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Retinal Detachment
I am wondering about a precise percentage number of patients who develop a retinal tear/detachment in the untreated eye after developing this problem initially in one eye? I am 56 and had a tear and then detachment in my right eye 1.5 years ago which was successfully treated with Pneumatic Retinopexy and then Laser. The specialist said that I developed the problem due to lesions in the retina which then led to a tear and detachment. He said that the lesions resulted from being myopic. He says that he has "fixed" that eye but that the other eye has two such lesions, and he strongly reccommends treating them prophylactically with laser as he says that statistically I have a greater chance for a repeat of history. Do you concur and as I questioned earlier - what are the percentages of such occurence in the, as yet, unaffected eye. It seems a shame to play around with (so far), perfect vision. Steve
Thanks for answering the % question. I forgot.
As you say, this is a case by case decision, based on consultation with doctors and reading the research.
I urged my doctor to do it--it was my idea. My current doctor says it was the best decision, since I had PVD. I also had extensive lattice, which they lasered 2-3 times. Even after the 360, it was lasered again. My current doctor says my chances are 6 n 1000 of the fellow eye detaching.
Cerclage has not been recommended in cases where patients have not had PVD. And you are very young. They say that cerclage can cause detachment on the perimeters of the lasering, if the patient has not had PVD.
If I had it to do over again, I would read more, and get a second and third opinion. Also, I would listen to the doctors here.
I hope for a lot of luck and good doctors for all of us.
As you say, this is a case by case decision, based on consultation with doctors and reading the research.
I urged my doctor to do it--it was my idea. My current doctor says it was the best decision, since I had PVD. I also had extensive lattice, which they lasered 2-3 times. Even after the 360, it was lasered again. My current doctor says my chances are 6 n 1000 of the fellow eye detaching.
Cerclage has not been recommended in cases where patients have not had PVD. And you are very young. They say that cerclage can cause detachment on the perimeters of the lasering, if the patient has not had PVD.
If I had it to do over again, I would read more, and get a second and third opinion. Also, I would listen to the doctors here.
I hope for a lot of luck and good doctors for all of us.
Here is an excerpt from an article from the web:
Prophylaxis Against Retinal Detachment by
Indirect Ophthalmoscope (IDO) Laser Cerclage
Robert Morris, MD, Terry J. Moore, MD, Suzanne Nelson, RN, C. Douglas Witherspoon, MD Ferenc Kuhn, MD
Rhegmatogenous Retinal Detachment (RRD) is an uncommon disorder among the general population. Large population studies support an incidence of 0.005% to 0.01%. However, certain eyes are at significantly increased risk for retinal detachment. These include fellow eyes in persons previously suffering from retinal detachment, eyes with pathologic or high myopia, and eyes undergoing vitreous surgery for any reason but particularly for macular hole closure. Fellow eyes in retinal detachment patients have been shown to have a five year risk of retinal detachment of between 10-26%. The rate of retinal detachment bilaterality varies with the presence of myopia, aphakia, and degree of lattice degeneration. However, even eyes which are phakic, non-myopic, and without lattice have been shown to have a bilateral RRD rate of 8% in the absence of prophylaxis.
It is generally accepted that fellow eyes should be carefully examined with scleral depression, and retinal lesions such as holes, tears, and significant lattice degeneration should be considered for treatment with laser or cryopexy. Such treatment has been shown to be safe and to reduce the risk of bilaterality from 19.4% down to 7.5%. However, treatment of only identifiable lesions appears to be imperfect since new lesions develop over time. In 57% of fellow eye detachments, the causative retinal tear(s) occur in retina which appeared normal at prior examination (i.e.: was free of lattice and defects).
*********I'm not so sure of the validity and reliability of this article. However, other journal articles published in the AJO and BJO (American Journal of Opthalmology and British Journal of Opthalmology, respectively) also vouch for the approximately 10-30% rate of fellow eyes detaching. Also, IMO you seem to have many risk factors that put you in greater danger of suffering a detachment in the fellow eye . However, when I talked to my doctors they were all highly skeptical of the above laser cerclage and said my best option was to take no action. The reason for this was b/c there are so many risks to any kind of treatment and the chances of more damage being done was too great, even given my history which put me at an extremely high risk, And with that said, I did suffer a detachment in the fellow eye.
Anyways, hope this helps.
Prophylaxis Against Retinal Detachment by
Indirect Ophthalmoscope (IDO) Laser Cerclage
Robert Morris, MD, Terry J. Moore, MD, Suzanne Nelson, RN, C. Douglas Witherspoon, MD Ferenc Kuhn, MD
Rhegmatogenous Retinal Detachment (RRD) is an uncommon disorder among the general population. Large population studies support an incidence of 0.005% to 0.01%. However, certain eyes are at significantly increased risk for retinal detachment. These include fellow eyes in persons previously suffering from retinal detachment, eyes with pathologic or high myopia, and eyes undergoing vitreous surgery for any reason but particularly for macular hole closure. Fellow eyes in retinal detachment patients have been shown to have a five year risk of retinal detachment of between 10-26%. The rate of retinal detachment bilaterality varies with the presence of myopia, aphakia, and degree of lattice degeneration. However, even eyes which are phakic, non-myopic, and without lattice have been shown to have a bilateral RRD rate of 8% in the absence of prophylaxis.
It is generally accepted that fellow eyes should be carefully examined with scleral depression, and retinal lesions such as holes, tears, and significant lattice degeneration should be considered for treatment with laser or cryopexy. Such treatment has been shown to be safe and to reduce the risk of bilaterality from 19.4% down to 7.5%. However, treatment of only identifiable lesions appears to be imperfect since new lesions develop over time. In 57% of fellow eye detachments, the causative retinal tear(s) occur in retina which appeared normal at prior examination (i.e.: was free of lattice and defects).
*********I'm not so sure of the validity and reliability of this article. However, other journal articles published in the AJO and BJO (American Journal of Opthalmology and British Journal of Opthalmology, respectively) also vouch for the approximately 10-30% rate of fellow eyes detaching. Also, IMO you seem to have many risk factors that put you in greater danger of suffering a detachment in the fellow eye . However, when I talked to my doctors they were all highly skeptical of the above laser cerclage and said my best option was to take no action. The reason for this was b/c there are so many risks to any kind of treatment and the chances of more damage being done was too great, even given my history which put me at an extremely high risk, And with that said, I did suffer a detachment in the fellow eye.
Anyways, hope this helps.
Do a search here on 360 lasering. I had it done, because I am high risk like you, and because my daughter had detachments in both eyes. Also, I had PVD.
It is not highly recommended unless you have had PVD. However, we do not know everything. You should get at least a second opinion and see what Dr. Hagan here says.
Find a second retina doc at ww.aao.org.
It is not highly recommended unless you have had PVD. However, we do not know everything. You should get at least a second opinion and see what Dr. Hagan here says.
Find a second retina doc at ww.aao.org.
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