Katsmeow
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Jul 11, 2009
- Messages
- 5,308
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.
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.
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