5 months post scleral buckle with vitrectomy w/ pending cataract surgery same eye

[llymphs]

posted some months ago re: post scleral buckle. well, it's been almost 5 mos and the bucled eye's acuity has decreased from 23/30 to 20/100 in the last 6 wks. have had excruciating headaches at work (pharmacist) and i have a high pain threshhold. have had to leave wk twice in last week...went to opthamologist yesterday...huge cataract due to the surgery (i assumed the eye replaced the vitreous slowly, but what you have is all you have, therefore it is now "water-filled")... the loss of viscosity of the vitreous, which serves the md as a type of "cushion" beneath the lens during surgery, makes the surgery more difficult, according to my surgeon. she said to expect the unexpected. that the surg would take longer, as will recovery. also, spoke with retinal surgeon (that's a lie, spoke with a nurse, of course), no offense. said it was ok to have surgery as soon as 1 month post-op!? do you agree? this was NOT my surgeon who most probably said flipantly, "1 month". (i have had previous dealings with this little god who told me to "eat my vegetables"). my surgeon is great, by the way. the 360 lasering was terrible. short-term memory loss and anxiety. (can you tell?). BUT, my right eye has "HD" distant vision! makes me say, "Whoa." all is good. any comments/advise? l,j

[John C Hagan III, MD, FACS]

While cataract surgery in a patient that has had a vitrectomy/scleral buckle is more difficult it is not dramatically so.  

As long as you have the permission of the retina surgeon and the cataract surgeon is okay with proceeding there is little room to delay if the vision is bad.

JCH MD

[berrywoo]

Oftentimes retinal surgery can advance the progression of an already developing cataract or cause a cataract to develop. This mostly occurs when a PPV is followed by an intraocular tamponading agent either gas or silicone oil.

You need to speak w/ the retinal surgeon and make sure he/she feels that your eye is stable enough to undergo surgery, especially since cataract surgery carries the risk of rds. Also, you can ask you retinal specialist to recommend a cataract surgeon for you. Both doctors should communicate w/ each other and you should make sure both are informed about you case and any decisions you make.

[John C Hagan III, MD, FACS]

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[llymphs]

thanks. the giant retinal tear surgery results were actually much better than expected, yet i did lose my peripheral vision in left eye. it was detached almost entirely...so i am happy with my vision as it is. i was a -10 in both eyes...now -11.5 right eye and -16 in left eye. distant vision is remarkably good, yet my "short arm syndrome" (presbyopia) has extened to approx 7 ft away.  i also have CSR (chorionic serous retinopathy) in both eyes...makes straight lines look wavy (a door frame looks as if someone is dangling a spagetti noodle!). full moon looks like a wedge, etc, ...one last thought ...md's seem to be blind to the gravity of my particular situation, which is, my career as a pharmacist is/may be in jeopardy. bummer. (p.s i already had cataracts prior to vitrectomya)
later, john

[llymphs]

duh, last line...vitrectomy :)

[John C Hagan III, MD, FACS]

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