Vitrectomy: What To Expect with Macular Pucker Surgery and Recovery
89Some surgical procedures are still so new that it is difficult to find enough information on the Internet about them. Such is the case with the macular pucker peel procedure, which has been performed only since about the mid-90’s. I have just had this procedure done on my left eye, and I hope that what I write will help someone who is contemplating the surgery.
A macular pucker, also known as an epiretinal membrane, often occurs as part of the aging process, but sometimes it can be caused by previous trauma, retinal detachment, diabetes, or post-vitreous detachment (PVD). The epiretinal membrane is scar tissue that forms over the macula, the area of the retina responsible for central vision. The membrane creates traction on the retina, resulting in distortion, blurriness, or both. For some people, the distortion makes straight lines look wavy or crooked, and for others, the vision has a patchy quality.
What is the Goal?
The visual impairment created by a macular pucker typically stops at the 20/60 level, but sometimes it can progress beyond that. If aided vision cannot be corrected to better than 20/40, surgery may be a possibility. The goal is to improve visual acuity, reduce some of the distortion, and possibly prevent permanent damage to the macula.
Existing Cataract?
If you already have a cataract formed in the eye with the epiretinal membrane, you need to be aware that the ERM peel surgery will very likely cause a worsening of your cataract.
However, if your cataract is already pretty advanced, you may consider very strongly having the cataract removed before any retinal surgery. Your retinal surgeon has to look directly through your natural lens in order to do the surgery, and a cataract is cloudy and yellow enough to obstruct his view.
In my case, it made better sense for me to have the cataract removed first, followed three months later by the ERM peel. If you take the same route, expect that your retinal specialist will have definite opinions on the type of intraocular lens you select to replace your natural lens. Some IOL’s will make the retinal surgeon’s field of view more uncertain and distorted.
What is Surgery Like?
At the time of surgery, the patient is anesthetized, their eye dilated, and the surgeon inserts trochars and infusion cannulas directly into the eyeball. First the surgeon performs a vitrectomy, which is the removal of the vitreous humor from the eye. The vitreous is later replaced by a saline solution. Next, the surgeon places a special contact lense over the surface of the eye, giving him a window that he can look through in order to see the retina. With the aid of a high-powered microscope and special lighting, the surgeon takes tiny forceps and peels the epiretinal membrane from the macula. This usually takes about 30 minutes, but can take over an hour depending on the texture of the membrane.
What Kind of Anesthesia?
Most frequently, this surgery is performed using a topical anesthetic and light sedation. Some surgeons, like mine, will prefer to put the patient under general anesthesia. This eliminates the possibility of the patient moving during the delicate procedure. Do not assume that your procedure will go exactly the same as what you've read about on a retina surgeon's web site. When in doubt, ask your surgeon what his routine is. If your pre-operative screening involves doing blood work, an EKG, and a chest X-ray, you are most certainly going to be put under all the way. If you are under general anesthesia, most likely the surgical team will give you a nerve block as well.
Video of ERM Surgery
What Kind of Surgical Instruments?
I had state-of-the-art surgery, using either 23 or 25-gauge needles. This means that my surgery was sutureless, and my incisions healed within a week. Within 7 days, all the redness, swelling, and bloodshot quality was gone from my eye, and you would never guess that I had surgery.
If your surgeon is not using the most modern sutureless equipment, I would ask why not, and get a second opinion. If there are no sutures, there is no post-operative pain, and the incisions heal much faster. But with sutures, you are likely to experience some pain, irritation, and grittiness for a while. It does take considerable skill to use the finest needles. Think about the difference to your recovery and healing.
Dyes Used in Surgery?
There should be no need for your surgeon to inject a dye to stain the epiretinal membrane. Some of them might do it so they can see the membrane better, but there is always the possibility that such a dye could be toxic. When in doubt, ask.
Possible Gas Fluid Exchange
On your surgical consent form, you will see listed the possible use of a gas bubble in the patient’s eye.
The most common reason this would occur is that the patient’s retina detached or tore during the procedure, which happens about 2% of the time. You need to know that a retinal detachment is one of the risks of this, or any, eye surgery. Very serious, but hopefully, it won’t happen to you.
Another possible reason for a gas bubble is to insure against any damage which might have occurred during the surgery. Unexpectedly, my surgeon put a short-acting gas bubble in my eye. He made an on-the-spot decision to peel the ILM (inner limiting membrane) as well as the ERM. Based on what he saw, he could not be sure he did not leave a true macular hole, so he inserted the gas bubble as a precaution. Fortunately, after surgery, we found out that everything was OK.
