retinal detachment after multifocal lenses

[lissac8]

I had victrectomy for retinal detachment 2.5 wks ago, am very concerned that my vision will not return to even a close normal as I had Restore multifocal lenses implanted 15mo ago with cataract surgery. Has anyone had this happen to them? I have a long acting gas bubble in the affected eye so vision is totally blurry at present.

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

ReStor IOLs are not more prone to retinal detchments (RD)s than other IOLs.  There are problems but they have to do with night vision, need for glasses, and unwanted light reflexes (dysphotopsia).  Without increased risk factors the chance of a RD after uncomplicated cataract/IOL surgery is only one in about 3000-5000.  But once you have RD in one eye if you have an IOL in the other eye the change of Rd may be as high as 5-10% so watch the other eye carefully. Also let your blood relatives know about your problem as it puts them at higher risk also.

[lissac8]

Thanks Dr. Hagan, I will let my daughters know about your recommendation as above. I failed to mention that by the time I was seen by my opthalmologist office and then sent to the retinal MD (same day) they said my macula was "off". They did not explain this, I had to look it up. At any rate, my concern now is how my vision might be adversely affected by the lenses I have implanted. Any thoughts on this ? (This may be a duplicate question)

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

Most surgeons will not implant a multifocal IOL like ReStor in a person with macular disease.  The macula being off dramatically reduces the chance of normal vision being restored even if the retina can be detached. It may be as long as 6 months before you know what your final visual acuity is.  Not many people are going to be wild about doing an IOL exchange.

[lissac8]

Well, that is what I had suspected - unfortunately I guess I will just have to wait and see, but it worries me that since I have these lenses I could have serious problems if the other eye detaches. Any suggestions as to how to prevent that? Lifestyle modifications or avoidances? I appreciate your thoughts very much.

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

Avoid trauma to the eye, avoid activities that jerk head around (think amusement park rides), avoid contact sports, don't do yoga where you stand on your head or in a head down position for a long time. Keep your self healthy: don't smoke, if you drink alcohol do so in moderation, keep weight, blood sugars, blood pressure, cholesterol-triglycerides under control, exercise regularly, See opthalmologist once or twice/year after things settle down.

[lissac8]

thanks so much, I quit smoking 10yrs ago but recently found my b/p to be high but my pcp thought that might be due to the stress of my eye, so has me on medication and I am tracking my b/p. Thanks for the great advice!

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

best of luck

[lissac8]

thank you,

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

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[lissac8]

Hi Dr. Hagen,  Just wonder about your thoughts on air travel - I am 9.5 wks out of my victrectomy with long acting gas bubble. I saw my surgeon on 5/2/18 and asked him if he thought I would be able to travel by 5/15/18 as I had a vacation planned. At the visit, he said "I should be fine to travel as the bubble would probably be gone by then. However as of today (5/12) I still have a small bubble so I doubt I can go on the 15th which is only 3 days away. I may be able to rebook my trip for 5/18 instead. My question for you is: if the bubble disappears by next week, is it safe to fly if the bubble has only been gone for a few days.  My daughter's friend who is an MD thinks its too risky, (but he is a cardiologist..)  Just wondering what your thoughts would be and I really appreciate your insights.

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

No way I can make that decision for you. It is contrary to MEDHELP guidelines. This is a generalization. The problem is related to the volume of gas in the eye.    Retina surgeons have emergency work all the time and 24 hour phone lines. I suggest you call the practice and explain your problem to the retina surgeon on call.  

[lissac8]

yes, I understand of course,
thank you,

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

Best of luck and have a good trip when it happens.

[MrPresley]

I wouldn’t fly myself until all of the gas is gone.

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

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