Scleral buckle or Vitrectomy?

[Bunuski]

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?

[Forum-OD-MP]

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

[aimee37]

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

[aimee37]

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?

[aimee37]

Oh, also, thanks for taking the time to reply, anything, and I mean any advice is helpful.

[aimee37]

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

[aimee37]

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.

[aimee37]

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?

[aimee37]

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

[aimee37]

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    

[aimee37]

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

[aimee37]

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 surgery except you'll be looking
through a clear lens.  Of course you'll notice what seems like
sand in your eye for a couple of days.  That's normal.

Keep us posted on your progress.  Is your other eye OK ?

[aimee37]

I had a gas bubble during the first surgery. The way the dr xplaned it to me is that the bubble sets the retina back in place. As it dissolves it breaks up into numerous bubbles. I saw the bubbles for MONTHS. It can be quite annoying. Weird things I see all the time! But never ever hesitate to call or go in. I may go in twice a month. Even superbowl Sunday I was in the Retial specialists office due to strange colors and flashing lights.  They call it debris. I am vary well known through out the office. For one I am the youngest.  
I saw a disease specialist at the Miami eye institute last week. I officially have two strikes against me now. My retinal detachment was due to my nearsightedness but I also have Hystoplasmosis (SP?) It is a disease you can only get in the Missouri river valley. I grew up in St. Louis MO. I ran a restaurant in downtown STL that used loud noises to scare off pigions. We had a large patio and spent much time out there cleaning and what ever else. It  is from Bird or Pigions &^*%#@!!! Yuck! They say there are spores in the air that either land in you heart, spleen, lungs, or eyes. It causes intense scaring. The scaring can get into your central vision and cause vision loss. I have none due to this as of
yet. I did have laser surgery on my good eye due to weakness in the retina that has caused a loss of vison in on my left side.
I am quite curious how Bunuski is doing We both realize what he just went through!
Sherlock never ignore any signs. I had additonal tearing one time when I saw flashing light!\
Nikole

[aimee37]

I wouldn't worry too much about that Hystoplasmosis thing.
I would think that if the scarring hasn't yet impacted your
central vision, then it wouldn't from this point on.  How
would it spread ?

Yes, I'm am interested in Bunuski's results too.  You know, I
wish I would have chimed in earlier.  I'm worried that
he might have had DR on both eyes at the same time.  When
he heard you were back in 10 days, I wonder if he understood that
you could return because you had one "good" eye.  Not that
you surgery eye was good enough to return.   If he had
both done, he'll be pretty much home ridden for a good while.
I'll meet with my doctor tomorrow at 4 pm.  BTW, I found out
that I did not have a gas bubble.  I guess my detachement was
lower in the eye.  The Dr. is curious about the 'bubbles' I'm
seeing.   My eye is still much smaller than the good eye.  That's
beginning to worry me.  My double vision is still pretty
prevalent unless I'm looking straight ahead.  BTW, if they
shut down this forum, it will still be available for historic
viewing, but the 3 of us will be unable to communicate.  My email
is ***@**** just in case.

[aimee37]

OMG I never in a million years thought about them doing both eyes at the same time! OH..the dr would not do such a thing.  My heart truly goes out to him.
The dr says I do have issues with the Hysto. For what ever reason I do not have debris floating in my good eye I have fragments of cells. She must ck my eye once a month for progression.
Any idea why my eye would twich? Other than I run a restaurant in SWFLA during season with 140+ children working for me. It can make you crazy. My dr associates it to stress.
If we lose the site you can reach me at ***@****
Good luck tomorrow. What did you have if it was not a gas bubble?  If no bubble seeing bubbles can't be good.
Let me know how it goes.
NIkole

[aimee37]

Oh my!..This really picked up when I was out of commision.I just dropped in to see how Nikky was doing. I have heard of the spores from the pigeons making people sick, I never even thought of the effect it would have on the eyes!! Well, I'm back at work.. under 10 days..who hoo! I had the buckle , and compared to what I read from this site it really went well, some double vision, but they said that would go away in 3-4 months.Starbursts and wavy effect. it looks like it completly attached, there is scar tissue that could not be removed , my eye is still red , and seems smaller , then the other ..but so far so good. I owe a big Gracias to Nikki for her support, that I didnt get anywhere else, including my husband!!Oh yeah Bunuski is a she.

[aimee37]

Fantastic!!!!! I was worried. 10 days is great. Yea I have one eye smaller than the other. My boyfriend says it gives me character! He also wants to buy me a pink helmet and protective eyeware????
I have no idea why i assumed a male.
Did they do both eyes at the same time?
So glad your back in the swing of things! Please do not hesitate to ask any questions. I do not think anyone has any idea of what we go through. Sure, they try and sympothize. Scary stuff.
You owe me nothing. I have a huge smile on my face. I am so glad you are ok!  

