Vitrectomy & later cataract surgery (also post-LASIK)

[Katsmeow]

I have read the prior vitrectomy threads. I wonder if anyone here has had cataract surgery post-vitrectomy? It is looking like I need a vitrectomy. I was told a few years ago that I have cataracts in both eyes, but not bad enough for surgery.

I had my last regular eye exam in 2019. I had LASIK surgery in 1998. When I had my eye exam in 2019, I was still seeing very well in my right eye but my left eye was 20/40. It is farsighted with some astigmatism. I don't wear distance glasses but do need readers and computer glasses.

Recently I noticed my left eye vision seemed to be getting worse. I thought it was either progression of the cataract or just my astigmatism/vision in that eye getting a bit worse. I was planning to get this checked. If it was the cataract, I had researched IOLs for people with LASIK and I was most interested in the light adjustable lens. With the LAL, the prescription in the lens is adjusted post-surgery using UV light making it ideal for people who have had LASIK (it is very hard to know what prescription to use for LASIK patients.

Well -- earlier this week I was checking out my left eye vision and looked at something typed on a piece of paper. I noticed that all the lines were wavy and slanted. I also saw a couple of small floaters (I never see floaters). No other symptoms.

I was worried about macular degeneration (DH has the dry form) as distorted vision is common with it. OTOH, it could have just been my astigmatism. But the next day we called DH's retinal doctor's office and they set up an appointment.

The good news is that I don't have macular degeneration. The bad news was that I had a retinal tear. I don't know exactly when it happened as I didn't have any of the symptoms of a retinal tear. The worse news was that I had the tear long enough that I have developed scar tissue. It is that scar tissue causing the distorted vision. Also my 20/40 eye is now a 20/70 eye.

The doctor did laser to repair the tear that day. He said I needed to wait a month and then come back to do a vitrectomy. He didn't go into a lot of detail about it at this visit, but said that it involves 3 incisions in the white of the eye and then he uses "tweezers" to remove the scar tissue. He said that for most people it does improve the vision, but I might get all of it back and there are some people it doesn't help. He warned me that it would make my cataract worse.

He said that I could have cataract surgery but I would not be a good candidate for a multifocal lens. That is OK, because I am not a good candidate for a multifocal lens due to having had LASIK. However, I was hoping to do the light adjustable lens since that can often correct distance, intermediate and near vision even thought the lens is a monocular lens. He did not know if you can use a LAL post-vitrectomy since it is such a new technology.

I had never heard of a vitrectomy so looked it up after I got home and when I could see better after the laser procedure. He had not mentioned the actual removing the vitreous gel part. (I am sure this would come up in the next visit in a month, but this visit was focused mostly on the laser repair of the retinal teat. From looking online, I would guess the scar tissue is a form of epiretinal membrane and he is proposing to do a peel. From what I read this has a good chance of improving my vision although not guaranteed.

All of this was very shocking to me as this came out of the blue and I had no symptoms of the retinal tear at all. It was only when the distortion got bad enough that I noticed this. Clearly, the surgeon feels that it is bad enough that I should get it repaired. I know some people have epiretinal membranes and it doesn't affect their vision. But, this has taken me from 20/40 to 20/70 and I have the distortion.

So questions -- if anyone has dealt with any of this.

1. Has anyone had cataract surgery post-vitrectomy? If so, what was your experience? From what I've read there are more complications with cataract surgery after vitrectomy. The aqueous humor that replaces the gel is less viscous and doesn't support the lens as well in the eye so sometimes when they put in the new lens the capsule moves more and there is refraction error. Also, there is a greater risk of the capsule rupturing. Everything I've read says, though, that cataract surgery can be done but must be done carefully and has a greater risk of complications. Even if my cataract was not that advanced before a large percentage of vitrectomy patients have cataract surgery within 2 years after the vitrectomy even if they didn't have a cataract pre-vitrectomy. (I know some people have cataract surgery at the same time as the vitrectomy but I am not interested in that).

