RD issues and worries

[madamhelga]

Hi all -

I'm 21 and I had LASIK in May of this year. Before surgery, I was a -6 in my L and a -13.50 in my R. Following the LASIK which was relatively successful, I started noticing lightning flashes and floaters in my right eye, which was then diagnosed as a PVD several months ago.

However, I am still concerned because my retinal specialist noticed lattice degeneration in both eyes and an asymptomatic retinal hole in my left eye. The specialist has opted not to treat either: he didn't see the need to treat the lattice in both eyes which would be quite an extensive treatment without any real guarantee that they could stop an RD from happening, and the retinal hole because it has been asymptomatic. My concern is that should a PVD occur in my left eye (which could be within the next year or two, seeing as they usually occur bilaterally) and the vitreous begins to liquidize, will it seep out of the retinal hole and cause an RD?

Is my retinal specialist right in wanting to hold off treatment, or should there have been treatment suggested in order to prevent a detachment? He has been quite good throughout the whole evaluation process, very patient and highly regarded, etc.What is the risk of having an RD in the near future?

These concerns about the potential RDs and so on have been causing me some anxiety lately, especially since I am about to leave the country for a year to do a master's course.

Thanks in advance for any input!

[Ray T Oyakawa, MD]

Most studies suggest that after a PVD your chances of RD decrease.  We know that if we do cataract surgery in a high myope such as you, the chance of an RD is less if a PVD is present before cataract surgery.  The detachment of the vitreous leads to a retinal tear and detachment.

Dr. O.

[madamhelga]

Thanks for the speedy reply, Dr. O. Do you have any input on the likelihood of an RD occurring in my case, a 21 year old with the above described issues? My doctor has basically said that it's a "it might happen, it might never" kind of case. What do you think?

[Ray T Oyakawa, MD]

You have a good retinal doctor.  Asymptomatic retinal hole (not a tear) has less than a 0.5% chance of leading to a detachment.  Laser treatment has a 5% complication rate.

Also, new retinal tears occurs 1/3 of the time in "normal looking retina" and not in the area of lattice.

Dr. O.