Face-Down Positioning, or Sleeping on Your Stomach
Don't worry. This probably won't be necessary.
The vast majority of patients get up, walk away, and have someone drive them home. That is the extent of what they do, and they take it easy for a couple of days. They can usually lie on their back, prepare meals, and drive a car after the first 24-hour follow-up visit.
But those few patients with a gas bubble need to stay in the face-down position 90% of the time until the doctor says it’s OK to be upright. Since I had a gas bubble, I had to assume face-down positioning for 3 days only. The purpose of this is to exert just the right amount of pressure against your macula, which is located at the back of the eye. When the doctor determines that your macula is all right, he will give you your “get out of jail card.” It is dangerous NOT to do what he says, and you cannot fly in an airplane while you have the gas bubble. With a retinal detachment, the face-down positioning will be more strict, and might have to last for two weeks.
Your vision with a gas bubble in your eye is like looking through a goldfish bowl. When you move, the liquid sloshes around in your eye, but in a matter of days, it goes down, and you can see over the bubble. Gradually it disappears (in my case, it took 10 days to go away).
It’s good to be prepared for anything to happen. I was prepared, so I knew where to rent vitrectomy recovery equipment, and that such equipment may be covered by medical insurance. Try to be aware of any possibility, even if it seems unlikely to happen. Question your surgeon in detail about all of the inherent risks.
Read more about what is involved with face-down recovery.
What Are the Results?
There is not one standard outcome to be expected from this surgery. How much visual improvement you can expect depends on your healing capacity and the length of time the macular pucker has been present in your eye.
This surgery is not like cataract or Lasik or PRK surgery, where the surgeon plugs numbers into a formula, trying to hit a refractive target for your vision. Everyone’s retina heals differently, and some retinas are more damaged than others. However, as a general rule, 85% of the people undergoing this procedure will get some improvement, typically about 2 lines on the eye chart. Another rule of thumb is that he/she will get back 50% of the vision that was lost. Some fortunate patients improve even beyond that and go back to 20/20 vision.
My visual improvement was documented about 2.5 weeks after surgery. Before the surgery, my best corrected vision in my left eye was 20/40. At the 2.5 week point, it was 20/30. About 5 months after surgery, I could see 20/25 out of that eye.
I do have some residual distortion. That's fairly typical. With a successful ERM peel, you will be seeing better through your visual distortion. I know that sounds strange, and none of your explanations will make sense to you or anyone else. Just accept that it's something of a paradox. I had one correspondent who had this surgery, and she said that, although she still has quite a bit of distortion, she can see better because "the central blurriness disappeared as well as the huge floaters and faded spots."
After the surgery, there will be some lasting damage to your macula, however slight. Two months after surgery, one of my ophthalmologists took a picture of the back of my eye, and let me have a look. The macula is supposed to be very regular and spherical. Mine looks like a spinach leaf that an insect decided to nibble on, and not finding it tasty, moved on to the next vegetable.
Hope
I’ve begun to refer to the ERM peel surgery as “Peel and Hope.” Because that is all you can do. With a competent surgeon, you stand an excellent chance of an improvement in visual acuity. And having the surgery just might mean the difference between being able to pass the eye test at the Department of Motor Vehicles, and failing it. I am glad that I had the surgery.
It takes 3 to 6 months for full healing to take place after an ERM peel. I believe the 20/25 aided vision I have now with my left eye is about as good as could be expected.
Research from PubMed
Macular function and ultrastructure of the internal limiting membrane removed during surgery for idiopathic epiretinal membrane.
Diffractive multifocal intraocular lens interferes with intraoperative view
Outcomes of idiopathic macular epiretinal membrane removal with and without internal limiting membrane peeling: a comparative study.
23-gauge transconjunctival sutureless vitrectomy: a retrospective study of 164 consecutive cases
Disclaimer
The information in this article is not meant to diagnose or treat any disease. If you have any of the symptoms mentioned, consult your personal physician.
