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Gas bubble
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Gas bubble

I had two vitrectomy's, one for each eye, due to detached retina's.  The gas bubbles lasted 60 days in one eye and 59 days in the other.  ----- Q1) Is this a long time?  ------- The retina specialist said everyone is different but I do not see any post here where the gas bubble lasted that long.  I have no idea on the type of gas used.

My good eye had the first detachment and now is not very good.  I went from a 2.5 to 7.5 diopter and the distance is still not very good and changes from day to day or morning to night.  I can drive when it's good but I avoid it when the distance is too blurry...and cannot drive at night. I finally got the 7.50 lens last week, ----- Q2) is my brain still adjusting?  Or is it the cataract that formed due to the surgery?  Or the gas bubble? -----  I was diligent in laying face down for 14 days as instructed but since the gas bubble lasted so long should I have stayed down the entire time?  Actually, I have a 6,5 lens for viewing the computer and inside my house as this works better than the 7.5.  I also used my old lens of 2.5 to read where before I did not need glasses to read.  I have also noticed how the stress has affected my vision.

My other eye had a cataract before the surgery and they could not get a lens to work or they gave up a few years ago. I think I was 20/200 with glasses and that is just seeing the outline of the big E, not a clear, sharp E.  It is very hard to find a eye glass doctor willing to stay the course and work with you.  I've read about solution such as wearing a contact lens and glasses but no eye glass doc every suggested that to me. Q3) any suggestions anyone on finding a good eye glass doctor willing to work with you?

As for the removal of my cataracts I read nothing but bad news when reading these posts about patient results.  I do not see how the claim of 95% success is valid.  The Internet is full of bad results...Though I suppose if you had a successful cataract surgery you would have went on with your life and not spent time telling your success story here.  I'm 51, not 80, and have worn glasses since early 20's for first an astigmatism then for distance.  I haven't met anyone my age or younger who had the cataract surgery to talk to.  Most people I know are older and could see distance but could not read.  The last thing I want to do is take out my natural lens and have the wrong IOL put in and my vision is worse.  Q4) how many test should the eye MD run to measure your eye for the IOL?  What types?

I appreciate the information here but I end up with more questions than answers.
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21 Comments Post a Comment
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711220_tn?1251894727
It is unusual for a gas bubble to last that long.  Your surgeon probably used a long lasting gas, C3F8.  This is not used in eyes with lenses place since a cataract will develop or progress unless you had a very complicated detachment or there was some other reason. The progression from -2.5 to -7.5 diopters is due to the cataract.

The result of your cataract surgery will depend on the ability of the retina to see well.  Many patient do not recover normal vision after a retinal detachment.  Also,  cataract surgery is more difficult after a vitrectomy.

Dr. O.
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Avatar_m_tn
Thanks.

I was told my central vision was unaffected and was told they expected my vision to be what it was prior to the RD....which did not happen which everyone points to the new cataract.  I was told six weeks for the gas so I do not know why they used this type.

Why is a cataract surgery more difficult after a vitretomy?  I take it I want someone with experience doing this then.
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Avatar_m_tn
My gas bubbles lasted right around 8 weeks for all of my surgeries. I feel i know when this one will go away.it is still 1/2 there & has not "sunken" that much since Dec.13th..
even though this one is clear, the othes weren't.
Corrinebeth
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Avatar_m_tn
Sorry to hear you had more than one surgery.  Did the gas bubble cause cataracts?  I'm still disappointed that one surgery to fix something causes more damage to another area.  Just doesn't make sense.
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Avatar_m_tn
Why did my cataract form so quickly after my vitrecomy?  I had it 9/13/10?  Everything I read says many months or years after not weeks.

Now I read how cataract surgery after a vitrecomy is more risky/dangerous.  I fear that is just going to cause more problems with my eyes.  Maybe not right away but down the road for sure.  What is the truth abouit this?
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Avatar_m_tn
At age 46, Post vitrectomy and buckle, my gas bubble lasted nearly 12 weeks - it was c3f8 gas. My cataract was noted to be developing shortly after my vitrectomy (and scleral buckle) surgery. I was warned to expect a cataract "soon" after, but that was very fast apparently  The buckle also increased my myopia.  About 4+ months post vitrectomy, i had IOL/ cataract surgery  Post cataract surgery my vision was at least 20/40 uncorrected and is nearly 20/20 corrected 2 years later now age 48.  My retinal specialist did all my operations, so the complexities were expected and routine for a retina specialist.  
Did you Also have a scleral buckle on One or both eyes?  I had one on one eye only,  my other eye had a much simpler retina detachment treated by cryo only, no build or vitrectomy.  Talk to your specialist in detail.
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Avatar_m_tn
Thanks Matt,

I did not have a buckel but had a vitrectomy in both eyes.  I did not know the RD signs so I waited a couple days too long to give myself a chance of laser or cryo.  I'll never know if I could have avoided this.  With my other eye I was on top of it and went to the doctors twice when I saw the signs and each time they said nothing was there.  So over the weekend I see more floaters and come Monday they say it happened again.

