Question about vitrectomy

[RubenDavid15]

I've been seeing bunch of new floaters and a shadow in my upper vision for 2 weeks. I went to an ophthalmologist and they said the retina has been detached. I am gonna have the vitrectomy in a few days. It detached in the lower part of the retina so the process of detaching is advancing slowly. Now I have a question. I have a high myopia -6 on both eyes and I am a healthy 20 year old. I haven't been hit in the eye. So the detachment probably came from the vitreous pulling on my retina. Ahen they change the vitreous after the surgery should I be safe in the future as far as the pulling of vitreous goes ? Since there's no vitreous, nothing should be pulling on my retina anymore right ? I know I am still in danger of being hit since I have a high myopia but I just want an answer from an expert about me being safe from vitreous pulling on my retina anymore. I have another question. Does the shadow in vision always mean that the retina has been detached or the appearance of the little shadow can still be on the retinal tear stage which can be treated with the laser? Thanks for all the help.

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

Unfortunately your conclusion is wrong.    First it is not possible to remove 100% of the vitreous especially in young people because it is so much more firm than older people.  The 'core' vitreous in the center will be removed. Some of it is liquid vitreous and some of it formed vitreous.   The layer touching the retina of often tightly adherenent and cannot be safely removed.   Second while the risk of RD will be less after vitrectomy, scleral buckel and laser or freezing treatment it will not be zero.  Third the eye most likely to have another RD is your other eye.  You should ask your surgeons to try and give you the number but the risk could be as high as 5-15%.

[RubenDavid15]

Thanks a lot for your in-depth answer !  I already did have a laser treatment in my other eye. I have another question for you. My dioptry is still rising, is the area of the retina that has been lasered in danger if the retina stretches more ? Or the danger is the same as all the other parts of my retina that hasn't been lasered ?

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

The biggest risk is generally in 'new areas' when they do laser then create adhesions at a short distance from the hole/tear. That allows the eye to change in size without applying pressure to the tear.

[RubenDavid15]

Thanks a lot Doctor !!! Really awesome explainations !

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

Happy to help. Avoid trauma to your eye and violent whipping action such as roller coaster/thrill rides.   Don't do yoga stand on head. Eye protection for eye hazardous activities. Live healthy lifestyle. DON"T SMOKE.

[RubenDavid15]

Thanks again !!! It's really .... nice to have people who are there to help others in trouble like you do Doctor. I've run into a few eye specialsts who barely speak and seem to not care at all. And since the condition is serious I have many questions. I would still like to know one thing. You said earlier that even after the vitrectomy and laser treatment the risk for me of having another tear/detachment won't be zero. This means that I am still at the risk but the chances of me having it again are "low" as long as I keep them safe. Am I in the same danger as other myopes or I am at bigger risk since I already had a detached retina ? Again ... I couldn't be more thankful to you ...Thanks for all the tips for keeping my eyes safe.

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

The risk in your unoperated eye is very high as I said in the first response.  After your surgery on the eye with the RD the risk of another RD will be much lower than the other eye but higher than normal for non-high myopes.