Photo Credits
Picture of blue eye from jonycunha
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Thanks very much for this article. It always helps to hear about a first hand account of the process. I had a Vitrectomy on Jan 5th. The procedure like you said was a piece of cake. I was fully under anesthesia temporarily, then awoken during surgery but couldnt feel anything. I was actually able to see the instruments/light in my eye (was pretty cool actually). My vitrectomy was to repair an "optic pit" which I had forever. My retinal specialist finally recommended surgery after years of monitoring. It was getting worse, leaking fluid etc, so now was the time. Since Jan5th, I still have the gas bubble in my eye (albeit a little smaller now). I'm hoping it dissapears shortly. From what I can see past the bubble, it doesnt seem all that improved. It's as if I have a grey line passing through the center of my visual field. My peripheral vision seems clearer, but whatever I am looking directly at is blocked out to an extent. Hoping this improves over time after the gas bubble dissapears.
Cath, thanks for adding some helpful information to this hub. I hope your retinal detachment repair goes well for you. It is encouraging to read about the improvement of your distorted vision.
Helen,
I'm glad you find it helpful. I don't know much about how aging affects outcome. This problem is more of an over-55 phenomenon anyway. I have heard of some very young people who have an epiretinal membrane, but you can bet that they have other medical problems or eye conditions that contributed to it, and probably their situation is worse than yours, in many respects.
Healing rates do vary with the individual.
Just discovered your forum, thanks! I had vitrectomy, ERM peeling and cataract extraction 3 weeks ago, but developed a retinal detachment the day after surgery. I'm having another vitrectomy tomorrow, with gas bubble and cryopexy (freezing). I'm told I'll have to stay upright for the two weeks! yes, even sleeping!. It's been a bit of a rocky road for me, it's good to know I'm not the only one! I'm in the UK, it seem that the combined cataract/vitrectomy/peel operation is done more often here. My condition was called, by various people: epiretinal membrane, macular pucker, cellophane maculopathy, retinal fibrosis. They are all terms for the same thing. I'd like to say that, despite the setback of the detachment (rare, I'm told!) I'm glad I had the surgery, because although there is still some distortion, I am able to see people's faces again, and they don't look like aliens any more! Fingers crossed the detachment repair goes well, If so I will have much better vision than before. Good luck to anyone else having the same thing...Prayers and good wishes. Thank you for posting all you have, there's not much stuff out there to read, and yours is very informative and reassuring.
Thanks for the wonderful information. I'm taking my time to decide. Do you know if age affects outcome?
Helen, thank you for this information. Wow, I've never heard of it referred to as premacular fibrosis before. I believe sometimes it is also called cellophane maculopathy. Looks like I have more information to add.
If you read my article here, I stated that I had to go face-down for 3 days, which is uncommon with this surgery, but does happen. For what to expect with this positioning, visit my linked article just before the comments section here, called "Hints for Enduring Face-Down Recovery after a Vitrectomy".
Because I had a gas bubble (don't get confused if your surgeon sometimes refers to it as an air bubble, because they're the same thing), I was required to be face-down. But I got the impression from some of the comments that I received that some patients only had to lie on their side, and I'm not sure why. Definitely pin down your doctor on this issue, because it is important. You need to know how strict the face-down positioning is likely to be. Mine wasn't that strict, and by that, I mean that about once per hour, I straightened up for 5 minutes or so, and stretched.
In reading about the timing of the surgery, I have taken note that doctors say that the sooner the surgery is done, the better the chance for a good outcome, but I don't have the details on a citation from the literature. I'll try to find the research if you would like. I'm not an expert searcher, though :-). During my time as a medical librarian, I worked with the acquisition and organization of scientific journals, which is very important, but doesn't have the immediate feedback and timeliness needed by the library patrons.
You can ask your doctor about this, but I would think that, if he is only projecting a 50/50 chance of a good outcome, you might want to take a little longer to decide. I corresponded with a fellow retinal patient about this very issue, and she still has the distortion, but she had other problems with the floaters and what she called "a big white blob", and she was very glad that she had the surgery, even though it was only partially successful. Some people, like this lady, are very relieved to be rid of all floaters, and that is one of the side benefits of having a vitrectomy. Some people are willing to take a gamble for greater success than what the doctor predicts. Only you know whether this is workable.
I just went to my eye clinic's website and it says that Macular Pucker is another name for Premacular Fibrosis. I'm glad I checked. I'm in the right area after all.
I've learned a lot here. And have a ton of questions to ask my doctor. Thank you! May I ask if surgery is successful if performed sooner rather than later? I'm wondering if I can put the decision for surgery off for a few months or if I need to decide soon.
I'm sorry, the doctor kept using the term a pucker in the Macula, but said it was Premacula Fibrosis. He said he would use a gas bubble in the eye, and that generally the surgery is about 85% successful, but because there is a split in the Pucker it lowered the odds of a good outcome. It sounds very much like what you have described here, but I will also go to medhelp.
