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Old 04-08-2011, 03:05 PM   #1
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Vitrectomy with silicone oil

Hi,

I was diagnosed with a detached retina in February, had surgery which involved a scleral buckle, vitrectomy with a gas bubble, and laser photocoagulation. This held for about a week. A second surgery involved vitrectomy with silicone oil, cleanup of scar tissue from the first procedure, and more of the laser. This one is holding well, thankfully. Although the vision in that eye is not clear because of the oil, the blind spots that developed from the detachment are gone. My doctor is expecting to keep this oil in my eye for at least 6 months. So here are my questions:

1. For those that have had the silicone oil procedure, did you just go for that time with limited vision in that eye, or were you able to get glasses/contacts to help? If so, at what point?

2. I understand this procedure hastens the development of cataract. How long did it take for that to form? I'm not looking for what's expected, but simply what has happened for others.

3. After both surgeries, I was on Atropine to keep the eye dilated. I've been off that drop for 3 weeks now and the eye is still dilated. How long should I expect that to be the case?

jim

 
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Old 08-17-2011, 03:59 AM   #2
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Laura1000 HB UserLaura1000 HB UserLaura1000 HB User
Re: Vitrectomy with silicone oil

Hi Jim, I'm probably at the same recovery stage as yourself so am not yet able to help answer the longer term questions I'm afraid but I can share my experience ... I had retinal detachment of night eye in march with 3 sets of surgery to repair (I have retinopathy of prematurity which makes things more complex) and now too have silicon oil in situ.
My vision has changed from around -4 to +4 and is improved slightly with my new prescription in my glasses. But my vision in the right eye is very 'oily' with no straight edges and no ability to read or any close work at all. Is this the same for you?
The second procedure I had was a gas bubble vitrectomy which caused a cataract in just 3 weeks! So I have already had my lens changed during the oil vitrectomy and a 360 fully encircling buckle. I suspect it may be likely that the surgeon will remove any cataract that forms for you during the oil removal.
My pupil is also permanently dilated and my surgeon thinks this is due to the oil and it may return to normal after oil removal.
Very best wishes for your recovery
Laura

 
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Old 08-17-2011, 04:01 AM   #3
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Laura1000 HB UserLaura1000 HB UserLaura1000 HB User
Re: Vitrectomy with silicone oil

Hi Jim, I'm probably at the same recovery stage as yourself so am not yet able to help answer the longer term questions I'm afraid but I can share my experience ... I had retinal detachment of night eye in march with 3 sets of surgery to repair (I have retinopathy of prematurity which makes things more complex) and now too have silicon oil in situ.
My vision has changed from around -4 to +4 and is improved slightly with my new prescription in my glasses. But my vision in the right eye is very 'oily' with no straight edges and no ability to read or any close work at all. Is this the same for you?
The second procedure I had was a gas bubble vitrectomy which caused a cataract in just 3 weeks! So I have already had my lens changed during the oil vitrectomy and a 360 fully encircling buckle. I suspect it may be likely that the surgeon will remove any cataract that forms for you during the oil removal.
My pupil is also permanently dilated and my surgeon thinks this is due to the oil and it may return to normal after oil removal.
Very best wishes for your recovery
Laura

 
Old 08-17-2011, 09:39 AM   #4
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Re: Vitrectomy with silicone oil

Hi Laura,

Thanks for the information. It's been a while since I had posted my question, but hearing others experience does help. I'm now just about set for my next surgery on Sept 1st, to remove the oil.

With having the oil in my eye, I don't have numbers as to how far my eye has shifted, but like you, I cannot focus on anything.

My dilation is also still there. As with you, my doctor is also guessing it's from the oil.

My doctor was surprised that after the first two surgeries that a cataract hadn't formed, and it wasn't until maybe a month ago that he could even see signs of it forming. Likely this next surgery will make it happen, and since it has started, I'm hoping it comes on before the end of the year since I've already paid the insurance deductible for this year!

What complicates things for me is I have phakic intra-ocular lens implants (my natural lens is still there). With the change in prescription, it'll likely make this lens useless, and I would be back to wearing glasses. With cataract surgery, that lens would be replaced anyway, making the whole thing a moot point. but they have to wait some time after removing the oil to get accurate measurements on what my correction will be. I guess it's fortunate for you that it was done before the oil.

I assume that for you the oil is doing it's job holding things in place? Do you have a time frame for how long they will keep the oil in your eye?

I'll post here what happens sept 1st.

