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Gas Bubble with Vitrectomy

Does anyone know if having a gas bubble inserted during Vitrectomy/ERM surgery causes more of a chance of getting a Cataract faster ?

Also, how common is it to have a gas bubble with just a Vitrectomy/ERM peel with no detached or torn retina?
Doctor has not done the surgery yet, but told me yesterday he might want to put in the gas bubble and have me in face down position 14 days.   I thought that was only for torn or detached retinas???  
Now I'm confused and don't know if I want him to do the surgery, especially if the bubble causes me to get a cataract faster.  
Anyone have any experiences with this ?
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177275 tn?1511755244
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Avatar universal
yes they did dialate your eyes the first visit after surgery
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177275 tn?1511755244
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My opthalmologist did dialate both of my eyes, but that was likely because I had laser treatment a week prior for a retinal tear in my other eye that did not have the vitrectomy/ERM peel procedure.
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177275 tn?1511755244
No comment on this conversation since 2011. JodieJ use to be quite active but I think she's retired.  In our practice usually one week after surgery and pupils usually dilated every time the operative eye is checked.

JCHMD
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Avatar universal
Your surgery was much more complicated than a simple ERM peel, so it makes sense that your recovery would take longer than mine did.  But it sounds like your surgeon did a fine job, and your recovery is progressing well.  I'm sure that your positive attitude has helped.
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can any one tell me when you went back for your first appointment after surgery  did they dilate both eyes?
Avatar universal
Boy, you guys are starting to ask questions that are both above my head and that I didn't even know to ask my doctor about...

I had a macular hole, a detached retina and quite a bit of fluid buildup at the back of my eye.  The scan of the back of my left eye (I assume that is what you mean by OCT) looks horrible compared to the right.  From the other flatter view it looked like someone fried an egg on the inside of the back of my eye - lots of scar tissue.  About three weeks after the surgery the scan of my bad left eye pretty  much looked like my good right eye, so I am very pleased with the result.  It kinda looked to me like a dermabrasion had been done on it.

My doctor has told me that my prognosis is that the vision in my left eye will pretty much go back to what it was before I developed this problem. But I have been wearing glasses since the 5th grade, so I'm not miraculously expecting to throw the glasses away....  I might mention that my problem was not something that just occurred naturally over time.  I was socked in the eye about 2 ½ years ago by a drunken neighbor, whom I had asked to keep it down and that is what stated this whole thing in motion.  (And yes, I did call the police.)

I drove around the complex where I live about 3 days after the surgery, but it was closer to a week until I really drove to the grocery store.  I would not advise anyone recovering from this surgery to drive anywhere until they are absolutely comfortable with it!  Fortunately I am blessed with plenty of friends who helped me out with rides to places I didn’t feel comfortable getting to on my own.  Now at 2 months I pretty comfortable going anywhere other than any distance on the freeway.

I’m not aware if my doctor used sutureless instruments, but I pretty much guessing not.  He’s the type that would have told me if he had.  I’m very appreciative of my doctor in that he has had over 30 years of doing eye surgery and didn’t make me do this 14 days worth of face down stuff most others are seeming to have to do.  I only had to be face down3 or 4 times a day for 20 to 30 minutes.  (Sometimes I fell asleep and it would be more than an hour.)  I had to sleep on my side and was not allowed to lay on my back.  I went to have a couple of massages and that helped with the back problems.

I’m now at 2 months out and the last few days I am seeing better out of my left eye.  Thing is it’s kind of a double vision thing.  What I’m seeing out of the left eye is a bit lower and skewed down to the right.  It’s making me a little dizzy!  Oh, well I’m sure it will pass – all just part of the process..