I did learn a lot about gas bubbles here. Do you mind if I ask if you have to lay on a specific side of the body at night following surgery? It is my left eye. They tell me I will have to sit head down for a week.
Thank you
Helen,
Although I don't know anything about macular fibrosis, you definitely have to consider carefully any surgical intervention involving the macula. I'd be curious what surgery your doctor is contemplating. Does it involve lasers, or what? For the kind of surgery that I had with the ERM peel, a surgeon is manually working with the macular tissue, so it does leave some damage behind, and usually, some lasting distortion.
I'm of the opinion that you should visit http://www.medhelp.org in the eye care forums, and pose this question to an ophthalmologist.
Thanks for commenting.
I have macular Fibrosis with a split in the macula. I've been given the option of surgery, but the doctor tell me it's only 50% effective. I have a question: If the surgery fails what will I be able to see, light, colors, shapes? Will I be able to see using my peripheral vision?
Right now I can see out of the eye but everything is distorted. I need to know what I'm risking if I try the surgery and it fails. The doctor neither encouraged me to have the surgery but he didn't discourage me. I have a decision to make and want to be as informed as possible. Right now this is seriously affecting my life, but I'm not sure what the risk is if I have the operation and it fails. How will my vision be affected?
Any information would be appreciated!
Wayne, if you've had the macular pucker for that long and coped with it, no wonder the surgeon was non-committal about possible surgery. I'm amazed that your left eye compensates so well. I've read repeatedly in the literature that the macular pucker peel success is better if it's done sooner than later. But frankly, 20 years ago, the surgical peel procedure didn't even exist, and it wasn't even perfected or widely used until the mid 1990's or so. So you may have been at a disadvantage because you developed your ERM at a younger age. Now you know my opinion.
Like everyone else, I thank you for putting together such a comprehensive article. I have had the macular pucker for at least 15 - 20 years, maybe longer. I did nothing about it because I could still see perfectly well as my left eye is fine. I think I was in my late thirties before I started wearing glasses for reading and now I also wear them for distance. I had a CDL licence until one year ago when I failed the Registry of Motor Vehicle eye exam, but I can still drive on a regular license. With my right eye, I can not even see what direction the biggest E is on the eye chart . I think I was told that eye is 20/400. My eyeglasses have a plain lens for that eye rather than what might have to be coke bottle thick. Four years ago a doctor recommended against surgery. I can't come up with a good reason to do it since now I can see fine with the other eye and there is no evidence of any problem with that good eye. I saw a new Optometrist yesterday who said he had never seen a cellophane ???? like mine so referred me to a retina specialist. I saw him one day later and I would say he was very non committal. Is my thinking that repairing the bad eye (with absolutely no guarantee that it will come with any success)only when and if the good eye is injured sound thinking or not? I know your answer will include talk it over with your Opthalmologist, which I will have a chance to do in 6 months at my next check-up, but I value an outsiders opinion.
Isabelle, if there aren't any complications with the surgeries (are they being done at the same time?), you'll probably be able to drive and go back to work very soon afterward. The day after surgery you'll need to go back to the doctor's office for a check of your eye, and he might say that it is OK to return to work the next day. It all depends on how the surgery goes. And I hope it goes well for you.
Hello,
Thanks for this site. I am schedule for surgery for macular pucker + cataract next month. I am terrified (I am scared of any needle!). Anyway, my question is: I work on a computer all day long. How long do you think it will be after my surgery until I am able to work (and drive) again?
Hope,
Let me just say that having a macular hole is a more serious problem than having a macular pucker. And all I had was the pucker, so there was a better chance that I'd do well after surgery. Still, I will always have some distortion seeing out of my left eye, and if the pucker grows back, that will be a very difficult decision as to whether to have surgery a second time. I'd probably say "no" to that because of more macular damage that could happen during surgery.
It's really impossible to say anything about your left eye without knowing you. I'm always aware of the things I write, and how it could affect readers, so I say, discuss this with your doctor. And if you're not satisfied with the answers, look for help on http://www.medhelp.org. I really like their eye care forum. I have learned a lot on there, and it's a forum that is monitored by qualified ophthalmologists.
Best of luck, and thanks for your nice comments.
I had a retinal hole surgery 4 years ago. It was very difficult post surgery time with the gas bubble and beeing with head dawn for 2 slid weeks which caused me painful sansation in my neck jow and even swalloing because of being face dawn for so long the gravity resulted in much discomfort.
