Re: Macular vision loss after silicone oil removal
I’m afraid I’m not writing as an expert, but I have also had multiple surgeries including silicone oil fill for recurrent retinal detachment. My silicone oil is still in situ (15 months now) and my surgeon and I are contemplating removal in September.
So I’m writing to you with my support and best wishes and some knowledge I’ve picked up along the way on my 18 month ‘eye journey’.
IOP (Intra Ocular Pressure) is considered normal between 10 and 20. So your pressure of 38 after surgery is high (and if my experience is anything to go by, extremely painful!!). I believe this is relatively commonplace after a silicone oil fill and some people stay on meds the entire time the oil is in situ. My pressure rose after my 2nd vitrectomy and I was taking 3 different pressure reducing drops as well as Diamox (Ugh, terrible pills, terrible side effects, but they do the job!).
It is true that high pressure can damage eyes irreparably, but usually this is associated with long term glaucoma rather than short post surgery pressure spikes. My understanding is that as long as the surgeon controls the pressure afterwards we shouldn’t generally suffer long term.
Again, I’m no expert but having reasonable Visual acuity with an oil fill is considered very good. Most people have poor vision during this time. So this suggests to me also that your macula was functioning well prior to removal and the outlook is promising. When I am standing upright my oil bubble is not lined up for focusing, but when I put my head face down and hold objects very close, I have good acuity, I can read print with it. My surgeon says this is excellent news and I could see his visible excitement when he found out I can do this. He says this shows a good outlook for post oil removal, providing we can get the retina to stay attached! My macula is also working in there!
For this reason, if I was you, I would be seeking a 2nd opinion and fairly quickly. It’s not that your surgeon may have done anything wrong, but that different surgeons have different ideas and approaches to things. My surgeon has seeked advice from others about my case as I have an unusual case of ROP … and I really appreciate him for doing this. I know he is committed to my success, but I also know that ROP has no rule book. What works for one, does not necessarily work for another. Even with perfect execution, sometimes ROP retinas re-detach.
At least if you do talk to someone else, you will have some comfort of knowing you have done everything you can, no regrets, I don’t know about you … but when I look back to 2 years ago, I could not have even imagined the struggle, the journey, the hope & the sadness of recurrent detachments, It really is a journey and you need confidence in ‘your team’.
The other suggestion I can make is one that gives me great comfort. I have found a wonderful optician who has a hospital grade OCT scanner (not to be confused with high street optician retinal cameras). I go there regularly (every 3 months) and they store my scans so we can compare every appointment. We can email these to my surgeon if necessary as well. I find this reassurance helpful in between seeing the consultant.
I’m guessing by your nickname of SteveUK, that you are in the UK. If you are in the south of England I can certainly recommend an optician with OCT equipment and (in my opinion) a brilliant & committed surgeon.
Please feel free to email me off list if you would like any phone numbers.
Very best wishes