2. Has anyone with a epiretinal membrane or scar tissue on the retina had cataract surgery? If so, did you subsequently have the membrane/scar tissue removed? I read that the presence of an epiretinal membrane does create more risk of a refractive error on the cataract surgery. I did wonder if maybe I should skip the vitrectomy and just not repair the epiretinal membrane. But, then I would have some degree of lost vision in that eye that would be corrected through the peeling process. Also it might make it harder to get a good result with the cataract surgery. And, of course, I don't like the idea of just accepting the lost vision without trying to get it back. But, on the other hand, I would still have my vitreous gel so wouldn't have a more difficult cataract surgery. Theoretically they could repair the scar tissue after the cataract surgery, but I worry that would negatively affect the refraction since my vision would change.

3. This is a real longshot question. Does anyone know anything about using a light adjustable lens after vitrectomy? I did a doctor's website describing LAL patients and one of them was someone with a macular pucker. It looks like, though, she still had the pucker and had not had a vitrectomy.

I am planning on calling the retinal surgeon to ask him more about the vitrectomy and the options but just interested in any experiences. Also, I was planning to go back to the surgeon who did my LASIK as he is also a leading person using the the LAL and other lenses and does cataract surgery as well. I am 4 hours away from him now, but willing to travel.

 

[ShokWaveRider]

I had my vitrectomies (both eyes 3 or 4 weeks apart) but AFTER my cataract surgery. I also had (still have) a scar, wrinkle, kink or whatever you call it on my left retina. This manifests itself when I look at a straight vertical line or object, it has a little kink in it, looks like a small capital "D" in the middle of the line or object. During the first vitrectomy the surgeon "Tried" to remove the scar tissue but was not successful, the vitrectomy was however.

Now 3 years later, I am contemplating having them both done again as I just had YAG laser surgery done on one eye to remove the membrane that builds up behind the lens when it is put in. That membrane is now floating around in my vitreous. Seems like a never ending battle to get rid of floaters.

BUT, I was very comfortable with the Vitrectomies and really would not think twice about having them done again. Easy Op, and easy recovery.

 

[Chuckanut]

I had something that looked like your photo but it was called a laminar hole in retina. Apparenlty, the retina is made up of layers and some how the top layer got stressed and opened up. It was quite jagged. It caused a distortion similar to looking at a straw in a glass of water. The light was refracted and the straw is distorted. So, if I looked at anything with straight lines this distortion was there. FWIW, my 'hole' was a lot more rough and jagged than yours. Scary.

However, I could still see pretty well (2020) out of the eye. I just had to move my eye a bit to reposition the distortion now and then. The ophthalmologist said it would have to get a lot worse before she would attempt any surgery.

With nothing left to do but to hope and pray it would not get worse, I did my own research. I found a combo of vitamins and other eye nutrients called Areds2. It is one of the few such things that will sometimes slow down and maybe halt macular deterioration. There is no evidence it helps with any other eye issues including the one I had. But, what the heck, I started taking it two pills a day. It's just vitamins and other nutrients the retina needs.

I went in every 6 months to get a another picture of the hole to see if there was more cause for concern.

FF three years. I still have the laminar hole, but it is smaller. Most importantly, the jagged parts are now rounded and smooth. The distortion is gone. I now go back once a year for my yearly normal exam and a picture of the retina. So far so good.

I have no idea what would have happened had I not taken the supplement. Maybe the eye would have been worse, or maybe the supplement helped my eye heal. But, I continue to take one pill a day. It can't hurt. And it might have helped.

Note: Costco has the best price on the supplement which is rather expensive for what it is.

Note2: I am amazed that we can actually do surgery on the retina. It's so very thin and delicate. Will wonders never cease?

 

[Katsmeow]

I also had (still have) a scar, wrinkle, kink or whatever you call it on my left retina. This manifests itself when I look at a straight vertical line or object, it has a little kink in it, looks like a small capital "D" in the middle of the line or object. During the first vitrectomy the surgeon "Tried" to remove the scar tissue but was not successful, the vitrectomy was however.

That is interesting about not being able to remove the scar tissue. In my case, the scar tissue removal is the only reason for the vitrectomy so I would hate to have the negatives of the vitrectomy with no benefit. Of course, that is undoubtedly a rare occurrence. I know you received other benefit from the surgery due to your floaters but that isn't an issue for me.