I wish I had your amazing artical regarding retinal hole surgery prior to having it done.
my problem is that I did not gain my sight . My Doctor said it is because my retinal hole was large and possibly old and I should be thankful that the hole itself is closed. The sight in this (R) eye is 20/200 after 4 years . I also had the cataract surgery one year after the retinal hole surgery, and with corrective eye glasses iI still see half of the images andas well as the imagaes are distorted like shifting in and out. I am so heart broken and scared as now my vison on the (L) eye is weaker despite havin had the cataract surgery on it as well about one year ago. Can you please offer me a glimps of hope? Thank you again for sharing your experience and knoldge.
Hope
Chris,
If you have been helped by the information I presented here, I am delighted. I wish your husband the best as the surgeon makes decisions about treatment.
I don't think edema is that uncommon. I have heard of treating it with drugs before resorting to surgery. However, I can't speak from personal experience at all.
Grace,
Thank you so much for such good informative and detailed article - I have been doing a lot of research about this operation , my husband is scheduled to have it done in January .
Your article is one of the best ones that I found and it gave me a lot of reassurance. My husband does not research or asked the doctor many questions- he just puts his entire trust on the doctor, but I have been worried about it because it is such a delicate operation where the skill of the doctor counts so much.
One think that I have to ask the doctor who has been monitoring my husband for about 9 months and the last visit which was just yesterday he decided to schedule him for surgery right away because after looking at new picture of the macula he said that my husband had developed some edema so his condition had worsened- he then prescribed steroid drops 4x a day and some other kind of drops to bring the swelling down- but I have to ask the doctor that if the swelling goes down should he wait and continue monitoring the eye to see if it stays down in which case there should be no need for the surgery.
Did you have any edema?
Your comment would be appreciated
Thank you
Chris
Kevin, I am glad that my article was helpful. Good luck with your recovery.
No doubt, this is the more realistic and helpful commentary concerning this procedure. I'm 5 days out from ERM. Thanks very much for the candor and optimism presented here.
Mercia,
Thanks for coming by and commenting. Yes, indeed, those things do happen quickly -- especially with a cataract. And it does happen quite frequently that the cataract gets worse after the vitrectomy, for whatever reason.
I had a right eye vitrectomy 8 months ago(Feb 2011).My eye was bloodshot for quite a few weeks One of the porthole sites continued to bleed slightly,so was given steroid drops. It was about 8 weeks before my eye was Blood Free
My vision improved after surgery, however Im having probs again with very blurred vision in the same eye. My optician says I have a Cataract which needs removal.
I expected that this could happen as a result of the Surgical Trauma (Vitrectomy) but Im shocked that its happened so Quickly. Im 62 yrs young
i am 72 and have had macula pucker abouut 5 months i just woke up with a sore head and double vison i went to hospital thinking i had a stroke now i find it might be this macula can any one recommend a place that wont cost a fortune in thailand to fix please
Ryan,
I regret that I can't be more helpful. That is a question that only your doctor can answer.
Thanks.
I forgot to mention that I have a small amount of blood inside my eye. Much like a drop of wine in the bottom of the glass. It moves around and leaves Trails.
How is this blood going to disappear?
I have a post op on wed. Should I be worried?
Ryan,
You are correct. Most ERM surgeries do NOT require the face-down positioning. I included this information because, once in a while, it is necessary.
How red your eye is depends on the way they did the surgery. The redness may remain longer in the eye for certain people, but not too long (certainly not longer than a few weeks at the most). My redness was gone in a week. Different people have different healing rates, as well.
Yes, if you've got an air bubble in your eye, it's like looking through a fish bowl. That's very true. It's annoying, but it will go down each day.
Hi i had my epiretinal membrane removed two days ago.
they put air in my eye instead of gas. they never mentioned anything about being face down. they said sleep on your side the first day then don't worry about it.
My eye is 80% red and i am looking through what looks like a thick bloody fish bowl.
Is this normal.
I will see the retina specialist today and ask more questions. Bromday costs over 100.00 Dollars, not inexpensive. I was told that there is some swelling.
You have been of great help to me,
IRMA
Alisa I will be praying for you my love do not panic
your eyesight will come back. Please go back to your doctor and tell him the symptons do not panic sometimes it takes a good few weeks for the eyesight to come back.
God is great please pray I will also pray for you my love
do not forget there is a light at the end of the tunnel.