What I would say to homecrafter is that the worse thing about this is BOREDOM because you can’t see the way you are use to.  Find some things that you can do, talk to friends and relatives, have them take you out to dinner (people will stare, but who cares!!!)  One of the first things I did more of than usual was cook.  Cook stuff that involves chopping things up, stirring; just more complicated stuff than you would normally do – passes quite a bit of time.  (Then again, you’re a guy, so maybe you hate cooking..)
The books on CD’s or tapes are a good idea.  I remember one lady suggesting using CD’s to learn a new language.  I think someone else suggested jigsaw puzzles.  When I thought I was going to have to do the 14 days face down thing, I put my flatscreen tv on the floor and propped it up a little in the back, so I would have had to use those crazy glasses or mirrors.

Okay, I’ve been long winded enough here today.  I still have a bit of a problem typing on the computer – thank god for spell check!!
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Avatar universal
Again--check with your surgeon, but I think that macular edema involves inflammation.  It impairs acuity.  IOP is a measure of eye pressure.  I don't think the two are related.
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Avatar universal
I'm really not very knowledgeable about OCT numbers, so you should check with your surgeon.  Your numbers seem to me to indicate a rather thick layer of scar tissue and some macular edema--i.e., you should really benefit from your upcoming surgery.  My macular thickness was about 270 when I stopped using Nevanac.  I think that the "normal" range starts in the low 200's.  I've read that few ERM patients ever reach the normal range after surgery.  After my first ERM surgery, my OCT results continued to show improvement even 2-3 years postop.  But the improvement didn't really make a difference in my acuity, which was already good.  Conventional wisdom suggests that it takes about 3 months to restore acuity and 6 months to resolve distortion.
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Avatar universal
First of all, I want to thank you both again for sharing.  The information you are giving all of us is priceless and we appreciate it !
I will try to post my experiences after surgery too, in an effort to help others.

Jodie, my OCT results were never explained by any of the 4 specialist I've seen...so I don't even know if my numbers are "off the chart high" or just normal high.  Within the circle on the OCT chart the center shows 525 and the four surrounding numbers are 464,420,464, 599...and the outer ring is 324, 554, 410 and 341.  
Do you know approximately what your numbers were the last time you had the OCT test when you stopped taking the Nevenac ?  

Also, I am a little confused on Edema and IOP...apparently my edema right now isn't raising my pressure because the pressure is 17 in the bad eye.    
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Avatar universal
Homecrafter, I had the same questions about Nevanac.  It's used to reduce edema, and my local retinal specialist wanted me to stay on it for many months after surgery.  My OCT results showed that I still had some inflammation even though I could read the 20/20 line.  I haven't had an OCT test for a couple of years, but I don't think mine will ever be "normal."  Most retinal specialists seem to consider Nevanac a benign substance, despite the manufacturer's warnings.  In any case, I didn't have any problems after many months of using it.

Bramblerose, did you have a vitrectomy to peel an epiretinal membrane?  Did your surgeon use the sutureless instruments?  Both times that I had surgery, I was told that it would be okay to drive the following day, and I didn't have a problem.

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Avatar universal
I was given an antibiotic drop that I used 1 drop 4x day for a week - don't know what is was called as I got rid of it after about 2 weeks.  It was given to me in my post-op kit, so I did not have to go out and purchase it.  (Doesn't mean I didn't have to pay for it one way or another.....)

The steriod drops I was given were called Durezol.  The doctor gave me a card similar to a credit card.  The pharmacist swiped it and then my co-pay was $35.00.  Used it 1 drop 4x day for the first week and 1 drop 2x day for the second week.

(I'll tell you the hardest part of the drops are landing them in your eye and not on your cheek instead.  I was glad to have someone put them in my eye the first three days, but after that probably half of it ended up on my cheek!)

I've never heard of the nevanac either, but I have an appointment with my doctor on monday and was going to ask him if he could either give me something mildly anti-infl or at least some kind of soothing eye drops as sometimes my eyes feel a bit dry and I'm thinking that might relieve some of the mild discomfort.

I thought of another couple of things to tell you.