 

[ShokWaveRider]

That is interesting about not being able to remove the scar tissue. In my case, the scar tissue removal is the only reason for the vitrectomy so I would hate to have the negatives of the vitrectomy with no benefit. Of course, that is undoubtedly a rare occurrence. I know you received other benefit from the surgery due to your floaters but that isn't an issue for me.

After having 2 Vitrectomies, I see no negative issues to them, other than the week convalescing till the fluid fills in. They do many per day here. Our Retina Specialist is very highly respected. There were no promises with the scar tissue removal. I am considering another couple of vitrectomies because of floaters and a second attempt to remove the scar tissue. I recently had one of my Lens implant cleaned (YAG Laser), this is common, and there seems to be a lingering floater there.

 

[MRG]

After having 2 Vitrectomies, I see no negative issues to them, other than the week convalescing till the fluid fills in. They do many per day here. Our Retina Specialist is very highly respected. There were no promises with the scar tissue removal. I am considering another couple of vitrectomies because of floaters and a second attempt to remove the scar tissue. I recently had one of my Lens implant cleaned (YAG Laser), this is common, and there seems to be a lingering floater there.

Wow. I had one, as part a retina repair, I didn't have a fun time. Not sure what caused the pain but after following the directions to the T I'm left with 4 bubbles that cover 25% of my vision at certain times. The surgeon suggested another one and I freaked, "why would this be any different from the last?".

I just had YAG done on my other eye with great success except for the floaters that I notice now. I'll live with floaters rather than rolling the dice.

 

[ShokWaveRider]

Wow. I had one, as part a retina repair, I didn't have a fun time. Not sure what caused the pain but after following the directions to the T I'm left with 4 bubbles that cover 25% of my vision at certain times. The surgeon suggested another one and I freaked, "why would this be any different from the last?".

I just had YAG done on my other eye with great success except for the floaters that I notice now. I'll live with floaters rather than rolling the dice.

A Retina repair is a different kettle of fish. Mine is fine except for a small scar kink. My bubble went away in a week.

 

[MRG]

A Retina repair is a different kettle of fish. Mine is fine except for a small scar kink. My bubble went away in a week.

Parts of my bubble are still there 20 months post procedure.

 

[ShokWaveRider]

Parts of my bubble are still there 20 months post procedure.

There are 2 types of vitrectomy. One is a Saline replacement, another in more serious situations involves a more complicated procedure. with Retina detachment or other more serious issues. I cannot speak for those. I had the simple one twice to remove floaters and peel the scar tissue. Again, I had no issues.

I am sorry for your issues, but it does not speak for all. Like anything there is always a small chance of complications, just like the Covid Jab.

Based on my own personal experience, with no Retina complications, I would and will have another 2, one for each eye to remove my current floaters. I need to wait a couple of months though as I just had the YAG Laser last week.

 

[Crabby Mike]

I had a vitrectomy late last year for macular pucker, involving the peeling off of a layer of scar tissue. The eyeball refilled itself in about 10 days IIRC. My preexisting cataract grew quickly, as expected, and my cataract surgery is next Thursday. I've been warned that the risks are somewhat higher, but I don't feel like I have much of a choice, since the cataract has rendered that eye pretty useless.

 

[Crabby Mike]

And looking back at your questions, the vitrectomy was surprisingly non-problematic and not at all painful. My retina surgeon said it was healing well, but the cataract progressed so quickly I haven't seen the benefit yet. I should have had the cataract surgery a month or two ago, but had to delay for other reasons. Unfortunately, the cataract surgeon says the surgery will be more difficult because of the delay. I will likely need both surgeries on the other eye eventually, but either could come first depending on which progresses sooner.

 

[Katsmeow]

And looking back at your questions, the vitrectomy was surprisingly non-problematic and not at all painful. My retina surgeon said it was healing well, but the cataract progressed so quickly I haven't seen the benefit yet. I should have had the cataract surgery a month or two ago, but had to delay for other reasons. Unfortunately, the cataract surgeon says the surgery will be more difficult because of the delay. I will likely need both surgeries on the other eye eventually, but either could come first depending on which progresses sooner.