[aimee37]

What happened at the dr today?
Your health is in my thoughts.
Nikole

[aimee37]

Yes, very good news.  Congratulations.  It took
me almost 3 weeks before I could tolerate going
without the patch.  Most wear it 1 or 2 days.
For the first 6-10 days, I had an overwhelming
pressure across my eye.  Not painful, just extremely
uncomfortable.  The feeling of 'crossing' one
eye, except about 100 times more of that feeling.
That's likely a symptom of the the eye muscle issue causing the double vision.

I'm trying to measure my double vision
improvement, but the progress is slow.  My gaze
down is where it is quite prevalent.  Like you,
the doctor expects that to go away.  And my
eye is much smaller than the other.  The Dr.
said it's because of my eyelid drooping (which
he say's will go away too), but the eye is clearly
smaller, even when I lift the lid.

Overall, I've turned a corner and no longer feel
the pressure.  Still moderate vision progress,
but I think that will come in time.

Keep posting on your progress.  It will be a good
frame of reference to compare.

[aimee37]

Thanks for asking.  I appreciate the support.

I described to the Dr. the bubble shapes as
best I could.  Somewhat transparent bronze or
gold bubbles to the far left of my left eye.
Relatively large.  It you stacked them up from
top to bottom, there would be about 5.  Some
just seem to pop and all are very bright.

Anyway, he thinks they are likely produced by
factors involving blood vessels and light.
Or since he said I have lots of debris in the
vitreous, it could be floaters.  Such floaters
would be unlike the floaters typically seen.
You know, the small black dots or objects.
He thinks it's the former (blood vessels) and
I agree.  He is not concerned, so I left feeling
less worried about another tear or re-detachment.
He's a compassionate doctor and seems to really
be invested in my recovery.  I'm very fortunate
in that regard.

[aimee37]

A pink helmet! I want one..I have tears and holes in both,fluid as well, that was drained from the left. the Dr would only operate on the left eye, I have 20/20 vision with contacts in the right, If I do that one, I'm sceptical it will go as well. I might wait a few months.I want the best vision possible , before having the other eye done.So keep me posted as to what options they have for you , hopefully this will help others as well!  

[aimee37]

I have what only can be described as starbursts mostly seen when I close my eyes, the Dr said it was normal, and nothing could be done. It may go away.Does this sound like what you see? I'm so glad you found a Dr who actually "cares". You are lucky.

[aimee37]

I don't think mine are starbursts.  I looked around for starbursts
and someone described that as the spray of light around a car
headlight.  Kind of like when your eyes are dilated.

Mine really seem like bubbles floating quickly to the
top of my eye.  Sometime they move from the top to bottom,
though.  Since I didn't have a gas bubble as part of my surgery,
we could dismiss that.

[aimee37]

Vitreous fluid from the eye? I still have some that could not be completly removed.  

[aimee37]

Yes, it could be debris in the vetreous fluid.
I don't think it's the vitreous fluid itself
unless that's got behind the retina from a
hole (egads!).

[aimee37]

Oh, also, about the eye twitch, I had read somewhere that it is associated with the issues were having, it irritates the surface of the eye. My left , the one that was operated on twitches constantly, when it never did before all this. I attempted to discuss this with the surgeon before the operation, he said it was minor, and nothing could be done. I was actually trying to warn him, in case it twiched when I was under, but alas, my attempt was futile :)

[aimee37]

I can relate to all you guys...i am only 21 yrs old and i have had 2 retinal detachment surgeries...1st one was done with gas SF06 and 2 weeks later that failed and now i got silicone oil + cortisone in my left eye. All this resulted from eye trauma i got last year november.

My vision is very blurry and i lost my lens from the injury, i can only see light, some colors and large objects like cars etc. Now i have been keeping my head in the positions i was told to and sometimes(not often) i still see those flashes of orange/yellow light....when will this stop!?.

But my main concern is the dimness i notice...light is not as bright as before it feels like i have sunglasses on.And my vision alignment is a bit skew(to the left) and on top of all this i have a droopy eyelid!

This is the worst thing that could of ever happened to me...i can't focus at work i cant see well at night, i cant look people in the eyes...its all crazy. And my doctor says it will be months before i can see again if it all goes well. I hope my retina is attaching again... its been 3 and a half months...pls anyone some advice will be gladly appreciated.

