surgery. But, I don't know that it is advisable to wait that long. I plan to check next week and go from there.

 

[eytonxav]

That is a bit of a dilemma, as the cataract surgeon will implant a lens with the amount of power that your eye can handle, but since your operated eye is still recovering, it might be difficult to get the perfect match. I had the reverse problem, I got my cataract surgery first and the pucker/retina surgery a couple of years afterwards. So when the lens was fitted in my bad eye, he had to give me a lens that would accommodate a less than desirable retina. This caused my distance vision to not be as good in my right eye, although I can see better close up in that eye.

 

[Katsmeow]

That is a bit of a dilemma, as the cataract surgeon will implant a lens with the amount of power that your eye can handle, but since your operated eye is still recovering, it might be difficult to get the perfect match.

Yes, that is the issue. Some of it is mitigated by getting the light adjustable lens which can have its power adjusted (within a range) 3 to 4 times after it is implanted. However, you have to wear UV blocking glasses except when sleeping until the final prescription is locked. One of my main questions is for how long can I do that. Can I weight to lock in until I have the bulk of the improvement from the surgery (which should be back 6 months after surgery which is 4 months from now). And, of course, the fact I had LASIK previously makes it still more difficult. I just need to contact them and see what they recommend.

Oh - on the gas bubble. I am at 2 months tomorrow and still have a very small gas bubble. Think it is will be gone in about a week...

 

[TrvlBug]

I am sorry to hear about all you are going through Katsmeow but this thread has been super helpful to me. I just had emergency vitrectomy surgery on Monday. Thursday night, a dark crescent started appearing in my lower right eye...the one I've had cataract surgery and 3 subsequent retinal tears and detachment repairs. Uh oh, I knew I was in trouble and got on the phone first thing Friday morning. Unfortunately by the time I got to see the retina specialist, the clinic surgery center as well as Stanford's eye clinic was no longer accepting patients for the day and I really didn't want to have the surgery done in a hospital setting.

There were detachments and tears throughout the retina and it was much worse than the original films showed. I was also given the C3F8 gas due to the amount of damage. As a back sleeper, I couldn't sleep on my side w/o ending up on my back during the night. Been sleeping on the couch cocooned in two blankets so I can't move! My 'backpack' is set to arrive Friday and I can sleep in my bed again . Looks like I'll be sleeping on my side much longer than the 2 weeks I was hoping for.

My cat is not happy that I can't pick her up. The other one doesn't like to be picked up so is in seventh heaven . Just wait...I'll make it up to her!

Wishing you a speedy recovery.

 

[Katsmeow]

I am sorry to hear about all you are going through Katsmeow but this thread has been super helpful to me. I just had emergency vitrectomy surgery on Monday.

I am so glad the thread was helpful. Yes, that long acting gas is a super pain. I am 10 weeks as about 50 minutes ago and I still have a tiny gas bubble. It was such a pain to deal with, particularly the first 8 weeks.

Good luck with the backpack to help on the back sleeping. It was a huge help to me. I am mostly a side sleeper anyway but I didn't want to take any chances.

One thing the doctor stressed to me was the importance of following instructions as to recovery. Of course, that isn't a total guarantee but I do think it gives us the best chance for a good result.