Vitrectomy Experiences

[juanmc12]

Doctors say I may end up having a Vitrectomy to remove floaters after a YAG laser treatment.  I have to wait six months to see if the floaters go away by themsleves.  I can't obviously count but I have hundreds of floaters right now casting a curtain of shadows on my retina, it is not just a few.

My question to the community here is who has had a vitrectomy before for any type of problem.  I'd like to know your experinces and outcomes.  I'd like to know as it would eventually help with deciding what to do with my surgey if it comes to that.  From reading and talking to doctors I know that there is a chance of a cataract forming which for me it is not an issue becasue my problem eye had a cataract which was removed.  Second major risk is retinal detachment / holes.  My understanding is that there is a 3 - 5% risk of either of these complications occuring after a vitrectomy.  My eye is healty I have had no retinal issues.  Only issue was the congenital cataract.  I have 20/30 vision in that eye.

Please let me know of your vitrectomy results.

Thanks

[a_j_t_j_a]

My pars plana vitrectomy experience has been a living nightmare. I'm allergic to just about every medication they've given me to control inflammation (Pred Forte and Durazol) and IOP, (Azopt, Combigan, Lumigan, Alphagan P, Simbrinza). I had the Sulfur Hexafloride gas bubble tamponade for an 11mm inferior peripheral retinal tear. The bubble lasted for exactly 10 weeks. I'm just at three months post op, and my eye is still red. I also had the complication of a mid-dilated pupil. My pupil stayed around 4.5mm for a little over a month. The Retinal specialist said time would tell if the function would return. He turfed me to a Glaucoma specialist because I am an aphakic and had elevated IOP. My IOPs have always been low to mid 20s... so I never was concerned. But about forth week into my recovery, I had a huge spike after being allowed off the Pred Forte, but remaining on Lumigan. I'm not sure if inflamation caused a closed angle Glaucomatous attack, or if maybe I rolled in my sleep and allowed the gas bubble to invade my anterior chamber, but I woke up blind in my left eye... an hour later, something drained away and I could see again. I went in to see the surgeon, but saw one of his fellows. My IOP was 47 so he put me on Diamox 500, and all the other drops except the Lumigan, which I'd already been taking as my original OD was concerned about my mid 20s IOPs before surgery. I've had PVD in my right eye, so I'm less concerned about it, though the Glaucoma specialist said it was suspect due to some retinal thinning. However, he said my left eye, post-operatively, "looked great". I had visual fied testing, for which I've lost none of my field. The Glaucoma specialist took me off of all the drugs and wants to see a base line in five weeks. I must admit, I'm greatful to be off the drugs as I had horrible side effects from pretty much all of them. Depression, tachycardia, anorexia (I lost 30lbs in less than eight weeks due to the beta blocker in Combigan.), I couldn't sleep, had all sorts of anxiety and bad nightmares... I still have not slept quite right in nearly 13 weeks, not to mention the glare, photophobia, hellos, sic. The one thing that has been a gold star to me was at the Glaucoma specialist, when they dilated my pupils. I was very frightened that my left pupil would not constrict as I feared the sphincter had been strangulated by ischemia during the closed angle experience. I was told that the pupil had formed a posterior synechiae to the anterior portion of what remains of my capsule. However, the full dilation must have broken the bond as both eyes dilated equally. However, I'm thinking the sphincter is weakened as the pupil in my left eye has reduced considerably, but is still at least .5 to 1mm larger than the right. I'm guessing, again, that in time the muscle will strengthen and possible return to normal. The Glaucoma specialist said that "only time will tell". I can accept that as I've seen at least a modicum of improvement over what it was just a day ago. Glare, starbursting, hellos, just a freaking nightmare for sure. But, if all goes well, and I've managed to "weather the storm" of this process, yes, the specialist described the IOP issue in that manner as he described my angles as open and my situation as "not glaucoma", maybe my life can return to normal. I'm back to work and can still drive and do the things I've always done... for the most part anyway. But, there is an undercurrent of fear that another shoe will drop. I'm just going to keep living. And hope that the iris sphincter strengthens. It is obviously not dead, as if it were, my eye would still be fully dilated. But it is certainly not normalized as of yet. Again, "only time will tell". So, in all... if you can avoid having a vitrectomy... do so. It is not a good experience. Though I no longer have floaters, and my retinal is in tact, or "A-ttached" as the retinal specialist described it, I'm still fighting the red veiny appearance of my left eye and its pupil dysfunction, and the fear of another IOP issue.

[JohnHaganMD]

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[JohnHaganMD]

Thank you for sharing your experience. Best wishes for a complete recovery

[frwbeach]

Great post. I cannot believe the doc would make such a statement. I have had multiple eye issues and several separate issues at the same time that the docs have said they make the overall treatment somewhat complicated but never such an IRRESPONSIBLE statement. Would have been my ex doc immediately- one thing i have learned is that good eye docs posses the ability to listen with compassion to a patients sight issues . I also realized ( after 38 years of excellant vision ) that anyone with normal vision cannot fully comprehend sight issues., The very good eye docs do a super job in understanding the patients point of view .