And i know that there are people with far bigger problems than mine out there but this is about me i need to see again...im way too young for this. :(

[aimee37]

I'm only 5 weeks post surgery, but I've read on
some forums that ( depending on the individual ),
expect anything from 6 months to 2 years to fully
heal.  The dimness may be due to a cataract forming
(which is pretty common), but you said something about losing a lens.  I'm not sure what you meant by that.

I also have vision alignment issues to the left
and the gaze down.  Double vision is the result,
but it is suppose to get better.  Time will tell.
As for droopy eye, I'm experiencing some of that
but am told that will diminish over time too, as
the muscles grow stronger.

Good luck.  You're among friends.

Another forum for really good insights is at:

http://groups.yahoo.com/group/detached-retina/messages?o=1

[aimee37]

Somethings wrong with this forum, i cannot see yours or my posts?.

[aimee37]

It's ok for me.  If you're using Netscape, try using
Explorer.

[aimee37]

You are way too young for this! We all are way too young. If you are 80 you are too young for this.
I will have my one year anniversery in May. For my surgery that is. It ALL looks bleak in the beginning. It won't stay that way. For whatever reason your body adjusts. Your feelings of overcoming take over. Trust me I am frusterated every day. Somedays scared. Somedays mad as hell!
It is so true how you take things for granted. Low lighting still effects me. I am sure the dr told you about cataracts.This has a lot to do with light perception. In time they can remove the cataract. I believe they wait a while after the inital surgery.
Stay positive. There are alot worse off then us.... Wow it is hard to believe that somedays!
Do not hesitate to ask ANY question.
Nikole

[aimee37]

Nikki is right she is now a vetran. Since you lost the lens,what options are there for replacing it? I've had retinal detachments in both eyes, and I'm healing from scleral buckle 3 weeks now. It takes time, and patience, don't rush yourself. I havent had the gas bubble, but that was one of the options I was given. I have read it feels like your going blind , untill it all subsides,I can only imagine what thhe oil is like. I didnt choos the bubble, because I couldnt imaging being face down for 2 weeks. Did the retina complelty detach? Keep us posted on your recovery, were all in the same boat, keep your head up!!  

[aimee37]

Yeah to everyone thanks for the kind words, im still hanging in here but its tough im just sick of waiting but im gonna have to, i am even thinking of canceling my trip to thailand later this year(in December).

I actually dont know if my retina was completely detached or not but after the 1st surgery my vision was terrible i could barely see light, then after the 2nd op with the oil things seem much clearer better than b4 the op.

As for the cataract, i lost my natural lens in the injury so i dont think i have that...so it still leaves me with the question 'Why is everything still dark/dim?', and could an artificial lens improve my vision for now while the retina is reattaching back ?

And what are the chances of this happening to my other eye which is fine? but i sometimes freak out and catch little anxiety attacks now and then when i feel something funny in that eye...man this sucks.

Anyone?.......Help.......Thanks.

[aimee37]

i've had surgery for about a month now, and i'm not sure if my lids are still swollen but it seems like my bottom lid has moved up and so when i open my eyes my eye with the surgery opens smaller than my left eye which didn't get the surgery.... will it ever open back to its normal shape and size and if so how long ... i fee like a wierdo with one eye smaller than the other and its such a miserable thing to look at... any advice from any one?

[aimee37]

i've had surgery for about a month now, and i'm not sure if my lids are still swollen but it seems like my bottom lid has moved up and so when i open my eyes my eye with the surgery opens smaller than my left eye which didn't get the surgery.... will it ever open back to its normal shape and size and if so how long ... i fee like a wierdo with one eye smaller than the other and its such a miserable thing to look at... any advice from any one?

[aimee37]

i've had sceral buckle surgery for about a month now, and i'm not sure if my lids are still swollen but it seems like my bottom lid has moved up and so when i open my eyes my eye with the surgery opens smaller than my left eye which didn't get the surgery.... will it ever open back to its normal shape and size and if so how long ... i fee like a wierdo with one eye smaller than the other and its such a miserable thing to look at... any advice from any one?

[aimee37]

i've had sceral buckle surgery for about a month now, and i'm not sure if my lids are still swollen but it seems like my bottom lid has moved up and so when i open my eyes my eye with the surgery opens smaller than my left eye which didn't get the surgery.... will it ever open back to its normal shape and size and if so how long ... i fee like a wierdo with one eye smaller than the other and its such a miserable thing to look at... any advice from any one?

[aimee37]

i've had surgery for retinal detachment for about a month now, and i'm not sure if my lids are still swollen but it seems like my bottom lid has moved up and so when i open my eyes my eye with the surgery opens smaller than my left eye which didn't get the surgery.... will it ever open back to its normal shape and size and if so how long ... i fee like a wierdo with one eye smaller than the other and its such a miserable thing to look at... any advice from any one?