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Old 03-03-2013, 06:26 PM   #61
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

hey Vit cat glad your getting better vision..... when you had the Yag laser done did you notice any side effects?? did your vision just get instantly better?? they say that when they Yag
the hole in the capsular bag it kind of blows out at the back of the hole ,making sort of lateral tissue spikes and weakens the bag somewhat, so that they generally cant do a lens explant on a capsularbag that has had a Yag done......second cataract is a real pain in the *** problem and they really need to come out with better ways to deal with it.
I just saw another Doc about cataracts and he said they were very minor and he would wait
but I have serious glare problems that would make driving unlikely and a very slight greenish tint to many things that I hate. I dont know what to do now. They gave me a free OCT..I never had one because I thought they had radiation. It was ok but I dont want to go to another Doc now for awhile because I have been dilated 4 times in 9 months...
I think its best if its limited to twice a year but any serious stuff requires what it requires I guess.
Anyway hope it continues to get better..I have learned a lot from reading this whole thread.

 
Old 03-03-2013, 07:04 PM   #62
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Misano, My floaters probably were caused by some unusual eye strain and myopia. 20/300 both.
I did a stupid experiment years ago and wore reduced RX glasses to try to force my eyes to get better.It caused some bad eye pain and I always felt that it was related to the floaters. I got them one day driving thru Colorado after a strange movement sensation in one of my eyes.They are a true torture for the thousands of people who have them bad.I saw a Doc in Bellevue Wa. years ago and he saw them and said he would do a Vit sx but I decided to wait. That was 5 years ago.That Doc now does them alot but charges 10,000 dollars and that is ridiculous. Larceny.Its taking advantage of people. Floaters are that bad but we are a private club for sure.

Last year I went to Wilmer in Baltimore and was unimpressed by the crowded and hectic clinic.
The thing to understand about the big teaching hospitals is that they let the training residents do most of the work so the patient is getting treated mostly by rookies. You can get surgery done at Wilmer and Bascomb Palmer but it will be twice as expensive and really wont be necessarily better

Last edited by Administrator; 03-03-2013 at 09:40 PM.

 
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Old 03-04-2013, 07:05 AM   #63
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Just wanted to give a quick update. For the pre-op authorization on my 3rd vitrectomy I was sent to a Dr's office for blood work. A few hours later I had a terrible case of the flu. The surgery was hence rescheduled for tomorrow.

I am praying that the silicone oil which I am told will be left in my eye for 6 months or longer will at least result in stable re-attached retina. Unfortunately the silicone oil has an index of refraction that will make me even more far sighted than I already am (20/200 without glasses, 20/40 [before surgery] with glasses). I am told they can make me a special contact lens I can wear in my vt rx'd eye to at least undo some of the additional far sightedness. However, I will not know how clear my ultimate vision will be until the oil is removed. So I am looking at mid-September before I know totally what vision I will have saved through this 3 vtrx, in 2 months nightmare of a beginning to 2013.

Thanks and I truly hope everyone here has a full recovery.

 
Old 03-04-2013, 07:16 AM   #64
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

When my right retina first detached 3 years ago, I went to a teaching university. I was given laser surgery by a student rookie for a first round which was excruciatingly painful. The student was drilling the lens into my cornea as if they were hoping to literally thread it on. The second round was done by a student with an even heavier hand. Since the first time was so painful, I opted for a full block instead of the topical numbing drops. Unfortunately, the second student doctor did not properly inject my eye as the doctor in charge noted to her that my eye was still moving. The end result was me suffering a panic attack during the procedure and nightmares for months following. I would literally wake up in a cold sweat in the middle of the night dreaming of the laser burning a hole in my eye as I felt every last bit of it.

From that point I found a doctor at a private clinic that does excellent work regardless of his extremely hectic clinic. I have had numerous laser procedures that have been completely pain free. In addition, he has stabilized my left eye and every surgeon that looks at it mentions how well the work has been done. Not a single doctor has anything good to say about the work the University of Illinois, Chicago did to my right eye. I often wonder if I'd be having a 3rd vitrectomy in my right eye if I had gone to him initially.