Thank you. This is interesting and your situation seems somewhat similar (except I also have had LASIK). Are you getting a monofocal lens? If so, are you doing monovision? Did you hear of/consider the light adjustable lens or any other premium lens?

 

[Crabby Mike]

Thank you. This is interesting and your situation seems somewhat similar (except I also have had LASIK). Are you getting a monofocal lens? If so, are you doing monovision? Did you hear of/consider the light adjustable lens or any other premium lens?

I'm just getting the basic lens. My retina doctor had suggested that, and the cataract surgeon told me that was my only option given my previous retina surgery. I told him I'm used to wearing glasses and don't mind if I will still need to, and he said that is "the mature and sensible answer." They will try to choose a lens that lands somewhere between near and far vision, and to that end I'm paying $285 (or close) out of pocket for an option called ORA, where they do a precise measurement of the eye during surgery to optimize lens selection. I'd suggest you Google that, because I just read that it's particularly recommended for those who have previously had Lasik.

 

[MRG]

I'm just getting the basic lens. My retina doctor had suggested that, and the cataract surgeon told me that was my only option given my previous retina surgery. I told him I'm used to wearing glasses and don't mind if I will still need to, and he said that is "the mature and sensible answer." They will try to choose a lens that lands somewhere between near and far vision, and to that end I'm paying $285 (or close) out of pocket for an option called ORA, where they do a precise measurement of the eye during surgery to optimize lens selection. I'd suggest you Google that, because I just read that it's particularly recommended for those who have previously had Lasik.

Good advice.

I opted for mono-vision, post retina surgery I wear glasses to take it away.

 

[Katsmeow]

So following up on this. I want to make sure that I am making the optimal decisions both for removing the scar tissue on the retina and for the best result on ultimate cataract surgery. Of course, all this is complicated by the fact I had LASIK.

The surgeon who did my LASIK surgery was the first person in the US to perform LASIK and the first person in the US to use the latest laser surgery for cataract removal. So I contacted his office. I am going in for a very complete cataract surgery evaluation next week, taking my retina doctor reports with me. I think this will give me the best advice as to what is possible for me given my current situation.

I also see the retina doctor for a follow up to my laser repair this Friday. This is when he will talk to more about the vitrectomy.

I did get a copy of his report from my first visit. A lot became much more clear after reading the report. In fairness to him, at the first visit he was most focused on repairing the retinal tear and why that was important. While he touched on the vitrectomy and the removal of the scar tissue it wasn't the main focus of that visit.

But, in that visit he tended to not use medical terms to describe what was going on. I understand he probably thought I didn't know them. (And, some of them, I did not). But, it made it harder to research what was going on. For example, he indicated that the retinal tear had resulted in scar tissue that he needed to use tweezers to remove. All of that was accurate, but it wasn't in the terminology that I found when I was researching. I kept wondering if what he was talking about was the same as what I was reading about. I kept reading about peeling an epiretinal membrane using forceps. Was that what he meant? I wasn't sure.

Well, getting a copy of his report was illuminating. It seems to indicate that I had a horseshoe shaped tear of the retina due to PVD (I had no idea I had had PVD). The scar tissue is, in fact, a macular pucker.

Chuckanut mentioned my photo looked like a hole. Actually, it is a pseudohole where the scar tissue forms in a way that looks like a hole but really isn't. So, all of that was very helpful. Had he simply told me, though, that it was a macular pucker that would helped the research as I kept wondering if it was one...

Anyway, my plan is to go to see him and see how my eye looks now and get more information about what he plans to do. I will tell him that I am going to the cataract surgeon's office for an evaluation. I assume that the proper order here is likely to do the vitrectomy and then do the cataract surgery later. But -- that is something I want to ask and to get clarity on. Once I know what my options are then I can decide what to do when.

I am not happy about the whole situation. This isn't the fault of anyone. It is my bad luck that I had a retinal tear in the macular area causing the pucker which is causing problems with my vision. Due to prior LASIK I was already limited in the cataract lenses I could use. Nonetheless I had hoped to use the light adjustable lens (which is very cutting edge) in order to end up with good distance, intermediate and near vision. It seems to be the perfect solution.

