Advice about a Vitrectomy

[gene10]

I had a retinal tear about 5 years ago that was repaired by laser surgery. It did leave a macular pucker, but that's not been a problem. This year,  in the same eye, in January and again 3 weeks ago,  I had blood vessel tears in the retina (just blood vessels, no apparent retinal tears). My vision cleared fairly quickly from January's with no action taken and has cleared somewhat from the most recent incident.

I'm told the my problems have to do with my vitreous withdrawing and pulling on the retina. The doctor discussed with me the possible advisability of a vitrectomy to clear (1) clear my vision and (2) reduce, but not eliminate, the chances of further incidents.

Of course, I'm concerned about the possibility of future incidents that could progress to be far worse than what I've experienced. I'm also concerned about the real risks to me of a vitrectomy. The doctor's given me reason to think my particular surgery would not be extensive (1 hr., outpatient, local anaesthetic), which leads me to conclude safe and a short recovery, though he hasn't said so.

My questions are:

--how common is it for the vitreous pulling to be going on after 5 years ?
--What can be said about the probability I'll have another "pull" and tear ?
--Can I conclude surgery to remove my vitreous will be pretty safe in my case ?
--What will my restrictions be in recovery and how long will it take ?

Thanks,

G

[gene10]

I had posted this before but don't see it or a reply, so I am reposting.
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If the vitreous is attached to just the blood vessel, would another pulling incident mean only another blood vessel tear, not a retinal tear/major eye injury ? (I ask for two reasons --(1) I thought the blood vessels were embedded in the retina so I don't understand how the vitreous could pull away from one and not the other and--- (2) if I'm at risk only of another blood vessel tear and not a more serious retinal tear, maybe doing nothing by way of surgery would be best).

The lasering around the area of traction you suggested earlier--is it possible that the lasering that was done five years ago could already have sealed the target area ?

Thank you very much for your help.

Gene

[gene10]

May I impose on your time a bit more.

If the vitreous is attached to just the blood vessel, would another pulling incident mean only another blood vessel tear, not a retinal tear/major eye injury ? (I ask for two reasons --(1) I thought the blood vessels were embedded in the retina so I don't understand how the vitreous could pull away from one and not the other and--- (2) if I'm at risk only of another blood vessel tear and not a more serious retinal tear, maybe doing nothing by way of surgery would be best).

The lasering around the area of traction you suggested earlier--is it possible that the lasering that was done five years ago could already have sealed the target area ?

Thank you very much for all your help.

Gene

[Ray T Oyakawa, MD]

The vitreous has pulled away from the retina but it is still attached to the blood vessel.  No one can predict your future for such a rare problem.

A vitrectomy without complications does not require a face down position. Face down positioning is for a retinal tear/detachment.

Dr. O.

[gene10]

I'd assumed the vitreous would have already pulled away from the area around the torn blood vessel. I was worried about other areas of contact which might be troublesome later. You've given me something else to think about.

From what I've told you, can you say how probable it is I'll have another incident ?. Knowing that seems critical to making any decision about any intervention.

Also, if I did the vitrectomy, do you think I'd have to recuperate "face down" for a long period ?

Thanks,

G

[Ray T Oyakawa, MD]

This is very uncommon.  It would  probably be safer to laser around the area of the torn blood vessel (this is the area of traction).  The main complication of a vitrectomy is a retinal tear and retinal detachment.  However, less than 1% in good hands.

You might consider a second opinion.

Dr. O.