Take care,
jim

 
Old 08-18-2011, 05:49 AM   #5
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Laura1000 HB UserLaura1000 HB UserLaura1000 HB User
Re: Vitrectomy with silicone oil

Hi Jim, thanks for your reply, yes my silicon oil is holding the retina in place perfectly at the moment. I'm having regular visits to my consultant (who has been terrific ). My scleral buckle is still giving me a headache quite a lot of the time but I feel so grateful to have some vision and a plan ... That the headache is a small price to pay and it is improving.
My oil removal date has not yet been decided, we want to be sure everything is stable as the ROP caused previous a vitrectomy to be unsuccessful. But I hope it could be around December time.
Very best wishes for your op in September, I've been reading that some people get lots of 'bubbles' after oil removal, due to small amount of residual oil, have you heard this?
Kind regards
Laura

 
Old 12-01-2011, 08:51 PM   #6
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kmiller1949 HB User
Re: Vitrectomy with silicone oil

I also have had two surgeries for retinal detachment (1st vitrectomy; later sceral buckle and oil). And just yesterday I had cataract surgery. (All in left eye). I've got what I take to be contradictory info from my two surgeons. At one time, the retinal specialist seemed to say that the oil has no effect on clarity of vision. And yet he now says he wants to remove the oil (because it eventually breaks down, he says). The cataract surgeon says that everybody he's seen with oil does have somewhat blurry vision. I haven't been able to find any information online. What, if anything, have you heard about these topics?

And Laura & Jim: how are things going for you?
Ken

 
Old 12-02-2011, 05:33 PM   #7
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Re: Vitrectomy with silicone oil

Hi Ken,
I've had my oil since May this year and my prescription has changed a lot during this time. My vision with oil is correctable to 6/24 and occasionally on a good day to 6/18 (If I were to keep changing my lens every 6 to 8 weeks!). My experience is that although on paper this sounds reasonable, its not that simple as although I can 'make out' letters to 6/18 my vision is wobbly/wavy due to the oil. My eye isn't terribly useful at the moment and my brain is almost always suppressing any image it see's and I only use it when I cover my good eye.

My surgeon is delighted with my vision progress and say's that considering the extensive surgery and the ROP ... it's remarkable!
I'm not expert, but I have researched a lot and I am privleged to have a brilliant consultant who spends a lot of time helping me understand! and I think your vision now and in the future after oil removal can depend on the reason for the detachment. If your macula has been unaffected then you have a better prognosis than if the macula has suffered damange.
My macula is certainly still working as it is possible for me to see (and read) fairly small print if I tip my head forward and 'line up' my oil bubble correctly. When i'm in a normal position my oil bubble is not lined up to see any detail at all.
So, I think your oil experience so far is normal, you would expect it to be fuzzy.
My surgeon explained to me that the silicone oil that is available now is so good it can remain in the eye for a very long time (years) before it emulsifies. Each person will be looked at differently, depending on the reason for detachment and other underlying factors will determine how long the oil should remain in place.Your surgeon will need to balance the risk of re-detachment if removed too early with the risk of possible damage to the inside of the eye.
I really hope this is of some help and that your recovery is quick and successful.
Do you mind if I ask why your eye detached and how you have got on pain wise with your buckle please? Is your buckle a 360 fully encircling buckle?
Kind Regards
Laura

Hi Jim, I hope you are doing well and that your oil removal went ahead successfully in September.

 
Old 12-03-2011, 09:29 AM   #8
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kmiller1949 HB User
Re: Vitrectomy with silicone oil

Hi, Laura,
Thanks for the input. I appreciate knowing that there is some hope for the vision to get better!

We have no idea why the eye detached. I was told several years ago that I was a "candidate" (connected with being quite near-sighted; -10 in that eye). I read recently that it's not the near-sightedness itself but correlated genetic factors that increase one's risk.

I had a little discomfort with the buckle for a few days, but I'm not even aware of it any more (since a few days or weeks after surgery). I thought that that was normal.

I don't know what kind of buckle, although I had the impression that it is 360 degrees. I didn't even realize until a couple days ago that there was more than one type!

Ken

 
Old 12-12-2011, 09:33 AM   #9
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fiset94 HB User
Re: Vitrectomy with silicone oil

I'm so glad that I came across this forum!

I had a RD 10 years ago- No idea why it happened. Dr. believe it is because of me being so nearsighted. I had a buckle placed in and gas in the eye. Recovery was slow but after 1 year... I had no problems in the eye and could see great with my contacts. Fast forward to this week. I woke up to find that my retnia had detatched AGAIN. THe doctors find this unbelievable because of the time that has passed with out any complications. They examined my eye to find a massive cataract obstructing thier view. I am scheduled to have my cataract surgury on Friday.. then the following Friday to have the surgury to reattach my retnia.