Now I am facing the possibility of having to use just a regular monofocal lens in the left eye. That will affect my ability to get the near vision I want from cataract surgery. My right eye is fine and perhaps could do something else. But, it won't be what I was planning it to be. Again, this is no one's fault, but I don't have to love this reality.

 

[Katsmeow]

Just a follow up on this particularly for folks who may have a vitrectomy pre-Cataract surgery and especially those who have had prior refractive surgeon. I have had a cataract evaluation since I last posted.

I am having my vitrectomy on the 29th. There is a chance no gas will be used and I will not have to be face down. Greatest likelihood is that I will need to be face down during the day for a week or so but can sleep on side at night. Possibility (although not likely) that something will be discovered or will occur and I will need to be face down at night also.

The cataract evaluation was interesting. I ended up going back to my original LASIK surgeon (4 1/2 hours away from where I live now) since he is also a noted cataract surgeon. In my case doing the vitrectomy first makes the most sense although sometimes it is done in the other order. My distorted vision from the vitrectomy is bad enough I will need the peel of my macular pucker no matter what so I might well do it and start seeing what improvement I get in my vision.

There is a good chance that before I have gotten all of the vision improvement from the peel (very small possibility of no improvement or being worse) that I will start having a worsening of the cataract. Basically many people are still in the phase where there vision distortion is improvement post-vitrectomy but there vision is worsening as the cataract gets worse.

At that point then I will do cataract surgery in that eye. The plan is that I will do a light adjustable lens which is OK to use with people who have had a vitrectomy. The light adjustable lens is one where you can use UV light after surgery to fine tune the prescription based upon your experience with the lens. For people who have had LASIK or other refractive surgery this is often helpful.

Once I have the left eye done I will probably have the right eye cataract done a few months later. For that eye, I will use a different lens, most likely the Vivity lens which again will be good for someone who has had LASIK. But it would not be good for my left eye due to the vitrectomy. There is no probably having different lens in the two eyes. The left eye will be set to a monofocal distance. The Vivity lens gives good vision from distance to intermediate. I would have some improvement in near vision but would likely need reading glasses.

If I get improvement in my left eye from the peel, I will probably set that eye for intermediate distance although that will depend on how much improvement I get from the peel.

 

[Crabby Mike]

Your post reminds me that I haven't updated since my cataract surgery. I had the surgery on 6/10 on my right eye, which had previously had a vitrectomy for macular pucker.

The cataract surgery went flawlessly (despite the surgeon warning me that it would be more difficult because I waited too long), and I was amazed by the results. As everyone says, you suddenly see a much brighter world through that eye, as you're no longer looking through the yellowish haze of a cataract. However, to my dismay there is a "wiggle" in the center of my vision, apparently due to a further flaw in my right retina. The best way I can describe it is if I look at a straight line, it will appear to have a little curve in the middle. Because my cataract grew so quickly after the vitrectomy, I had never been able to assess the result on the retina. I have a followup with my retina surgeon in a couple of weeks, so we'll see what he says.

Meanwhile, my cataract surgery on the left eye is scheduled for next week. The cataract there is not nearly as bad, but enough to qualify for removal, so I've elected to go ahead. I will probably eventually need a vitrectomy on that eye as well, but I would just as soon see the improvement from cataract surgery first, especially given the imperfect result of the vitrectomy on the other eye.

I've elected to take the standard lens in both eyes, selected using ORA, and am fine with needing glasses for reading. I have already found, after the first cataract surgery, that I can now drive without glasses -- my distance vision in the repaired eye is 20/30 without glasses, and I can read the speedometer. I can't wait to have the other eye done now!

 

[Katsmeow]

Your post reminds me that I haven't updated since my cataract surgery. I had the surgery on 6/10 on my right eye, which had previously had a vitrectomy for macular pucker.

Thank you Mike. This was all very helpful. Couple of questions since you had a vitrectomy for macular pucker which is what I am having.

1. After surgery were you face down at all, or just during day or at night also? I've been told that face down during day for a week or so is most likely but could be one of the others. If you were face down, how did that go?

2. After your vitrectomy were you able to see any improvement to your vision before you started having problems with the cataract? If so, about how long after surgery did you start seeing an improvement?

