Complications after oil removal post detachment

I'm basically seeking some perspective on all my eye issues.  My doctor has horrible bedside manner which makes me walk out in tears, but I know I have some serious problems.  So, I'm just wanting to hear if anyone else has had similar complications or if one of the MDs has an opinion.  Of course, I'm still religiously seeing my ophthalmologist, doing everything I'm told, etc.  I also don't think he's totally whacked out.  He's called in two other doctors for a consult and everyone's on the same page.  

Background:  Retinal detachment in left eye at age 21.  Detached last June, was operated on last July.  Buckle was put on and silicone oil inserted.  No complications with the surgery, although pressure was in low 20s for a couple weeks after surgery.  Regained full field of vision back after surgery, despite being told it wouldn't happen.

31 Dec: Surgery to remove the silicone oil.  (Worthwhile noting that the 2nd surgery was in DC while 1st surgery was in CA.  The DC doctor was they guy who first found the detachment but he didn't operate on it because I was on vacation at the time.)

DC doctor notices immediately during surgery that my eye had healed very poorly from the first surgery and since he was having to cut into the same place, he's was worried about the wound.  He used more sutures than normal, but the wound was looking good the day following surgery.  Retina was looking good.  

1 week after surgery:  IOP is nonexistant.  Basically 0 or 1.  Dr sees a lot of fluid where it shouldn't be.  Fluid was pushing up against the retina which was still attached.  He starts to see me every day, puts me one more drops, including steroid drops.  Decides inflammation could be the problem.  Starts me on oral steriods.

Today, 13 days after surgery:  IOP is 21 and doctor is relieved.  Fluid inside eye looks normal.  Retina is attached.  BUT.... because pressure is back up and the eye is a normal shape again, the wound looks really bad.  Says wound is sealed shut and isn't leaking, but he can see the inside layers of my eye where he shouldnt be able to.  He describes my eye as "shredded."  Says I probably won't ever have any useful vision in that eye... but doesn't say way other than it's gone through the whole detachment business.  

I'm on steriods for a month for the inflammation (or in big words- retinal edema?).  He mentioned a rare complication we'll be on the lookout is my good eye becoming inflamed as a result of the inflammation + weak wound combination in my left eye.
I'm on regular drops, no steroids and am to be super careful about not touching the eye, due to the wound.
I'll see him in a week.  

So... what are the impacts of the inflammation and wound business??  I'm in pain, but other than that, am very pleased the retina is still attached, I can see light everywhere, and although super blurry and nearsighted, I can recognize objects.  Only thing I'm frustrated with is a cataract in my central vision which I wonder if it'll ever be safe to operate on.  

Thoughts on the retinal edema?  Rupture of eyeball?  What this means for my dreams of cataract removal?

Any comments are appreciated!

Cheers
Ryann

[Ray T Oyakawa, MD]

How old are you now.  Did you have your first retinal detachment at age 21 and later had a recurrent detachment?  

I doubt there is a rupture of the eye with a normal pressure.  This sound very complicated. Did retina redetached with the silicone oil removal?

I would suggest you get a second opinion.

[ryann13]

I'm 22 and have only had the one detachment.  Just 6 months ago.  The silicone was removed on Dec 31 and there have been no signs of detachment.  Retina is looking good.  

What would ordinarily cause a rupture of the eye?  A weak wound seems improbable?

Thanks for your response!