Ari
Alisa,
I wish you all the best for the return of your vision. Sorry, I can't help with this, as I am not a doctor.
Had a collapsed retina with macular detachment. Prior to surgery, I saw only darkness. During surgery, scar tissue was removed, retina reattached, vitrectomy & gas bubble.
Two days later and I still see nothing. I can detect so light. As if closing your eye and looking at a light bulb. Is there more going on that isn't being detected? Am I going to regain any sight?
Irma,
Also, I looked under Epiretinal Membrane - Drug Therapy in PubMed, and came upon an article about the use of Nepafenac (Nevanac) in epiretinal membrane surgery. However, I don't think that is the drop that you are using. There's no abstract available for this article. Here's the link to the article:
Irma,
I have checked my favorite eye care forum for a discussion of Bromday (Bromfenac ophthalmic solution) and didn't find anything related to epiretinal membrane, only about glaucoma. Also, I checked PubMed, using the terms epiretinal membrane AND Bromday; also looked for macular pucker AND Bromday and still didn't find anything.
Muldron, everything I have read says surgical results are better if it is operated on sooner than later. If you know you've had it for one year, you know more than I did when I had my surgery. Everyone's case is different, and some of the ERMs are kind of borderline. Everyone's case is different, and it may also depend on how much it bothers you.
I actually have had macular puckers in both eyes. But the one in my right eye is very tiny and should be left alone.
I would like to know if anyone had to use Bromday eye drops and if they helped.
Thanks you, Irma
I have had a macular pucker in left eye for about a year and am thinking of undergoing the surery. I think you mentioned or I read that the sooner the surgery, the better the results may be. Is that true? Should I have it asap since it has been a year.
And as a side, it seems like everyone who has written here has had the pucker in the left eye.
Moonlake,thanks for commenting. I appreciate your taking the time to do this.
Dee, let's hope that you heal well, and that your sight is better. It's always nice to be able to say that your retina specialist is great. Mine certainly is!
I had a torn retina and had the gas bubble surg. I had a large tear and was to keep my face down two weeks. I healed in 7 days. I am still looking through the bubble but it is getting smaller. I still do not know how well I will see but I had the best Retina spec.
So glad you were able to get your sight improved.
I have MacTel and I have yet to find anyway of getting something done for it. I have to keep my left eye closed just to be able to read.
So much good information on this hub.
Carol, the way I understand it, the barometric pressure at the very high altitudes that commercial jets fly at changes suddenly -- so much so that a gas bubble could expand inside your eye. You have a natural pressure inside your eye that your ophthalmologist is always checking to make sure it is OK -- and if it gets off too much because of gas expanding, there could be a serious problem.
I've also heard that doctors advise people with serious sinus infections not to fly, either, because of the pressure on the sinuses.
Your doctor is the only person who knows how long the prohibition on flying is in effect. He will monitor the size of the bubble, and make a recommendation.
I am really sorry to hear about your mother.
I just had retina detachment surgery Thursday. The surgeon inserted gas in my eye which was no surprise to me because I have had 2 previous surgeries for the same thing. Could you please tell me why you cannot fly with the gas in your eye? My mother is dying in Texas and doctor said I can't fly for maybe a month.
Irma,
I'm not familiar with this drug. However, I will do some research and see what I find out. Thanks.
I have ERM. My Optometrist told me to take Bromday and at the some time he told me that it only helps in 10% of cases.I took only the sample he gave me. Now I have a retina specalist and again he gave me a sample of Bromday and talking with the the nurse and the Pharmacist I will take Flurbripofen. Has anyone improved with Bromday?
Virginia,
I am glad that your surgery went well. It's nice to get over the scary part. Thanks for your comment.
now i feel comfortable after reading your article here ..i had my right eye surgery same as what you had . it was done here in calgary alberta Dr.A. Kherani is the best retinal specialist surgeon ..i only had 24 hrs. facedown the next day i was told that i can sleep on my back and side gas bubble is gone in 10m days then could drive and back to work after 4 weeks ..i am 62 yrs. old 4, 9.5 " tall weighing 50 lbs ....
Shaz, it is impossible to answer this question, since I've never had a retinal tear. I know that a retinal tear or detachment is a big surgery that takes a lot of time to recover from. This is something you should ask the doctor. I'm sorry that your son had to go through such a thing so young. I really hope the recovery and outlook for him are OK.
my 11 year old son had a 3 hour surgery on right eye as he had tear,doc used band,oil and gas bubble to repair,its been 2 weeks and he feels pressure when moving,is this normal?
