cataract development post gas bubble

I had a detached retina with scleral buckle and gas bubble the 21st of April.  About 1 month ago the surgeon said I have a cataract in that eye.  How quickly will this cataract grow?  I am 46 and my vision seems a little cloudier everyday.  Do cataracts from a detached retina surgury grow fast compared to those from aging.  With the buckle in place what is the cataract surgury success rate?
Will the stringy floater in the eye go away?  That on top of the cataract is so annoying.

Thank You

[Forum-OD-MP]

no one can predict how quickly a cataract will grow.  i get that question all the time, and i feel really badly, but i have no idea.  neither does anyone else.  cataracts are really common after retinal surgery.

no, cataracts from retinal surgery are just as difficult and unpredictable as cataracts not-from-surgery.  could grow really quickly, could totally stop, could grow any speed inbetween.  no one knows.

most floaters go away after 6-9 months.  some are permanent, but very few.

[JodieJ]

I also have a cataract developing following retinal surgery (vitrectomy with epiretinal peel).  I've been told that cataracts progress faster than usual after retinal surgery, especially when a gas bubble has been used.  From what I've read, it's a little trickier determining the correct power of an IOL after a scleral buckle procedure, because the axial length of the eye (a measurement needed to determine IOL power) may have changed.  It might be best to see a cataract surgeon who is experienced with this situation.  I'm sure that your retinal surgeon can give you referrals.  Sorry, I don't know anything about floaters.

[leelee00]

Hi,

Thanks for your imput.  Are there any website articles you have read that directly explain the catatract and scleral buckle together.  Just curoius, what do you see of your eye?

[JodieJ]

There's no single site that gives the info you're looking for.  There are a number of articles that explain why cataracts develop after retinal surgery.  (It's the exposure of the lens to oxygen that's the culprit.)  The following article identifies potential difficulties doing cataract extraction post-vitreoretinal surgery (including the problem with IOL power calculation):  www.aao.org/aao/news/eyenet/feature1/feature1_apr.htm
Another article discusses types of IOLs from the perspective of a retinal surgeon, and which ones (e.g., Crystalens) to avoid post-retinal surgery:  www.retinalphysician.com/article.aspx?article=100091  (Hope I didn't make a typo.)

Unfortunately, the above articles are very technical.  There are lots of sites which explain the scleral buckle procedure and cataract surgery in less technical language.  Try typing "scleral buckle" and "cataract surgery" on any of the big search engines, and you're bound to come up with some info written for perspective patients.

You might also try posting a question about cataract surgery post-scleral buckle on the Google group sci.med.vision.  I've learned a lot from that site (as well as from this forum).

Sorry, I'm not sure that I understand your question.

[leelee00]

Thanks so much.  I live in a city where there will be many cataract surgeon choices.  Its good to have questions and find the one who is most familiar with the post retina situation as well.  My question is what do you see out of your bad eye?  What distortions etc, just curious?

Thanks

[JodieJ]

I had a wonderful surgeon, who was very successful at removing the layer of scar tissue from my retina.  My vision peaked about 2-3 months post-surgery, when I could read the entire 20/15 line on the eye chart. Then things started going downhill because of the developing cataract.  Colors became less saturated, and everything looked yellowish when I closed my good eye.  Plus I've become much more nearsighted in my cataract eye over the past 3 months (from -5.25D to -7D and getting worse).  With the right correction (from disposable contacts), my vision in the cataract eye is still good (although everything has a faded yellowish tint).  But I really miss having glasses in the right prescription.

[leelee00]

That sounds alot like what I see.  My eye with corrected gas perms is -11.  I've always had bad eyes.  The cataract seems to make the corrected vision seem like its corrected but like looking through the bottom of a glass.  I also have one large blurry floater that moves in and out.  When will you have your cataract fixed?  My retina surgeon's procedure is successful since I'm 20/25 but I hate the blurriness and sometimes feel disoriented from it.  Does that ever happen to you?  I'm 46 and cant believe I could deal with for years to come.  I guess things can always be worse.  I do miss my old vision even if it was never good.