I'm glad to hear your IOL came out well.  I am very worried about it.  Question, when you say 20/20 corrected are you wearing glasses?

My retina specialist does not do cataract surgery but I have been seeing a cataract/glacoma guy who he works with at the same hospital.  The problem with the specialist I have is they are too busy to spend a lot of time with me....frustrating.  I spend all my time with the doctor doing a fellowship with him.  I also looking at other doctors and hospitals.  I want to make sure I find the place that actually cares about me and my vision.  I also want to know they do more than one measurement on my eyes for the IOL.
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Avatar_n_tn
To jd3450
I'm 49 years old and had a vitrectomy in my right eye on 9/29/2010 with a scleral buckle, cryo, lasering, and C3F8 gas, and the bubble didn't completely go away until 12/22/2010.   That's 84 days, or 12 weeks - 3 full months in other words!   It started out as occupying 90+% of the interior volume of my eye and slowly took up less space as it dissolved and was replaced with the aqueous humor fluid.  My retina had detached off of the macula, so I followed the face-down instructions for 3 solid weeks, and then went to a 50% of the day face-down period of a couple of weeks more.   I was told to not sleep on my back until the bubble completely disappeared so as to minimize any contact with my lens and the gas.   The cataract still developed, with a vengence.   I am scheduled to have my cataract removed tomorrow morning.  I have had slight early-forming posterior lens cataracts diagnosed since I was around 25 years of age, but they were never an issue until now.   What's odd is that the precataract that I had in my left eye also got significantly worse since the vitrectomy in the other eye, and I am scheduled to have that one replaced on 2/03/2011!   I don't know if this is from the prophylactic lasering that was done to my left eye to prevent any kind of a similar detachment, or if the C3F8 gas components migrated there after dissolving into my bloodstream.   My retina Dr. wasn't even sure why.

To matt_ret_d_vitrectomy:
It seems that we have similar experiences.   What type, and brand, of IOL did your Dr. implant, and did you have your eyes corrected for good distance vision, or good near vision?   Do you have to wear glasses in certain situations?  How is your night vision, do the stars look the same at night?   Are oncoming headlights and glare a problem?   Any halos, or ghosting?   Did you have any issues with an epiretinal membrane forming in your vitrectomy eye?   Tell me all about your experiences!
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Avatar_m_tn
No, I had Cataract surgery first then the Retinal Detachments followed.
thank you for caring ~~~
Corrinebeth
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Avatar_m_tn
Similar experience yes. My IOL is not a multifocal, it is single focal length, aspherical silicone lens set for distance. I wear glasses on my IOL eye (vitrectomy+buckle) to make a minor distance correction and for reading and glasses + contact lens on the other eye (cryo + bubble only this eye is still -8.5 or so nearsighted) to correct the differences in magnification between both eyes. I wear progressive lenses for reading.  I do have minor glare issues at night, but not bad enough to stop driving, but I've also had lens capsule clouding since before the IOL- so I can't say what the cause is exactly.  I haven't needed to have YaG laser treatment yet, but I plan to when I feel it is necessary.   I had the good luck to have a dr (and the fellows and residents) who took the time to answer all my questions, and be at a great hospital (mass eye and ear in Boston). Also, I was lucky not to have any membrane complications, just cataract and lens capsule clouding.  See my other posts about my experience by searching my username.

