Laser Cerclage Post-Vitrectomy Problems

[Pedrito]

Hi,

First, thank you for this very informative forum. Second, my situation is as follows. I had a vitrectomy about 1 year ago for severe floaters. The vitrectomy included a 360 degree prophylactic endolaser cerclage of about 1000 burns on on the peripheral retina in order to avoid retinal detachment. The problem is that since the operation the laser burns have been causing several very disturbing problems, including:

1. Shimmering effect (sort of like heat rising from a pavement) in the lower and outer vision. Very bothersome in birght light.
2. At night, with eyes closed, I see a "ring of fire" round my vision in the operated eye, composed of the dots which the laser cerclage was done.
3. Diffuse pain in the eye

The doctor who treated me has said that these effects are indeed due to the laser and are just "temporary", but I have seen little improvement over the past year and frankly I don't trust my treating doctor anymore.

Has anyone here experienced something similar?

Do any of the doctors here have any experience with laser cerclage and can tell me if there is anything I can do to make this go away?

Thanks,

Pedrito

[berrywoo]

In bright light you might want to try sunglasses or some type of transition lenses that may lessen the shimmering effect. As for the "ring of fire" you're just going to have to learn to deal w/it.
To be honest there probably isn't much that can be done to help your symptoms. Maybe in time your brain will learn to ignore your symptoms. Just like floaters, if you don't fixate on them they won't be quite so bothersome.
As far as laser photocoagulation goes the symptoms you are experiencing are not shared by those who've undergone this procedure. Most patients don't have any lasting effects from laser, except maybe a blind spot or two depending on the extent of the tear and laser session.

[Pedrito]

Thanks  berrywoo and Dr. Pernoud for the quick replies. I'll try to get in touch with AnnaE. The floaters were very severe and indeed had to go via vitrectomy, there was unfortunately no other option. As for the laser cerclage I have no idea why the doctor did it and he did not inform me of the many risks involved. Dr Pernoud, thanks again for the reply and your valuable time. I was wondering whether you have experience with similar symptoms for patients who have had laser photocoagulation for retinal detachment or diabetic retinopathy or other conditions, who have experienced similar symptoms, and if so, how did you treat them or how were they able to mitigate the effects of those symptoms (I'm really hoping there is some sort of possibility to mitigate the effects of the symptoms because it is driving me nuts quite frankly).

Thanks again...

[berrywoo]

A second opinion probably would help. A floaters only vitrectomy is not a standard recommended procedure and neither is laser cerclage as the risks are numerous.

The first two symptoms are more than likely due to the damage in the peripheral part of your retina that was inflicted from the laser. Symptom 2 is especially indicative of the damage and you're brain is just picking up on this.
As for the last symptom I'm not sure if it is from the laser. It may be from other causes which you and your doctor should seek out.
Lastly, there is one person on this forum, AnnaE, who has had a laser cerclage done. You may want to try and get in contact w/ her.

[Joan M Pernoud, MD]

Dear Pedrito,

In my experience, I have not seen this done on a preventive basis.

I believe that the visual phenomenon will not be amenable to treatment.

However, I believe your pain is treatable but you will need to have an ophthalmologist look at your eyes to try to determine the cause of your pain. Once the cause is found, I believe the treatment will help.

A second opinion is a good idea if you have lost trust in your doctor whether or not
there is merit to that assertion.