[JodieJ]

That floater must really drive you crazy--hopefully, it will disappear soon.  I've been trying (unsuccessfully) to set up cataract surgery for about 6 weeks.  I ruled myself out as a candidate for multifocals due to past retinal disease and mild astigmatism, but I thought that I could at least get good distance vision without correction.  Doc #1 agreed to do the surgery and was going to use Lasik on my other eye, but he backed out at the last minute because he wasn't that experienced with Lasik.  He referred me to Doc #2, who predicted that I'd probably develop macular edema post-surgery(a fairly serious surgical complication), which didn't exactly inspire my confidence in his surgical skills.  Doc #3 wanted to do a lens replacement on my second eye (and bill it to Blue Cross), but he told me that I'd probably need Lasik on both eyes post-surgery to correct a large anticipated refractive error.  This made no sense to me.  I have an appointment with Doc #4 in a couple of weeks, and I have high hopes for him.  Do you know what you're going to do about your good eye post surgery?  Unless you want to stay nearsighted or wear a contact lens continuously, you'll have to do some type of refractive procedure.

[JodieJ]

Re your blurriness and disorientation, I don't think that your eye has completely healed yet from the buckle surgery.  It may also take more time for your brain to get used to your post-surgery alignment.  And that floater and the cataract symptoms are probably contributing to your woes.  I predict that your vision will improve signifcantly with time (especially after cataract surgery), and your good eye will compensate for residual problems with your other eye.

[leelee00]

That all sounds quite confusing for you.  Too many opinions get even more scarier and complicated.  I dont really ming wearing a contact in one eye.  I guess it just seemed like it would be ok.  I just want to see out of the other one weel, as I'm sure you know how I feel.  I want to find a doc whose done cataracts with a buckle thousands of times, but seems unlikely.  My retina surgeon had performed over 15,000 retina detachemnt procedures.  I want the same experience for the cataract.

It's just weird to go into the retina surgeon's office.  Most people are older and I find this so frustrating.  I wonder if others feel this way or if age makes you just happy to see at all.


Good luck with everything.  Let me know how it goes.

[JodieJ]

I know what you mean--I never expected to find myself in the office of a retinal surgeon either.  My doctor also specializes in cancer surgery involving the eye, and the waiting room is always filled with patients of all ages.  Whenever I'm there, I feel like I'm one of the lucky ones.

Having 20/25 vision post buckle surgery is really fantastic.  (That's probably 20/20 vision with both eyes.) There's a post somewhere on sci.med.vision from a woman who complained about having blurry vision for several months after buckle surgery, but she eventually obtained excellent vision.  I think your outcome will be similar--just give it time.

[eelkiller]

I have had retinal detachments in both eyes in the last 2 years abd sure enough cataracts have developed in both cases. The good news was that after cataract removal my distance vision is now better in the left eye than before I had the retina problem. I don't know how this is possible but it is a fact.

Now I can't wait to get this other cataract done

[leelee00]

Thanks for the good news.  Were your detachment scleral buckle repairs?  Do you have any large floaters?  Just curious?

I'm hoping next week to find that the cataract is bad enough to fix.  I really want to see without so much distortion.

Thanks again.

[eelkiller]

I have had one eye done via scleral buckle and the second did not require that method (it was caught earlier). I did have very noticeable floaters in both cases prior to the detachemnets occuring.

I hope to have the second cataract surgery done in the next 6 months.

[eelkiller]

Sorry, I misread your question about the floaters. I have not had floaters since the retinal repairs were done (I assume that is due to the vitrectomies?

[HPS]

I have had both scleral buckel and the gas bubble in that order, and about 6 weeks since the bubble was installed. Bubble is about 75% gone and vision os blurry. I understood that cataracts would not form on my then existing lens implant. Can anyone comment on this? Can existing implants be removed and replaced?
Thank You

[JodieJ]

It's true--you can't get a cataract on an implant.  Your implant should last a lifetime.

[Ray123]

I had a PVD & vitrectomy of left eye, small retinal tear so I had a gas bubble.  After 2 weeks another tear repaired with scleral buckle, laser, another gas bubble.  Now it is 2 weeks later, I see 3 dark spots in left periphery alwoays in motion and what appears to be an object in the bubble.  I started with 1+ cataract and it has quickly degenerated to 3+.  The moving objects are making me crazy!  Is there any hope for this eye?