My understanding of the risks are this:  any eye surgery has risks of other complications developing. With eyes known to be prone to detachment, the risks of redetachment will be greater, but with laser or cryo scarring holding the retina in place, the chances are lower that a redetachment will occur than it would be without.  However, untreated cataracts have nearly a 100% chance of eventual blindness.  Ask lots of questions till you are satisfied, learn as much as you can so you can understand the dr, and don't hesitate to ask follow up questions ask to be seen if something doesn't seem consistent with the dr's expectations.
Good luck  for speedy recovery to you both!
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Avatar_n_tn
Another thought I just had is that I was told by my retina Dr. to NOT go with a multifocal IOL, as patients who have had detachments tend to have alot of problems with the vision afterwards with the multifocals.   He strongly recommended getting a good monovision lens when it was time to have the cataract surgery.   I've been doing so much reading on this website lately, and have come to the conclusion that a multifocus lens give problems to many cataract patients - even those who haven't gone through the detachments and vitrectomies as we have.   I finally settled on a monovision Tecnis 1-Piece lens, since I need the best possible night vision as well.   My surgery is tomorrow morning, so I'll post my experiences afterwards.
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Avatar_m_tn
Thanks everyone for the follow-up.  Though I am saddened you are in a simialar situation I feel a sense of comfort that I am not alone.  I very much appreciate your first hand accounts of your situations.

Terrachaos,...that is a very good peice of information to know.  I am just now starting to line up my questions for my doctors and 2nd opinion doctors too.  I'm not going to just talk to one.  I have heard of a few issues with multifocal IOL's from certain brands.  One doctor in MedHelp posted an artictle about it.  My original doctor wanted to look at a Toric lens.

My eyes were a 2.5 and 1.75 diopter prior to the vitrectomy's.  I was told the surgeries did not change the shape of my eyes and the cataracts are like a puesdo-myopia...I think a MedHelp doc used that term.
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1485310_tn?1287955010
I plan to follow this group as I'm in the same boat.  Severely myopic Left eye - 14 or so, right eye - 16 or so.  I'm 46 and male.  Right eye detached in Oct after 2 small tears were lasered, 3 more very large tears (not giant) found a week later and the young MD attempted to laser them, giving me a detachment the next day.  I dropped him like a bad habit.  I believe he should not have attempted to laser such big tears, and should have put a gas bubble in till retina quieted down, then do a laser cerclage.  He should have known it was going to detach.  I'll circle back with him later, got bigger fish to fry now.  

Researched and found a real and top MD (former chief of surgery of opthm, Baylor College of Medicine in Houston, considered a superdoc by his peers), a week (didn't realize the distortion I was seeing was a detachment, thought it was from the lasering) later I'm getting a vitrectomy, gas bubble and 4,000+ shots of lasering to hold it down.  Left eye had laser cerclage as preventive.  No buckles yet.  My gas bubble lasted almost 3 months.  From Oct 14th thru Jan 4th. Now, when I say it lasted, I'm including the period when it was the size of a pea.  It seemed to shrink faster the smaller it got.  Its been 3 months and have micropsia (things appear smaller) and wavy vision, oh and my pupil is permanently dilated.  MD says I had a "big bad detachment" even though I was seeing clearly the day of surgery.  Which means macula was on, HOWEVER, we never know if the macula was detached during surgery do we?   I do however, have a lot of confidence in this MD, and I'm aware what I'm experiencing is sadly, very common.  It will take at least a year (and studies show longer) to see where VA will finally land.

MD also says I'll need a specialist/extra good MD for my inevitable cataract surgery, as I don't have vitreous to help support the lense.  He says you don't want a run of the mill cataract surgeon.  Bad retinas run in the family, my dad had his cataract surgery over 35 years ago, and his monofocal lense is still working fine.  Oh, and he had a detached retina after his surgery (more traumatic then) and they fixed it with cryo and that was about 35 years ago too... I do not plan on a fancy multifocal lense, my contacts have been monocular for many years.  When asked, my MD says he's only seen it one time, where a cataract surgery on an already operated/healed/detached retina eye caused a detachment.  For the record, where you were lasered on your retina, is STRONGER than the day you were born, per every MD I've ever talked to.  
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Avatar_n_tn
I, too feel like I am doing a fellowship with the surgeons with all the questions I ask.
I don't think they are used to the Baby Boomer generation....We ask questions, unlike our parents who never did ask questions.


Sue
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Avatar_m_tn
I...I don't know what to say.  It is so important we all share our experiences so we can ask and demand the best treatment for ourselves.  No one else is going to do it for us.  So thanks for sharing and you are in my prayers.

I am glad to hear about your father...gives me hope.  Now, to find the cataract doctor the doctors go to who will treat me like I am a doctor too!

