Visual Improvement After Vitrectomy for Macular Hole

Has anyone heard of a vitrectomy patient not having any visual improvement until several weeks or months AFTER a vitrecomy was performed to close a macular hole?

I had my vitrectomy five weeks ago, and the hole remains closed.  My vision was 20/50 before surgery, with the characteristic central blind spot and distortion one has when the hole is open.  Days before the surgery, I had a posterior vitreous detachment, which put the hole at the Stage IV level.  It was a Stage II when I was initially diagosed.  I had noticed the vision problems for about a month before I was diagnosed, although we are not sure when the hole first appeared.

I have no other health issues and did not experience any complications from the vitrectomy.  My doctor attempted to peel back the internal limiting membrane during surgery, but was not able to do so.  However, my research indicates that this would not necessary have an impact on my visual outcome.  He has declared the surgical outcome as "anatomically excellent," which I believe means that the hole has been successfully closed.  I have asked him and other doctors if they know of any cases in which the vision did not improve once the hole was closed, but went on to improve later in the healing process.  All I want to know is whether this has been the case for anyone out there, so that I can continue to hope for some improvement.  I realize that the central blind spot will probably never completely disappear, but would like to know if I have reason to continue hoping for a reduction of distortion, as well as an improvement in my visual actuity.  Most patients, if not all, seem to have experienced visual improvement immediately after the gas bubble disappeared.  Mine disappeared two weeks after the surgery, but there was no visual improvement over what it had been prior to surgery.

Thank so much for any information you can provide!

[John C Hagan III, MD, FACS, FAAO]

We have many discussion on this topic and you can access them using the search feature.

Unfortunately closing a macular hole often does not improve the vision or the distortion but just keeps it from getting worse.

JCH MD

[minkybrown]

My question was whether anyone knew of a case wherein the patient recovered some vision several weeks after the vitrectomy, as opposed to right away.

I have searched among the many threads and related topics on this and other sites, and not found the answer to this specific question.

[John C Hagan III, MD, FACS, FAAO]

Here's the answer: Yes.

JCH MD

[AnnaE]

Good luck. I hope your vision improves.

[minkybrown]

Thanks so much for your support, AnnaE.  I have seen your threads and understand that you have been thourgh many challenges with your own eyesight.  I agree with you that we must do everything we can to avoid negative people, input and thoughts, in favor of more healing, positive thoughts.  All my best to you,

minkybrown

[AnnaE]

You are very kind. I hope you have a talented and kind doctor.

Best,
Anna

[John C Hagan III, MD, FACS, FAAO]

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[hsum4]

Dear Minky:

I had a vitrectomy in my right eye and now I'm contemplating in doing it to the left eye.  I can see so much better.  It has been a year from the operation and I had to have a cataract lens put in, but I can see much better with that eye now.  

hsum4

[John C Hagan III, MD, FACS, FAAO]

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[gigs924]

Sounds like my situation is similar to yours and I have been hoping for late improvement (Feb 08 macular hole surgery), but I have just about given up at this point.  At this point my other eye is still good, but the one with the hole has 3 cloudy areas preventing me from reading and seeing fine detail and is not improving.  I think this is where it will stop improving, and hope it does not worsen.  Good luck to you.  It is at least good to know someone out there shares my despair with this.