They are gong to be putting oil in my eye because they think that the gas will not do the job to fix the detatchment... which after reading all the side effects about it.. I am really thinking that my vision is going to be next to nill. THey would like to leave the oil in for aprox 9 months.. and after doing more reading about it... that sounds like a long time... and I am worried that I will have side effects from this as well...

For those of you with the oil... how do you sleep at night? THey told me to be dilligent not to lay on my back or side... UGH- I am a side and back sleeper- how can you breath with your face down in the mattress???

Any tips that you can give me for this long road ahead would be much appreciated.

 
Old 12-12-2011, 02:22 PM   #10
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kmiller1949 HB User
Re: Vitrectomy with silicone oil

Yes, the face-down thing is definitely hard, and something you should think about and plan for. No matter how you sleep, being forced to be in that position pretty much continuously for a week means you're going to get very stiff and sore. Some suggestions:
Make arrangements with someone who will give you some massages--preferably several short sessions per day if there is someone in your house/apt who can do that, but get a real massage person in if necessary.

Kaiser gave me a cylindrical foam pad that I could put my face in. It had a hole in the side for breathing--though I had to enlarge the hole. Also, one of those face holders from a massage table was some use, but I had to rig up a way to lift it a bit so I could breath.

You have to keep face-down, but change positions as much as you can within that constraint. For instance, sometimes I would lay on the sofa or bed and managed to prop my head up slightly so that I wasn't 100% face- down, but rather tilted a little to the side. The docs said that was OK, as long as I didn't tilt too much (the gas bubble has to stay at the detachment).

Other times I came up with several ridiculous but effective positions. For instance, I managed to play games on the laptop, by laying it flat on the floor right in front of the sofa, kneeling on the floor, and laying my stomach/chest on a padded dining table chair with my forehead propped up on the sofa, so I was looking straight down at the computer. This position was a great relief for the lower back pain you otherwise get from laying flat on your stomach. And it allowed clear breathing.

I also managed to rig up another situation in my living room. I put pads on the coffee table, knelt on the floor, lay my head, chest, and stomach on the coffee table, with my feet either on the floor or up on the sofa. Again great relief to the lower back, though a bit hard on the knees. The more weight I could put on my chest/stomach (or feet on sofa), the easier it was on the knees. I actually slept like that sometimes. I would have to prop my head with it tilted slightly to make this work for breathing (and not crunching my nose!)

Good luck!

 
Old 12-13-2011, 07:55 AM   #11
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fiset94 HB User
Re: Vitrectomy with silicone oil

Thanks for all the tips! I actually was under the impression that with oil silicone I would only have to sleep face down.. but could preform all daily activities upright? I will have to double check this with my dr. this week.

I am especially nervous about not being able to see after the oil is removed. I've heard that many people have horrible vision... and my docotr already is shocked at how I manage with the vision that I have now.

I guess time will tell.

Michele

 
Old 12-13-2011, 09:33 AM   #12
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Re: Vitrectomy with silicone oil

Hi Michele,
With my experience in the last 9 months, I've come to realise that we all need different and very specific treatments as retinal detachment tends to be different from person to person depending on the cause. I tend to forget as I'm nervous at my appointments, so I take a list of questions for my surgeon to my monthly check ups :-). Never be worried about asking, your surgeon will form a plan of action together with you.
I had a previous vitrectomy with gas bubble and had to position for this, but now that I have silicone oil (2nd vitrectomy), I do not have to position at all. The silicone oils are 'heavy' so posturing/positioning can in some cases be reduced or avoided altogether.

It took me a few weeks to get used to the reduced vision with oil, but it feels normal now and I have been granted my driving licence back (as my other eye has correctable vision thankfully) and the time is passing quickly. I know it sounds like a long time, but hang in there, you can get through this :-)
I'm not able to help with the 'vision after oil removal' as I still have mine, but please do talk this through with the surgeon, he/she may have thoughts on this.
If you do have to position/posture there are companies who hire out the equipment to help make it a little easier.
Please keep us updated and good luck with you next appointment.
Best Wishes
Laura

 
Old 12-14-2011, 08:22 AM   #13
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Re: Vitrectomy with silicone oil

Laura,

THanks for all your information- I really appreciate it! My surgeon called yesterday and they want to piggyback my surguries. I will have the cataract surgury AND retnia detatchment with in minutes of each other. I'm not looking forward to the recovery , but I'm glad to get them both out of the way as I've noticed that My vision is next to nill from the attachement. At the begining of the week I could still see 50%... THat makes me really nervous!

 
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