BTW: I've read here and was told by other eye MD's that people who had a detached retina should not consider multifocal lens.  Which begs the question what happens to those folks how have a multifocal lens prior to having an RD?  I do not know about Toric lenses though.  Anybody?
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Avatar_m_tn
I would most highly recommend eye specialists at
Baptist Eye Center, Little Rock, Ark. They are off  I 630 & easy to get to, if you are anywhere in Ark. Lots of patients drive more than an hour to have them as their Dr.'s..
my Opthalmologist 3rd floor is there as well as my Retinal Associates, 2nd floor.
sincerely Corrinebeth
Hope I'm not out of line recommending my eye Specialists.~~~
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Avatar_m_tn
No problem...any help is appreciated.  I'm in the SE Michigan area.
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Avatar_f_tn
I've had two, soon to be three, vitrectomies to try and fix retinal detachments and scar tissue is my right eye. When they did the first one, the surgeon took my lens out because he said both the gas and the oil that is sometimes used can cause cataracts.
When they performed the second operation, they used a gas bubble, I had to be face down for 12 and a half days, and that was almost 2 months ago, and the bubble is still there.
In 11 days when they do the third surgery, they're going to take out the bubble and put in an oil again.
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Avatar_m_tn
Many of the comments here relaee to people who have got a lens in their eyes.

In my case, I had three opearations bfore I was one (in 1971), and the lenses were removed due to congenital cataracts.

On 4 January 2012 I needed VR surgery with a gas bubble containing 7 ml out of 50 ml of C3F8 due to detatched retina.  Had to sit (luckily) in an upward position for 10 days (50 mins in every hour), but the bubble continued to move.

20 days after the operation, the edge of the bubble started to show up giving me an image of the outside of the bubble.  For the next 4 days I had a sharp image in my right eye for the first time ever, but that appeared to be ony on the "horizon" of the bubble.  Now the bubble has moved further downards, above this area, I ge4t a blurred vision effect, but this cannot be  acatarct becuase I have not got a lens in my eye.  I have however had halos around patches of light.

Now it is day 25 after my op and I get some sharpness back whenever I put eye drops in, but it would appear the eye is lacking in moisure.  The mmgh level was 15 prior to my op, but 20 on day 12 after my op.  It has not been measued since.  My next appointment is on 14 February.  The bluriness ony started on day 23 post op around 6pm - my opertion on 4 Jan was at 10.30 am.

I am told it takes up to 6 months for things to settle but should I go back to ask advice?  The eye drops are Prednisolone acetate 1%.  I finish this on 1 February 2012.  Can anyone advise why I should be getting blurred image when I have no lsens for a cataract to form?

Thanks.
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Avatar_m_tn
Many of the comments here relaee to people who have got a lens in their eyes.

In my case, I had three opearations bfore I was one (in 1971), and the lenses were removed due to congenital cataracts.

On 4 January 2012 I needed VR surgery with a gas bubble containing 7 ml out of 50 ml of C3F8 due to detatched retina.  Had to sit (luckily) in an upward position for 10 days (50 mins in every hour), but the bubble continued to move.

20 days after the operation, the edge of the bubble started to show up giving me an image of the outside of the bubble.  For the next 4 days I had a sharp image in my right eye for the first time ever, but that appeared to be ony on the "horizon" of the bubble.  Now the bubble has moved further downards, above this area, I ge4t a blurred vision effect, but this cannot be  acatarct becuase I have not got a lens in my eye.  I have however had halos around patches of light.

Now it is day 25 after my op and I get some sharpness back whenever I put eye drops in, but it would appear the eye is lacking in moisure.  The mmgh level was 15 prior to my op, but 20 on day 12 after my op.  It has not been measued since.  My next appointment is on 14 February.  The bluriness ony started on day 23 post op around 6pm - my opertion on 4 Jan was at 10.30 am.

I am told it takes up to 6 months for things to settle but should I go back to ask advice?  The eye drops are Prednisolone acetate 1%.  I finish this on 1 February 2012.  Can anyone advise why I should be getting blurred image when I have no lsens for a cataract to form?

Thanks.
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Avatar_m_tn
Because they put oil in your eye as well as a buckle to hold the retina in place and it's a known fact that a cateract will form once the oil is in the eye. I just had my oil and cateract removed after 2 years. My cateract was 98% dense and only formed in the last 6 months, so rapid. They removed the oil and placed a gas bubble in my eye, fingers crossed I can have some sort of vision in my right eye as I have had none for 2 years.
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