Nordic,
It is nice to see your comments here. Yes, I'm glad that I had the surgery, but it wasn't very much fun for me.
I really hope that your procedure helps the vision in your left eye. Thanks again for stopping by.
First of all, I am really glad to read that your vision is on its best way ro return to you :)
Reading your detailed entry about ERM surgery is a boost to put myself under this procedure too.
I've got a serious handycap because my visual acuity on my left eye is around 0.16 (it is 20/125 on the chart used in the US). It is probably caused by RPD which I have since 3 years, however, the pucker has occured only a few months ago.
I am far from feeding any vast hopes about the procedure's effecttiveness in my case, but I am planning to share all my experiences about recovering from this deep. The guy who going to do the surgery is one of the most famous eye professionals in my country, this gives me some hope. The counterpart is that I already lost my vision with my right eye completely after a quick and unmanageable retinal detachment.
If you have a gas bubble, it could take 2 - 8 weeks to go away: Developing a small gas bubble in the eye is a common occurrence with this type of surgery. Don't worry, it will go away on its own after 2 to 8 weeks. Hospital for Retinal Detachment Surgery in Thailand
rosie,
Sorry that your mom had to endure the gas bubble. Yes, a gas bubble has dark edges. You can even see the outline of the bubble with your eye shut. For sure, after only 4 days, it's hard to see above the annoying gas bubble. It's like looking through a dirty goldfish bowl. Some bubbles take over two weeks or more to go down completely, although mine was gone in 10 days. It depends on what kind of gas bubble the surgeon installed. The visual acuity you'll have after this surgery is not evident at first. Everyone is different.
I'm glad that you found this helpful.
I just returned home from nursing my mom, who has undergone a peel on her left eye. Mom had a cataract removed two months ago, in preparation for this procedure. Because the surgeon repaired a tear, and tried to thin the retina, mom was the recipient of a "gas bubble". It has been 4 days since her surgical ordeal, and still she can see absolutely nothing...needless to say she has become quite anxious. When tilting her head the bubble has very dark edges, is this normal... and when can she expect to "see the light"? Thanks for your informative and encouraging site...Rosie
John, sorry, since I don't live in the Pacific Northwest, I don't have a recommendation for you.
I took a look at your blog, and you have really been through a lot, what with all of your serious retina problems. Also,the results of your raw diet sound very encouraging. After my surgery, I took a different path, and concentrated instead on an anti-inflammatory diet, with the use of proteolytic enzyme supplements. My surgical results were already pretty good, but I am sure that giving the extra attention to my diet helped.
I had a vitrectomy almost six weeks ago and now have PVR. I will most likely have a Macular Pucker Surgery next month but I am traveling to Seattle this next week and would like to have a doctor there just in case I need one. Anyone you can recommend?
Sarah, thanks for your comments. There are no guarantees, of course. In fact, should my macular pucker grow back again, another surgery is a possibility -- and some people do have an ERM peeled from the same eye twice. However, I think there is a limit to the number of times you can do this kind of surgical procedure on the same eye because of the increasing chance of damage to the retina. Sorry you have had to endure what you have, and I appreciate your taking the time to comment on Vitrectomy: What to Expect With Macular Pucker Surgery.
Hi, I have just had a vitrectomy and in the surgery I had 2 tears and so had to have the eye frozen and laser surgery to try to seal the tears . I now have gas in my eye and have to lie on my side for 10 days whilst having 3 lots of drops in the eye 4 times a day.
I have read plenty of negative articles since the surgery and can't help but think that the risks and chances of future surgery may have made me think twice if I had set aside more time to research . Although most things are generally documented from negative experiences!!! I did find your article lifting a cloud from my doubt ..... Thank you :)
Amadeo,
Thanks for the comments about your surgery. It's important to hear patient's experiences, and everyone's is a little different. I hope you have an excellent outcome.
I have heard of doing both the ERM and cataract surgery at the same time, and your comments bring a little special interest to this article.
Sorry, I forget to mention that I am from Argentina. I was operated in Buenos Aires, by a Doctor I think is very skillful in retinal surgery. He works since 15 years on this and I think he also use the last updated instruments.
Surgery, both for cataract and ERM lasts only 30 minutes with locala anaesthesia and, as I said, I return to home at the end of surgery. Next dat I return for removing the patch. A little air bubble inyected during surgery (it bounced as a friendly ball) disappeared in 2 days with no care for positioning.