3. I know cataracts can progress rapidly after a vitrectomy. About how long after your vitrectomy did you start seeing the deterioration in the cataract?

 

[Crabby Mike]

Thank you Mike. This was all very helpful. Couple of questions since you had a vitrectomy for macular pucker which is what I am having.

1. After surgery were you face down at all, or just during day or at night also? I've been told that face down during day for a week or so is most likely but could be one of the others. If you were face down, how did that go?

2. After your vitrectomy were you able to see any improvement to your vision before you started having problems with the cataract? If so, about how long after surgery did you start seeing an improvement?

3. I know cataracts can progress rapidly after a vitrectomy. About how long after your vitrectomy did you start seeing the deterioration in the cataract?

I wasn't face down at all. I only had an epiretinal membrane (scar tissue) peeled off. I think the face-down treatment is for your retina to heal after a repair of a retinal tear or whatever.

I don't recall seeing much improvement in my vision after the vitrectomy, except that my floaters in that eye were gone (sucked out with the vitreous!). At my followup appointments, the surgeon noted that my retina was in the process of healing, but he could also see the cataract accelerating. I think my vision in that eye got worse before it could get better. I'll be very interested to see what he says about it at my next visit.

I would say the cataract was noticeably worse within 2-3 months.

 

[Katsmeow]

I wasn't face down at all. I only had an epiretinal membrane (scar tissue) peeled off. I think the face-down treatment is for your retina to heal after a repair of a retinal tear or whatever.

I don't recall seeing much improvement in my vision after the vitrectomy, except that my floaters in that eye were gone (sucked out with the vitreous!). At my followup appointments, the surgeon noted that my retina was in the process of healing, but he could also see the cataract accelerating. I think my vision in that eye got worse before it could get better. I'll be very interested to see what he says about it at my next visit.

I would say the cataract was noticeably worse within 2-3 months.

Thanks. That is very helpful. From what I understand from my surgeon, if all I need is the peel and he doesn't see anything where the gas would be helpful then I would not be facedown. But, in some instances he will and will end up recommended day time face down for a week or so. He thinks it is unlikely I would need face down at night but sometimes they find stuff during surgery. Also a tear or detachment can occur during the surgery.

I did have a tear (which is what caused the scar tissue in the first place) but that has already been repaired by laser.

That is interesting about the cataract being worse so quickly. That is definitely soon enough that I could see it making it where you couldn't see the improvement from the peel yet. My doctor said that is common.

 

[Marita40]

I had the vitrectomy in my right eye for a macular pucker. Two years later I had the predicted cataract surgery in that eye. Both surgeries went well. I did not need to be face down at all. As I recall, this was something I expected but was told either soon before or directly after the surgery that I actually didn't need to do. I'm not sure why. Anyway, I have other issues in that eye (retinal) so my sight is not great. I don't recall it improved a whole lot with the surgeries. A surgery on the eye is often scary but you'll do fine! I've now had several and will soon need cataract surgery on my other eye.

 

[Katsmeow]

I had the vitrectomy in my right eye for a macular pucker. Two years later I had the predicted cataract surgery in that eye. Both surgeries went well. I did not need to be face down at all.

Thanks, Marita. That is helpful. How long after your vitrectomy was it before you could use a computer, read, etc.?

I was told I can rent a face down chair and other equipment if needed. But, since I may not need it I am not spending the non-refundable cost for a week's rental I may not need.

I was told by the rental company that I could call day of surgery if I needed rental equipment and they could deliver it that day for a surcharge of $40 or could deliver the next day for no extra cost. The week's rental is $219 so I don't want to spend it if I don't need to.

 

[Marita40]

You know--sorry to be vague--it was about 8 years ago and my memory is bad. I don't recall taking off more than about a week from work, so I assume I could read/work at the computer by then. I think I just needed some eye rest breaks for awhile. I just don't recall that the recovery was all that traumatic. (As a comparison, I had rotator cuff surgery two years ago, and THAT was a long, painful, and memorable recovery!) As you have said, I also remember lining up the face down chair but then again being told (post surgery I think?) I wouldn't need it. So you are doing everything right, and I hope you won't have to go through the face-down. When is your surgery?

