Cataract surgery after Vitrectomy

I'm posting on behalf of my husband, who has poor quality vision.  21 months ago his left retina detached at the age of 48.  His right retina detached at age 26.  He is very nearsighted.

To repair the recent retinal detachment in Left eye, they did a vitrectomy +scleral buckle.  Of course, he developed a cataract which was just removed 4 days ago.  Problem is, his vision in the Left eye is now WORSE.  It's distorted, he describes it as "wavey", kind of like looking in a fun house mirror.  He can't read, has hard time functioning at work.  So my questions:
1) Is this a typical outcome?  Will it improve?
2) Is there anything that can be done to improve the vision in this eye?
3) Does this indicate something is wrong with the retina?  Has the cataract procedure now messed up the retina?

His cataract surgeon says this is a typical outcome after retinal surgery.  You'll just have to get used to it. We wouldn't have had the cataract surgery if we knew vision is "typically" distorted in post-vitrectomy patients.  

Thanks for your help.

[JodieJ]

The distortion that your husband is experiencing is related to changes in the photoreceptor distribution in his retina due to the retinal detachment and the surgery to repair it.  I suspect that his retinal detachment involved his macula.  The cataract surgery sharpened his vision, making the distortion more noticeable.

There is a technical paper ("Retinally Induced Aniseikonia" by Gerard de Wit) in which methods for making vision more comfortable,are discussed.  These methods include special glasses, blurring foils, and the use of Scotch Satin tape.  Some of the references in the paper also offer suggestions that are relevant to your husband's condition.  The paper is available for free download in the "About Aniseikonia" section of Dr. de Wit's opticaldiagnostics website (try googling).  If you send me your email address in a personal message, I'll send you the papers I have stored in my computer on the topic.

It's a trial-and-error process to discover what will work best in your husband's case.  If his vision was comfortable before the cataract surgery, then wearing an (almost) invisible blurring foil on the inner side of his left glasses lens might work well.  Some types of distortion can be partially corrected with special glasses described in the de Wit paper.  Your husband will have to find a very good optometrist (perhaps someone associated with a major medical center) to work with him.

As you can guess, I also have some retinal distortion related to macular disease (in my case, an epiretinal membrane).  I was shocked by how little help I received from the eye care professionals I consulted about the debilitating problems that I was experiencing.  Now that the retinal specialists have become more adept at saving vision, it's about time that eye care professionals start offering better advice to their retinal patients than "go home and live with it."      


    

[John C Hagan III, MD, FACS, FAAO]

Thank you jodie J

JCH MD

[Nicolina2003]

Thank you very much for the information and words of encouragement!  I'll start to do research.

[John C Hagan III, MD, FACS, FAAO]

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