I would caution against ever trusting a teaching school for eye work. As you say, the doctors are rookies and the ultimate result can be questionable. I may spend 3 hours at my new doctors clinic, but that doesn't match the 8 hours I often spent at the UofI's.

 
Old 03-05-2013, 01:13 PM   #65
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Hi xx1944,

My secondary cataract sx for the right eye with the Yag laser was some 10 years ago, about 2.5 years after the primary cat sx, so I do not remember all the details, but my recollection is that it was a quick sx (few minutes), and, yes, almost immediately (next day?) my vision became better (20/20), and hasn't changed to this day. But I did not have any retinal detachment or anything then. The problem before the sec. cat. was that the "halos," and "glares" around lights, diodes and oncoming cars' headlights started to come back again in the night, like, those before the primary cat., and also, slight cloudiness. That cloudiness comes from the PCO (posterior capsular opacity). These things can't be corrected by refractive lenses, as you know. So, this sx is pretty minor - compared to what you have gone already. I read that in US, 2% of the population is at the risk of retinal detachment after YAG laser sx, rather than 1% after primary cat. sx.

So, you are right, the capsulotomy sx (not "capsulectomy" - that's something else altogether) removes a small disc from the posterior (aft) capsular bag, within which the IOL is located, using YAG laser. That disc gets absorbed in your vitreous behind the lens in a few days. (I don't know if it gets as easily absorbed if it is saline solution instead, which usually replaces the vitreous during vitrectomy sx., or what the interaction of the IOL is with the saline solution, now that it is exposed to it as opposed to the natural vitreous.) The diameter of this disc is something like the size of your pupil in normal daylight, and I have read that depending on the disc's relative size to the pupil, the light rays can "defract," or bend around the hole's edges, and can give different colors in your vision. The thickness of his capsule is that of one blood cell (extremely thin). So, yes, I guess, cutting a hole must be weakening the posterior capsule, but I don't know about the fibres that may show up post-op, as you say, since lasers, in general, are extremely accurate (sharply focused) and ought to cut a fine edge.

By the way, I don't know how OCT will help anything with PCO, as it is typically used to get the cross-sectional details of the retina, not the capsular bag or lens. And, OCT uses infra-red (IR) of low intensity, no X-rays or radiation that you were thinking; I don't think it is harmful or anything. Plus, I have not heard anything about dilation drops being harmful if taken more than 2 times a year - that sounds preposterous! Where did you get this info from? After these vit surgeries, I have been seeing my doctor pretty regularly to check the progress (1 day, 4 days, 2 weeks, 4 weeks, 7 weeks, etc.), and unless my eyes are dilated he can't see properly inside my eye. So, dilation is a must.

I saw you mentioned Bellevue, WA, for your cat. sx. in the other post - I also had done my cat. sx. in Bellevue, WA, at PCLI with Dr. Oli Traustason - great surgeon, but who has retired long time ago. Fortunately, my insurance paid almost all the expenses for all these surgeries (cat, vit, whatever) - so that's not an issue for me. But, especially, after the RD surgeries, when you get your vision back, I would pay them whatever rather than be ruined with a bad or no vision for life. I have really started respecting these surgeons now! It's money worth spent.

 
Old 03-05-2013, 06:25 PM   #66
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

Some cat doctors actually cut a hole in the posterior caps. bag as a hedge against future 2nd cataract,PCO. I might ask my Doc about it. I would like to wait on my cat sx but the slight yellowing
thing along with the terrible night glares is pushing me to do it now.Floaters and cataracts.
MAn ,what a life.

 
Old 03-06-2013, 07:05 PM   #67
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Re: Post-Vitrectomy Vision & Possibility of Repeat Retinal Detachment

xx1944 - Doing YAG laser capsulotomy during the primary cataract surgery because there is a possibility it may happen later, does not sound like a good idea to me. I would rather do the primary cat. sx., wait and see how things are, and avoid doing the sec. cat. sx., if it is not required. If it does happen later, do it. Why jump the gun?

 
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amblyopia, double vision, erm, retina detachment, vitrectomy



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