blurriness in eye after vitrectomy

[jd3450]

I have had two vitrectomy surgeries, one in each eye, since september.  My left eye was my good eye with a 2.5 diopter and was the first to have the problem,  The right eye had a cataract to start with but had an RD in November.  My right eye still has the gas bubble but my left eye went from a 2.5 diopter to a 7 diopter but I can handle an 6.5,  Why was there such a drastic change?  Will this improve over time?  I have not gotten the corrected lens because it is just awful to look through and it make me feel sick?  My retina doctors (along with a second opinion) state I am "doing fine" with my retina but I feel all alone with regards to my decrease in vision.  No on can explain it an dnot one seems to be willing to work with me to help.  I was originally told there would not be any change, then told everyone gets more nearsited but this is much worse and I am losing hope.

[jd3450]

1.  Well, I was told it "might" cause a cataract sooner...not right away.  I read this was unusual...but you say it's not.   I certainly did not expect a 20/20 percription two months plus after surgery to change in a few weeks to 20/40.

I also read where the gas causes a cataract.  Wish I knew what caused it in me - not that I can change it.  But it sure changed my life.  With a stay at home mom and two young kids I fear for their future.  I am going back to work but if I  cannot drive then I will likely lose my job and benefits.

2.  My question here was more about should I have a cataract surgeon who has dealt with vitrecomy patients before.   I want a doctor who is prepared and has experience.  One retina specialist told me to go see "anyone".    

The more I research cataract surgery the more I read about people who had problems and many seem to have worse vision than before the cataract surgery.  I already had one surgery which saved my retina but caused another problem.  

Question:  I have an astigmatism also and the my regular EYE MD mentioned a Toric IOL.  I tried a Toric contact lens years ago but it would always move so I abandoned it.  (i.e. not always focused).  Since the Toric contact lens did not work well so I expect the same with the IOL?  This is not like I can try on different type shoes.   Again, I am reading via the Internet of people who's vision is worse after the cataract is removed and they keep asking if they doctor got lens wrong.

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

1. vitrectomies cause cataracts virtually all the time. It is part of the "informed conscent".
2. When you can have cataract surgery will depend on your retina surgeon giving it's "OK"
3. As the cataract progresses your glasses RX will change and your vision will drop.'
5. No there is no research on removing cataracts without surgery that has any potential. Newest techniques are very very small incisions and lens that give good vision without glasses.
JCH MD

[jd3450]

To update you, I did get the glasses.  Four weeks ago I measured a crisp and clear 20/20 with the 7 diopter.  I waiting until the bubble in my RE went below the center line then got the glasses last week.  The best I am seeing is 20/40 in my LE....WHAT HAPPENED? ??? I was seeing 20/20 in the machine and with the mock-ups on.  Could the cataract continued to form in four weeks?  

I have been wearing the glasses four six days and feel fine.  The put a balancing lens in my RE.  I can see up close,  within ten to15 feet fine  with signs, like a STOP sign, but past that the blur or ghosting progresses in my LE.   Do I need to increase from a 7 diopter. going up until the ghost disappears????  When the EYE Optom started raising the strength from 2.5 to 7 I saw the images get closer and closer in the machine.  Once they lined up (at 7) they made a few adjustments and then I could see the 20/20 line crisp and dark and focused.

I did see a general EYE MD as I was not getting much personal support from the retina specialist.  He said I have a cataract in the LE that must have formed after the surgery...what rotten luck.  Did the gas bubble cause that?  I was on my stomach or side for two weeks and didn't cheat.  He did say that is what caused the increase from a 2.5 to a 7 diopter.

Next question...since the EYE MD recommended BOTH cataracts be removed should I be careful on who does this since I had a vitrectomy???  Anythiing I should be aware of ????  I hate reading the Internet due to all the "problem" stories.  Not many who did great take the time to write.  As you stated previously, there is risk with any surgery but does having a vitrectomy greatly increase the risk of problems?  The last EYE MD said I should not expect to experinece a RD because mine repairs look very good....but he did say nothing is for sure.

Lastly, is there any reseach going on to help remove cataracts without surgery?  It seems like the USA is the last to get on board with anything.

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

The Bates Method is a thoroughly discredited theory of what the eye weaker and what makes it stronger. It is worthless.

Perhaps I did not understand. If you still have your own natural lens in the left eye then the shift in myopia is due to progression of a cataract in the eye. VItrectomies cause cataracts and in eyes that have cataracts it makes them grown faster. As cataracts develop they cause pseudo-myopia and the minus numbers get bigger like yours did. It's most likely that you will need catarct surgery soon on the LE. In the mean time you will have a terrible problem with glasses because of the difference in power is so large (aneisometrophia). Any time the numbers are more than 1.5 diopters difference people often have problems. Wearing glasses plus a contact on the LE might help but contacts can be difficult.      Cataract surgery is the most common and successful surgery done on adults. In the USA there will be over 3.25 million cataract/IOL procedures. Complications occur in about 2-3% and most complications do not effect the final visiion. Think of it like driving. We all drive and travel in cars even though there will be about 50,000 automobile accident deaths this year. Nothing in life is risk free, certainly no medicine and surgery.

JCH MD

[jd3450]

Thanks JCH,

I did not have a buckle, just the victrectomy.  Both tears/detachments  just "happened",  I was all over the second one with the signs but still required surgery.  They saw nothing after the flashes. Two days later I went to ER and saw and Eye MD as I saw a graynish image at the bottom of my vision, just like before but he found nothing.  I saw more floaters two days later and then went to surgery.
The Eye MD did explain last night the lens changed or thickened during  the surgery which changed my refraction, which is disappointing as I thought this thype of surgery was supposed to minimize that. He stated my eye did not elongate. I can undertsand going from a 2.5 fo 3.5 or 4 but a 7...leaves me afraid and feeling fragile.   Why I state this is because my second eye already had a cataract for which I have been seeing my Eye MD twice a year for a few years now.  I hear horror stories of cataract removals going bad or doing nothing to improve your vision.  I'm not sure I want to risk it at this time, if ever.
The 7 (sphere) in mentioned above brings my to 20/20 but the mock up glasses were strong and left me with a falling sensation when turning sideways.   I'm not sure if I can live with that or will that go away?
BTW: it has been three months since the first surgery and one month since that gas disappeared.  Could my lens still be healing from the trauma?  The second one still has gas.

Have you every heard of the "Bates"s Method"?

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

1. If you had a scleral buckle that makes the eye more myopic since it causes the eye to elongate.
2. Even if your operation was successful and the retina reattached your vision may not return to normal, may not even return to "good" and your may have distortion (metamorphopsia) permanently.
3. You should have a personal Eye MD (usually the one that did the cataract surgery) get in to see that Eye MD to discuss your condition and see if glasses, contacts or refractive surgery will help. Most retina Eye MDs do not fit glasses or contacts.

JCH MD