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Eye Care Archive  (Expert Forum)
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Scleral buckle or Vitrectomy?
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.

Scleral buckle or Vitrectomy?

by Bunuski, Feb 05, 2007 12:00AM
Hello,
I have been diagnosed with retinal detachement in both eyes. The Surgeon gave me the choice of scleral buckle or Vitrectomy surgery. I have scoured the internet , to try to make a choice. I am only 30 and in otherwise good health. I am at -8.50 dia in both eyes. I'm trying to weigh the benefits of both. This has also caused cataracts, which the surgeon did not even address. Which would you recommend to a patient?

by Forum-OD-MP, Feb 05, 2007 12:00AM
cant make a recommendation here for 2 reasons:

1) i am not a retinal surgeon

and

2) i have no idea what your eyes look like on the inside and which would be more appropriate.  only someone who has SEEN your eyes can make that judgement call
Member Comments (36)

by aimee37, Feb 05, 2007 12:00AM
To: bunuski
I am 31.  I wish I had the correct answer for you. I had both. The buckle was second. I a can see objects, light, and movement. Every situation is different. All I can tell you is act fast. I waited. To busy at work, No one to cover, etc. Listen to your doctors and DO NOT OVER DO IT!!  I look forward to hearing about what decision you make and keep your chin up! You are not alone.
Nikkyswfla

by aimee37, Feb 06, 2007 12:00AM
To: nikkyswfla
Ok, maybe I'm just having a anxiety attack. I'm going with the buckle. How long has it been since your surgery? Besides the floaters, my vision is good with contacts,I need help with a decision, and my Dr is not very cooperative. Are you now more nearsighted?

by aimee37, Feb 06, 2007 12:00AM
To: nikkyswfla
Oh, also, thanks for taking the time to reply, anything, and I mean any advice is helpful.

by aimee37, Feb 06, 2007 12:00AM
To: Bunuski
We are few and far between. I know when I go the retinal dr I am the youngest by 30 years. I do not want to discourage you, every case is different. Mine was severe. I waited longer then I should thinking that it was nothing. I can only see light, movement and undiscript shapes. Yes I am much more nearsighted now. -9.75 in the eye that was operated on. What the Drs.do not tell you is that when trama occurs in your eye almost always a cataract will form after. they tell me removing the cataract will not improve my vision. My cataract formed directly in my central vision. I had my surgery Mother's day weekend. I am currently scheduled to go to the Miami Eye Institute to meet with a disease specialist. No one can tell me why this happened other then my drastic near sightedness. -6.75 prior to surgery. I do not let this inhibit my life as much as possible.  I currently work 50+ hours a week. I run a successful full service restaurant and went back to work 10 days after surgery. I
wish you all the luck in the world and will be glad to answer any questions. Drs are cold (at least mine is) Sometimes I want to shake him and say "For the love of God I am only 31 fix this"
Nikole

by aimee37, Feb 07, 2007 12:00AM
To: nikkyswfla
I hear were your coming from, my Dr wouldnt even address the cataracts. Did you ask about a IOL lens? maybe that could improve the nearsightedness?http://visioninfocus.com/423.asp

Of course , you probably already know that.
I'm already at 8.50 I'm worried it will change my vision to a -12, or worse, which would be beyond the capability of contact lenses, and the glasses would be thick and ugly. Since there is distortion in one eye, my Dr said he would consider it successfull if I can see his arm move. Which is not comforting. There are no other Retina specilists here in my city,only the 3 that are in his office. Or I would have gone for a second opinion. I've worn contacts and glasses , all my life, no one ever told me I was at risk of my retinas detaching. And it wasnt caught early.The Dr treated me like I shouldve known. Untill 3 weeks ago, i wasnt even familiar with any of the terms.I'm in utter shock.

by aimee37, Feb 07, 2007 12:00AM
To: nikkyswfla
Well let me know ,how it goes with the disease specialist, I pray he'll have some better news for you. I'll have the surgery tommorow. I can't imagine taking 10 days off work, how long before the swelling went down after the buckle?

by aimee37, Feb 08, 2007 12:00AM
To: Bunuski
I wish you all the luck in the world. The bruising and swelling went away maybe 4 or 5 days after surgery. I never had a chance to get a second opinion either. I went to the dr at 8:0am and I had my first in office surgery at 3:00.
I love it when people say.." I am so sorry I now how you feel" NO YOU DON'T! you can still see. I TRULY know how you feel Bunuski. God be with you. Please let me know how everything goes. I look forward to hearing your success story. I will be jealous.

Nikole

by aimee37, Feb 18, 2007 12:00AM
My experience with scleral buckle has been very bad. outcome was good after surgery bcause I had gone to the dr early after detachment though I wish I could have seen dr earlier.After buckling I got 6/9 vision but then the buckle started to intrude into my eye and got recurrent detachments and the cause was not diagnosed so I had gas plexies and vitrectomies till at last they saw the buckle inside my vitrous chamber and cut through my retina. So they performed another vitrectomy and cut the buckle. I got good vision after all surgeries but then ended up with a cataract due to vitrectomy.But buckle intrusion is rare and I am be an odd one out    

by aimee37, Feb 19, 2007 12:00AM
To: sol123
What are gas plexies.  I'm 3 weeks post DR surgery
and am noticing bubbles to the side of my eye.
I mostly notice it when my eye are closed.
I have a call into the doctor to ask about this.

I read a great research article on the gas
bubbles they inject to repair the tear.  It's
very technical, but essentially it discusses the
effects of the buoyancy of a small gas bubble versus
the surface pressure of a large gas bubble.  I
plan on asking my Dr. which method they used.
Just to keep him on his toes!!

http://www.biomath.medsch.ucla.edu/~tchou/pdffiles/retina6.pdf

by aimee37, Feb 19, 2007 12:00AM
To: nikkyswfla
Nikole, thanks for sharing your story.  I'm 47 and recovering
from DR surgery 1/30/07.  I think my Dr. did a decent job
establishing expectations, but I just didn't realize
the extent of the vision loss and how long it would take
to recover.  Time will tell as to how much I get back.  I
think I caught mine early, so my hopes are high.  I've
seen forums that give a 3 month to 2 year range for the
eyes to fully heal.

I am seeing some wierd things in both eyes now, so that
has me a little nervous.  But as you suggested to the other
poster, I made sure I called this AM about what I'm experiencing.

One of my problems with the DR recovery in the size of my
overall eye.  It's 1/2 the size of my other one.  So when
I move my head up or down, I see double.  I hope that goes
away.   The bloodshot in my eyes is finally starting to diminish,
but I am seeing big bubbles as we speak  (HELP!!  :-))

I had a  cataract in my other eye 2 years ago May.  That really
helped.  I think that will help you a great deal.  That's a very
simple surgery and relatively easy.  A few days and you'll be back to
feeling the same as before