What do I have to do during a vitrectomy? I'm afraid to have it.

[QuiltyNana]

All the retina specialist told me is that he will laser about 8 lattice degeneration places first and then do the vitrectomy, followed by cataract surgery.  He said 3 surgeries.

I've had one retina tear, and one lattice degeneration spot had a hole.  The laser surgery for the hole wasn't too bad, but the tear was bigger and the surgery took longer.  The burning was almost more than I could stand, plus having that blinding light in my eye and looking at the top left corner for so long.

Is that what the vitrectomy is going to be like too, or the surgery to fix 8 lattice degenerations?  If not, what is it like?  How much participation do I have to do?  How long to fix eyes on a spot, or the blinding light?  

Between that and reading about the cloudiness after vitrectomy that never goes away, I wonder if I'm not better off just dealing with permanent blurriness and double vision.

[sajsan]

I would get a second opinion. Vitrectomy has a lot of side effects and a very long recovery time.

[JohnHaganMD]

The time to check all this out is BEFORE you have surgery so the advice for 2nd opinion is sound.

[JohnHaganMD]

You might be wise to step back from a planned ton of surgery and get a second opinion about your situation and your options from another retina Eye MD ophthalmologist.  

[QuiltyNana]

Thank you Mr. Presley.  Was your vision better after the vitrectomy?  And did you have to remain still or face down or anything like that for days after the surgery?

JohnHaganMD, this was my second opinion.  The first dr said he would laser the lattice degeneration spots at the same time as the vitrectomy.  I got the second opinion then, not only to have an opinion on surgery but because the first doctor didn't ever explain anything.

[JohnHaganMD]

You said you have already had surgery. Doctor one did laser treatment?  And it hurt and your are blurry. Then Dr. 1 wanted to do a vitrectomy and then later a 3rd operation a cataract IOL.

So what did Dr. 2 recommend?  What did Dr. 2 say about your blurred vision.  Did Dr. 2 also recommend 2 more surgeries? vitrectomy and then catract/IOL.  Did Dr. 2 want to do the cataract/IOL? Do you live in USA? Most retina doctor's here don't do cataract/IOL unless its done at the same time as vitrectomy and absolutely necessary to see well enough to do the vitrectomy.  

[MrPresley]

QuiltyNana,

One laser treatment was done in my retinal specialist's office on my non-operative (right) eye, for a horseshoe peripheral tear discovered incidentally when I first saw him about symptomatic macular pucker in my left eye.  The OCT scan and  visual symptoms I experienced demonstrated a clear need for a subsequent vitrectomy on my left eye.

During the macular epiretinal membrane peel that was performed on my left eye, which was the procedure that required a vitrectomy, a retinal tear occurred in that eye which was laser treated in the O.R.  I did not have to do face-down recovery while the gas bubble that was inserted dissipated, but no heavy lifting or flying was allowed during that period.

Cataracts were not ever discussed at that point.  Accelerated cataract development often occurs after a vitrectomy, which happened in my case, but it was a year and half later before it had reached the point that I had to have cataract surgery.  My retinal specialist deferred treatment of the cataract to a separate  specialist, which I chose based on recommendations from my optometrist.

[JohnHaganMD]

That is usual sequence. Thanks

[QuiltyNana]

JohnHaganMD
I had a retinal tear in my right eye and it was repaired with laser surgery.  A month or two later, a lattice degeneration on my left eye had a small hole, and it was also repaired with laser surgery.  Since then, I have developed macular puckers in both eyes.  As a result, my vision is blurry.  I also have double vision in both eyes, and it may or may not be a result of the macular puckers.  

Both doctors said the only way to improve my vision is to have vitrectomy in both eyes.  Both  doctors also said that because I have 7-8 lattice degeneration spots in each eye, that those should be repaired before the vitrectomy.  First doctor said he would laser those at the time of the vitrectomy surgery.  Second doctor said he would laser those prior to the victrectomy.  Both said that cataracts are more than likely to occur or made worse (I already have one forming) after surgery.  

First doctor didn't say at what point he would do cataract surgery.  It was like pulling teeth to get the little information I did get.  Second doctor said cataract surgery would be later, when and if the cataracts formed.

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

So both physicians believe you have  epiretinal macular membrane "ERM" which causes macular pucker.  Since the agree on the diagnosis and the treatment you will need to choose the one you feel most comfortable with and in whom you have the most confidence. Best of luck.

[MrPresley]

The vitrectomy will be performed while you are under anesthesia.  A gas bubble will likely be used that will dissipate over the following 3-4 weeks until your body replaces the saline used to replace the vitreous removed during the surgery.  An eye patch will also likely be worn until the day after surgery.  Your vision will be compromised while the gas bubble dissipates, but should noticeably improve with time.  Be patient during the recovery, it's a slow process.