[wenwalky]

I am 52 and had a vitrechtomy on my right eye in April due to a macular hole.  I am told it was just a "spontaneous" happening.  The hole closed but the retina did tear slightly during the surgery.  Been hard to to accept, I guess mostly because it just "happened".  I am left with distortion in my eye and poorer vision than I had b efore.  I got new glasses and was told the vision could not be restored to 20/20 with a new perscription because the difference between my 2 eyes was so great, the corrective perscription would have made me dizzy.  So my right eye is corrected to 20/40.  I was told my brain would see what the better eye perceived.  This seems to be true, but my right eye feels like it is trying to pull what I see into focus.  I can read better without my glasses, but it is a challenge.  Having been a voracious reader (elementary school teacher) I find the reading deficit the hardest thing to overcome.  I have been checking out large print books from the library which has been a god send, my students have been wonderful and helpful but not everything is printed in large print.  I have been searching on the net for information about what I am going through since I was diagnosed and have been discouraged about not finding many people writing about their experiences. This is the first place I have found that has given me much.  I too feel odd in my retina specialists office when the other patients are in their 70's and 80's.  OK, I know I am rambling, but this is the first time I have come across some people close to my age going through this.  Did any of you experience "dry" eye.  My right eye feels dry most of the time and I use drops all of the time.  My retina specialist said that for some this is temporary and for others it doesn't go away.  Yikes!  I have developed the "token" cataract and am now struggling with what to do.  I know I will have my right eye done, but now I am concerned about having my left eye done.  (doctor said I have one starting on my left but it will be years before it needs to be taken care of) Which means I can't have the right one corrected to 20/20 because of "dizziness" so what do I get it corrected to?  Somebody please talk to me, I feel pretty much alone.

[JodieJ]

Yes, it's a real bummer.  But I think you'll have improved  vision with your right eye post-cataract surgery.  I suggest that you consult only experienced cataract surgeons, preferrably ones who have operated on many post-vitrectomy patients.  You can probably get referrals from your retina specialist.  Your doctors (cataract and retina) can advise you as to the best correction for your right eye.  You'll have several options for your left eye (e.g., lens replacement, laser surgery, contact lens).  In any case, you should end up with better vision than you have now with your developing cataract.

Before my vitrectomy I had a layer of scar tissue on my retina, which clouded and distorted my vision in one eye.  It developed gradually, and I wasn't even aware of the vision loss unless something obstructed my vision in my good eye.  Our brains are apparently able to adapt to such situations.  If you have 20/20 vision in one eye and 20/40 in the other, that doesn't sound bad to me at all.  Once your vision has stabilized post-cataract surgery, just give your brain a little time to adjust.

I know that you have experienced an unexpected loss, and that's a downer.  But in life, everything's relative.  I've said before that my retinal surgeon also specializes in treating ocular cancer, and visits to his office make me feel lucky.  Think of it this way, wenwalky, there are much worse diagnoses than macular hole.  I'm sure that your situation will improve.

[wenwalky]

Thank you for responding.  I have yet to meet anyone who has had this happen and I have felt really alone.  I wish I had found this site while I was first going through this, but am very glad to have finally come across it.  I have gotten a couple of referrals from my retina specialist for a cataract specialist but I never thought about checking to see how much post vetrectomy experience they may have.  My retina specialist does 2-4 a week of these a week.   In an area of about 1 1/2 million that does not seem like many, I will definitely inquire as to their experience.  Have you had any problems with "dry" eye?

[JodieJ]

I think that you can trust your retinal specialist's referrals.  If your insurance will pay for additional opinions, you might want to consult more than one cataract surgeon.  Different doctors might have different opinions about how best to correct your right eye and what to do about your left eye.  It's always good to have some alternatives to choose among.

I probably have borderline dry eyes, but I don't think it's related to my retinal surgery.  I used to be able to wear gas permeable contacts for as long as I wanted; now even my soft torics sometimes start getting uncomfortable after 12 hours of wear.  Actually, just about all the women I know in my age range (I'm 54) who wear contacts have the same complaint.

[wenwalky]

My problems with dry have occurred since surgery.  Doctor said some experience it, sometimes it goes away and sometimes it doesn't......I just carry drops with me and use them all the time.

[JodieJ]

That's a bummer, and who wants to be reminded throughout the day about the problem.  Maybe punctal plugs or Restasis would work better than those drops.