Recurrent tractional retinal detachment

[Geary99]

I apologize for the long post, but it's hard to summarize my experience in a few words! I lost the vision in my right eye suddenly last November and was diagnosed with a tractional retinal detachment and lattice degeneration in both eyes. I had a TPPV with scheral buckle and gas bubble inserted to treat the detachment as soon as it was diagnosed. I had laser surgery on the left eye at the same time; the TPPV was followed up with laser surgery a few weeks later in the right eye.

My retina started to detach again due to scar tissue building up, so I had another TPPV in January with silicone oil inserted at that time. By this time, I had developed proliferative vitreoretinopathy. (I am in my mid-40s and have diabetes in my family but have never had any blood sugar problems.) This too was followed up with laser surgery a few weeks later.

In April, I had another TPPV with a membrane peel due to more traction, which was followed by more laser surgery a few weeks later. I then developed a macular pucker, and the scar tissue was back, so I had another TPPV in August to remove the traction and the macular pucker. Each time, the silicone oil has been reinserted, and I have been told that I may have to have the silicone oil in for a very long time, possibly for life. I now have a very dense cataract in that eye, and my pupil has never stopped being dilated. I have light sensitivity to the point where I need sunglasses inside, especially around fluorescent lights, as well as daily headaches and chronic eye pain.

I am now two and a half weeks post-surgery on the fourth TPPV (seventh surgery altogether in that eye in the last nine months). I have some light and movement in the peripheral vision on the right side of the right eye. My questions are: is it normal to have this many eye surgeries in less than a year? Is it normal to have chronic eye pain after this many surgeries, and will this eventually go away? (This is the type of pain that over-the-counter medications do not always relieve.) Would removing the cataract help to restore any of the central vision? Does this run in families? (My sister had a retinal detachment several years ago, and my aunt has had vitreous hemorrhages.) Will my eye ever stop being dilated?

Thanks for any insight you can offer.

Kris

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

Maybe some day, you may live to benefit from it,  artifical vision, artifical eyes, and even the ability to grown new eyes with stem cells or nanotechnology offer hope for the future.

JCH MD

[Geary99]

Thanks so much for your reply. I have a good retina specialist who has been very honest and forthcoming about the prognosis. I just thought I'd check to see if others have had these issues or if it was common. Thanks again for your insight.

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

Oh and be sure you do not smoke and if you drink alcohol you do so in moderation only.
JCH MD

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

1. No it is not normal to have that many surgeries. You have a terrible problem. In the past most eyes went totally no light perception blind from your problems. You are having the worse type of problem maybe the worse 1-2% of retinal detachments. The prognosis for you eye is extremely poor. You need to concentrate on saving the other eye. That means meticulous control of diabetes, blood pressure, cholesterol, body weight, exertcise level, eat outstanding healthy diet, protect the good eye from injury and have your good eye checked at least every 6 months.
2. I suspect the cataract removal will not have much effect on your vision but the surgeon likely needs it done to see the back of your eye.
3. No its likely your "blown pupil" will stay big and not return to normal size. This is a not rare complication of the type of surgery you've had (I'm assuming you are not on a red top dilation eye drop).
4. Your problem does'nt sound like a hereditary problem.

Sorry I can't offer you much more hope about the "bad eye".

JCH MD