 

[Katsmeow]

You know--sorry to be vague--it was about 8 years ago and my memory is bad. I don't recall taking off more than about a week from work, so I assume I could read/work at the computer by then. I think I just needed some eye rest breaks for awhile. I just don't recall that the recovery was all that traumatic. (As a comparison, I had rotator cuff surgery two years ago, and THAT was a long, painful, and memorable recovery!) As you have said, I also remember lining up the face down chair but then again being told (post surgery I think?) I wouldn't need it. So you are doing everything right, and I hope you won't have to go through the face-down. When is your surgery?

Thanks. I am scheduled for the 29th (a week from today). As I understand it just the peel itself doesn't usually result in needing gas to no face down required. But if they find anything where you need to make sure it stays attached to the retina (like a tear or detachment) or an actual hole in the retina then you have to do some face down (although often not at night).

Based upon that then maybe I won't need gas. But I do have a pseudohole as part of my macular pucker. It looks sort of like a hole but there is no actual hole in the retina. A lot of how well it all goes is how well this all straightens out.

 

[Katsmeow]

Had Vitrectomy

I had my vitrectomy surgery on 7/29. It went fine. However, another small retinal tear was found during surgery that was repaired with laser. It was in a location that couldn't be seen before surgery. The new tear did not need to be peeled.

The surgeon said my macular pucker was very wrinkled but he that he peeled off all the scar tissue. The surgical experience was weird. I was awake although I could not feel my eye. They did give me "happy" medicine so I was very relaxed and unconcerned. That was probably good because I could see the forceps peeling my retina during the surgery which was really odd. I couldn't see anything else.

The big negative is that due to the retinal tear they had to give me the E3F8 gas that lasts 2 months. Often with a macular peel, no gas and no positioning is required. Even without the newly found tear, I would have had to have the 2 week long short acting gas so it could press against the peeled area to help it smooth out the wrinkle. Because of that I had to be face down during the day only.

But, I have the 2 month gas because of the tear. Basically until scar tissue forms around the lasered area it would be easy for liquid to get behind the tear and cause a detachment. After 4 weeks, the scar tissue around the repair will have formed so that isn't a concern. So they put in the longer acting gas to get through those 4 weeks. In an ideal world there would be a month long gas that could be used. But, there isn't. There is 2 weeks and 2 months and so I have to have the 2 month gas although I don't really need it after the first 4 weeks. Because of that I have to sleep on my left side at night so the gas will press against the repaired area.

The one week of day time face down was a pain. I rented equipment to help with it. There was a massage type chair that would be me in face down position. That was helpful for my back and neck and I could read or use my iPad during that time. But the face cushions pulled on my face so would get uncomfortable at a time. I also had a face cradle I could use at a desk or in bed. That is how people sleep who need to be face down for sleep. I did not need that but sometimes used it anyway just to get the body in another position. A lot of the time I sat on the couch and bent at my waist to get my eyes parallel with the floor (yes, they want the eyes parallel not just at an angle) and read on my iPhone. Still by the end of the week my neck and upper back were sore.

As of yesterday I can be upright during the day and things are so much easier. Which is why I can post this as I can now use my computer.

The gas bubble is a pain because you can't see through it. Basically I can see light and dark and some colors. When my husband was sitting 5 feet from me I could see that was a dark spot but couldn't tell what it was. Very weird. That bad vision will make my combined vision worse if my left eye is open so I keep the left eye closed almost all the time.

That is annoying and I can't drive or do lots of things. I can't lift anything over 15 pounds and can't bend my head below heart level (increases eye pressure). I have 2 drops I am using which are find but just have to manage doing it several times a day. But, again, it is so much easier now that I can be upright.

I don't think I will have much idea of whether my vision will be better until I get rid of the gas bubble. Even then it takes usually 6 months or so to get most of your improvement from a peel (and it can take up to 2 years to get it all). And, of course, I know my mild cataract in the left eye will probably start getting worse before that 6 months is up so it can be hard to even see how much improvement you are getting.

Oh -- one other thing. Since I strictly have to be on my left side at night and not on my back I am sleeping on my couch so I can't roll back. I also bought a sleep positioning device on Amazon so can't slide on to my back either. It looks weird but works excellently.

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