Bersdt regards.-
Thank you very much. It is a very useful article for people that have an ERM problem. Is difficult to find one as this.
I was operated 10 days ago, simultaneously by cataract and ERM. I went to home after surgery and, until today, I found that operation was well done. I have to return to my Doctor next Monday. I'll post any news.
Best regards.-
ElenaM222, thanks for your comments. I understand what you're saying. My left eye that was operated on is now my "good eye" (the exact opposite of the way it was before).
I've got a tiny ERM in my right eye as well that I hope never gets much larger.
There is definitely a lot to consider with this surgery.
I am very pleased to find more information related to macular pucker. I was diagnosed with it 2 years ago and have adjusted somewhat. I have difficulty reading and rely mostly on my right eye for far vision. I had lasik about 6 years ago and went the monovision route and glad I did for I have excellent vision in my right eye to compensate for the left one. I am due back for another check up. I wish there was another alternative than the vitrectomy. I travel a great deal for my job so I am very anxious about the thought of surgery.
Bill,
I'm glad this article was helpful. There are probably some questions that I did not think about, too. If you do have the surgery, I wish you the best outcome.
Hi
I'm considering having this surgery and found your article to be one of the most informative about the "nuts and bolts" side of things. Gave me a list of questions to ask my opthalmologist.
Dawn, my vision did improve even more. I just updated the information in my hub describing the level of improvement I got.
Find a surgeon who is passionate about what he is doing. Also one who is cautious, and who, hopefully, has good communication skills and lots of experience.
Mike,
Thanks for commenting. I hope it all goes well for you. I'd be interested in your experience if you do want to make a follow-up post. With your undergoing two procedures at once, I think you know about what to expect.
Thank you for posting your surgery experience. I am scheduled to have a macular pucker repair and a macular hole repair in a months time. You helped me understand the surgical options and the post operation recovery process. I'll post my experience after the surgery.
Very detailed report on your surgery. Hope your vision continues to improve. My problem is finding out if my Surgeon is really good or not. Ideas? I just may call my primary and also call the surgeon for other patient's thoughts and recommendations.
Cindy,
Thanks for the comments. Another account of a successful ERM peel! I'm glad you are pleased with your surgical outcome.
I HAD SURGERY ON JULY 1ST. IN SEATTLE FROM A RETINAL SPECIALIST...HE IS GREAT...THIS IS MY SECOND EYE THAT I HAVE HAD DONE......I WAS IN AND OUT IN ABOUT 1 HR AND ON MY WAY HOME....I HAVE A BUBBLE IN MY EYE BUT I DO NOT HAVE TO DO THE FACE DOWN....I JUST HAVE TO SLEEP ON MY SIDE FOR 5-7 DAYS....AND WEAR A CLEAR PLASTIC COVER ON MY EYE AT NIGHT...THE DAY AFTER SURGERY (5 DAYS AGO) WHEN I WENT BACK MY VISION WAS SO MUCH BETTER...I DO HAVE SOME WHILE LINES THAT HE SAID WOULD GO AWAY....PIECE OF CAKE !!HE WATCHED MY RIGHT EYE FOR ALONG TIME BEFORE MAKING A DECISION TO DO SURGERY BECAUSE I WAS CLOSE TO GETTING A HOLE IN RETINA. I CANNOT DRIVE YET BECAUSE IT IS ONLY 5 DAYS AND THE GAS BUBBLE GETS IN MY WAY WHEN I TRY AND LOOK DOWN :)....I GO BACK FOR A RECHECK AT TWO WEEKS....PLEASE CHECK OUR YOUR DOCTOR FIRST ...MY PRIMARY CARE DR. LOOKED HIM UP FOR ME AND SAID "WOW" WHAT CREDENTIALS....SO GOOD LUCK ALL
Slideseven, thanks for the compliment. This is a weird problem to have. And now I know what to look for should a similar thing happen to my other eye.
Superb article on Victrectomy. Informative, and reassuring information for anyone about to have this operation done.
Annette, I am very glad to be of assistance. In the right surgeon's hands, there's nothing to worry about with this procedure or the recovery.
Thanks for taking the time to comment.
This is the first positive article I've read on this type of surgery. Thanks for your comments. You have given me a better outlook.
gracenotes Hub Author 3 months ago
Sal, this was very interesting, so thanks for your account. I really hope your gas bubble disappears soon.