For the first about 3 weeks walking surfaces looked pretty flat to me.  Fortunately, I already had a cane to help me with curbs and stairs.  If you can borrow one, it will probably help you if you also experience this problem.   (I still use it when I go out walking just in case I run into some rough surfaces).

If I had it to do over, I'd probably ask my doctor for a temporary handi-cap thing to hang in my car when I started driving.  It's just easier to park near the front of buildings rather than play dodge-car further back in the parking lots.

Good luck on your surgery!  I know it sounds like a lot to go through, but it will be well worth it in the long run!
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Avatar universal
Thanks for the response...as you know this additional information from someone who has gone thru this is priceless.
I do have another question:
I just found out the prescriptions that the surgeon prescribed for my surgery next week.
Are you familiar with any of these?
1) VIGAMOX : 1 drop 4x day for 3 days post surgery (antibiotic drops) ($100 bottle)
2) OMNIPRED: 1 drop 4x day for 3 weeks post surgery (steroid drops ???)
3) NEVANAC:  1 drop 3x day for 3 MONTHS post surgery (non-steroidal anti-infl.)
($150 for 20 days= $400 ish out of pocket)
The pharmacist said she never heard of Nevanac being prescribed for 3 MONTHS...and I read that usage over 14 days can cause serious side effects.
I'm trying to do my homework on Nevanac before I call the Dr. with questions.

Any ideas Bramblerose, Jodie, anyone ???  
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Avatar universal
I'm glad to answer any questions you might have, but remember that each persons recovery will be a little different than others.  I do still have some inflammation, but have never had any real pain.  My area around my eye will ache, but that seems to be getting better with time.  Use of hot compresses at first and now cold compresses seem to help quite a bit.  I take Tylenol and occasionally supplement it with a valium and lie down for awhile.  (I admit I can be my own worst enemy and overdo sometimes...)
Don't expect to be able to see the same way you did before after a few weeks - it takes quite a while.  I was able to drive again (short distances) after about a week on roads I was familiar with and last week I took a short drive on the freeway where I did not have to change lanes, so I feel I am improving quite a bit.
When I was in the initial few weekss of recovery I mainly listened to books on cd's.  I still find reading a book is one of the hardest things to do because your eyes have to move back and forth a lot and that tires them out.  I found that tv was much easier to watch if the screen is lower than eye level.  I can work on the computer for about an hour before my eyes start to get strained.
I could tell the improvement in my eye much more the first few days than I can now, but it is definitely on the mend.  My doctor has told me that it can take up to 5 months to fully recover, but to me that is much better than going pretty much blind in the eye.
I'm also glad I waited 6 weeks to have it done when it was warming up outside.  I wouldn't like to be going thru this in the snow!!!
If you have any specific questions or want suggestions on dealing with this please feel free to ask.
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Avatar universal
I have the surgery scheduled for next week ...I feel relieved to have made a final decision.

How is your recovery coming Bramblerose, after surgery ?  Do you have the time to share any of your details with me ?  Are you seeing visual acuity improvement ?  Any inflammation or other complications ?
Thank you for sharing !  
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Avatar universal
I am now 7 weeks out from having my vitrectomy.  I was not required to be facedown for 14 days.  What my doctor told me was that I would probably have to have cataract surgery 6 to eight months after the vitrectomy.  Eveyone I know that has had the cataract surgery says it's a piece of cake.  Just drops in your eyes for a couple of weeks.
Have you asked your doctor what will happen to your vision if you don't have the vitrectomy?  I was told that I would pretty much go blind in the eye I had operated on, so living with the ordeals of getting over the vitrectomy are way worth the other outcome!!
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Avatar universal
A gas bubble and face down positioning are not needed for uncomplicated ERM surgery.
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711220 tn?1251891127
MEDICAL PROFESSIONAL
A tear in the retina is one of the complications of the surgery.  If it occurs a gas bubble will be needed.

Dr. O.
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