    I also like your advise to wait and see.  I had Vitrectomy and pucker peel that was needed and it took my vision from 20-120  to 2-60 in a matter of weeks. It was also enlightening to see under the lights for surgery- the floaters were very obvious and covered the whole area-and watching them get flushed away was something.  But like you said wait and see first- I have floaters from time to time now but they go away and vision gets back to normal .

[matt_ret_d_vitrectomy]

Search for my posts to read about my experiences with vitrectomy to correct a retinal detachment.
I would suggest waiting the 6 months and comparing your vision then.
I don't think a vitrectomy is a minor procedure, and shouldn't be undertaken lightly, despite the recent advances.
Good luck!

1077: Sorry you had such an inconsiderate Dr who let fly his emotional comments.  No doubt he has not had serious eye trouble himself!  

[juanmc12]

Old Navy,

What surgeon did you go to?  Did you do any background check on your surgeon.  I am stuggling on how to go about doing this.  Or was it a military surgeon?

[OldNavy966]

By the way, I didn't have to lie face down as member 1077.  Since I didn't have a detached retina, the doc just removed the vitreous and placed a type of salin solution in the eye.  I could see the large bubbles for about two weeks though.  The bubbles got progresivley smaller until they disapeared.  I took it easy for the two weeks with a patch on the eye but could get around.

[OldNavy966]

Answers to your questions based on my experience:

1. Suturless or not?
Yes it was suturless or self disolving suturess.
2. What was your recovery time?
For my first eye, my right dominante eye, it took about two weeks with marked improvment with each day.
For my left, non dominante eye, vision became clearer in about two weeks also.  Being in the navy at that time I was ordered back too soon and the eye degraded.  I took another week or two off and it also recovered nicely, although the doc didn't take out all the vitreous and I still have some visable vitreous to my temporal side.
3.What percentage did the floaters reduce by?
99.9% nothing at all to notice or bother me the slightest.
The doc was going to remove the remaining vitroues visable in my left eye but I back out at the last minute.  Now I see it's not worth the risk to remove the rest.  
Just weigh the risks. ..
best of luck

[1077]

I had a vitrectomy for macular hole in my left eye on March 30. On May 6 I was diagnosed with retina detachment and re-operated May 7 by another doctor who said he did not see such a detachment in any similar situation in 15 years of practice. He also commented that, had it happened to him, he would have jumped out the window. So the 3-5% chances that you read about are probably a function of the surgeon doing the procedure. Get all the possible info about the doctor's experiences before you submit. They put a gas bubble in your eye to hold the retina in place while healing. It is quite uncomfortable for the first two weeks as you have to preserve a face-down position 24/7. It is supposed to last 8-10 weeks. Because of the second operation I have now had a bubble in my left eye for over 3 months. It is shrinking, slowly, and I hope to get rid of it within another week or two.  I also developed a vein-occlusion. It is said that it can only come from high blood pressure or high cholesterol but I do suspect the first surgeon's error that caused the retina detachment to have caused the vein occlusion as well. No easy way to prove but the bottom line is that before the first surgery I had a 10% vision loss in that I could not read with my left eye but could use my eye for everything else. Now I have a 90% vision loss which, according to my doctor, will keep improving "with God's help" over the following year or so. I should not hope for 20/20 vision though he said. He does not say what I should hope for and I do not ask. What's the point? I am working at accepting psychologically that one can live with one eye. Praying (here is God again vs. medical science) that my right eye holds up... which is not a given!

[juanmc12]

Thanks OldNavy9

It was a while ago so your surgery was done with sutures?  The new 23/25 gauge surgeries seem even less evasive.  Yes I was born with a cataract in one eye and I did not have it removed until 21 years of age. The eye is about 20/30 after lasik.  My other eye is 20/20.  So I am fortunate but becuase I am young and some blured vision and veils in my catarct eye I went through a YAG surgery procedure.  It made things worse because now all that debris is swarming in my eye.  It is really bothersome.  I am waiting out the suggested 6 month period to see what the mind/body does with them but if I stil feel the same way I will have the vitrectomy.

Questions on your experince:
Suturless or not?
What was your recovery time?
What percentage did the floaters reduce by?

[OldNavy966]

Sorry, didn't see that you had already had cataract surgery. Belay my last.

[OldNavy966]

I had a vitrectomy to remove very bothersome floaters.  It worked out almost perfect for me after many years.I don't know how old you are but plan on having cataracts earlier than anticipated.  I am only 33 and you can find me on the "which iol is best for me boards".  If you don't know what an IOL is then you might want to research that first.

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

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[JodieJ]

I had a vitrectomy to peel an epiretinal membrane.  I don't believe that the vitrectomy had any effect on my acuity.  There is currently new "sutureless" vitrectomy equipment available, which will make your recovery much quicker and more comfortable than the older instruments requiring sutures.  The procedure is usually done with local anesthesia (you'll be awake); neither the procedure nor your recovery will be painful.  I never needed a Tylenol.  Your eye will be red for a week or two, but you should be feeling fine immediately after surgery.  If you do decide to proceed, see an experienced retinal surgeon.