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Information +thoughts sought on Vitrectomy.

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
J

JollyJack74

New Member
Relationship to Diabetes
Type 2
Had Lazer treatment on and off since approx 2001 Diabetic since 1997. Heart problems 3 years ago, by pass operation followed 18months later by mri scan showing 90/blockage of main carteroid artery right side of neck. Unenthusiastic confirmation of operations outcome by surgeon led to declining of the operation. Believe the Diabetic retinopothy in the earlier days was down to diabetes and my ignorance, but the heart problems increased the need for Panretinal Lazer treatments, three block sessions over a 30 month period. The last session of the last block was curtailed due to inability to see the bleeds in the left eye due to the thickening 'grey mist'. Hence the need for the Vitrectomy. My problem with having the procedure is a real worry about the possibility due to age 74, High blood pressure [I only have to see the hospital/docs and the Bp is running over 200/90 ] also have a real fear of the operation and the possibility of subsequent treatments in the future. The eye problems now seem to occur when high stress situations occur and twice in the last 5 months the greying has taken place in such situations but has overtime very slowly cleared. I am quite happy plodding along and the left eye being relatively 'blind' is not a worry. I do not drive anymore, the diabetes is well under control, last 3 month test was showing 5.5 although I am still on Metformin and gliclazide. Cholestrol is 2.5, kidneys ok, I am slowly loosing weight to try and get the Bp down and so loose some of the tablets etc. The Blood pressure when at home tickling about, between 120/64 and 127/68, so overall life is quite good, so do I really want to introduce more stess and worry by having the Fibrovascular membrane delamination /segmentation procedure etc. I am aware no one can really make the judgement except onself but I would appreciate any thoughts people may have as regards the surgery and its aftermath. If you have managed to get this far I do apologise for being so wordy.
 
Hello Jack,

Sorry you're having such troubles with your sight. I've had vitrectomies in both eyes - about 20 years ago now but I don't think much has changed about the operation.

For me I'd lost sight in one eye and in my other eye my vision had become totally obscured by multiple retinal haemorrhages getting trapped in my eyeball jelly . I'd had maximum laser on both retinas by this point so was desperate for any chance of seeing again.

Obviously considering an operation on your eye/eyes under general anaesthetic isn't a pleasant choice and you do need to be aware of the risks attached. Having the vitreous removed and all the trapped blood surgically cleared out was for me a huge relief. The vitreous jelly is replaced with saline and silicone oil and because it is liquid, if there are any further retinal bleeds the blood disperses a lot quicker in liquid than being trapped for months in the jelly. After dealing with the utter despair of waiting for bleeds to fade and disperse only to watch another bleed obscure my vision I found the rapid dispersal of any bleeds post vitrectomy less devastating and better to cope with.

Usually a gas bubble is put into the eye along with the new fluid to hold the retina stable. You do get used to seeing the bubble and over time it slowly decreases in size until it disappears, your sight can be distorted during this time. For my left eye I had to position for 7 days post surgery lying face down to protect my retina. You can move every hour for a few minutes. For my right vitrectomy I didn't have to position and just used the drops for 4 weeks. The eye does feel very sore to start with but over time the stitches start to dissolve and it becomes less red and painful. Getting some sight back when the eye pad was removed the following day post surgery was the best thing that has happened to me and as I had run out of other treatment options I'm so grateful for the sight I have in my right eye.

It is as you say your call and you need to weigh up staying as you are v the benefits surgery will hopefully bring plus the stress of dealing with the surgery. Both my vitrectomies went as planned and after having no sight I emerged with central vision in my right eye which has been the best thing.🙂 My left eye was too damaged from proliferative retinopathy to benefit from the vitrectomy but I needed my lens in that eye removing for other reasons so they performed both surgeries for me. The biggest relief post surgery was knowing that any further retinal haemorrhages would disperse rapidly, the vitreo-retinal clinic could get a view of my retinas ongoing for clinic reviews and I got some desperately needed light and colour back into my head.

I hope that helps you, I didn't really have an option not to proceed as I was totally trapped without sight. It helped me more than I can say and once over the initial trauma of the surgery things did settle well. I wish you well with whatever choice you make . If I've missed any detail you want to know please ask. 🙂
 
My heartfelt thanks for your reply Flower, its the first real explanation I have had about the procedure, so a lot of food for thought. The operation itself has been offerred as a local, believe this is down to the problems with the heart op when I had trouble afterwards with the lungs being somewhat reluctant to play ball. Your case sounds far more serious than mine and I can only imagine what a relief it must have been for you to see light and colours once again. Once again thank you for replying it really has helped to add to the discussion between the family and myself.
 
Couple of things, JollyJack.

Well done in getting your BP down, and the Diabetes is under control, there’s not much else you yourself can do.

The second thing, is that no doctor will ever offer a treatment or procedure if he or she doesn’t think it will benefit you. Keep that in mind.

By the way, nearly every eye procedure is done under local anaesthetic. Don’t worry, it just looks odd to you when they are doing it, but doesn’t hurt.
 
A friend lost the sight in one eye after a severe bleed. After waiting months he was referred for a vitrectomy. It was about an hour's procedure done under a general anesthesic. He was kept in overnight as he is diabetic (usually done as day surgery). Initially the brightness of the sky, and everything else, hit him. The bubble did not finally clear until the end of the third week. One problem he had was the motion of the bubble in a car/bus caused nausea for a few weeks. He was happy he had the procedure!
 
Thanks for the info Mikey, that's interesting about the nausea glad your friend is now ok.
 
May I ask some questions generally,

1 Everyone so far has been relatively positive about the outcome of the procedure. Has anyone subsequently had any bleeds or problems later on?
2 Has anyone refused the treatment and if so how did things pan out over time. Did the grey veil slowly lift?
3 Has anyone tried or found any alternatives?
4 Has anyone wished they never had it....?
 
One major thing that helped me when I had my first cataract removal, was a video I was 'asked/told' to sit through when going for my first actual hospital consultation at my hospital.

It sounds impossible I know, but you really cannot feel anything in that eye let alone see anything when they are actually operating - surgeon sits directly behind your head and your head/face is covered with a surgical drape which they drape over a frame so it's 'tented up' over your face and upper torso and they pump cooler air under it (it's not actually 'cold' but just not warmed so much by the ruddy big theatre lights above your head as the ambient temperature in the room, so it's comfy under there; like a pleasant very light breeze wafting around you, which is calming)

When I had to have a colonoscopy years ago, my BP was up when I arrived so they gave me some form of sedation and think they gave me enough for a horse accidentally because I was nearly asleep during the procedure (suited me but difficult when the operator wished to communicate LOL) and slept for well over an hour afterwards, and they had to wake me up! I'd want to ask if they could do something like that for me I think?
 
I had a couple of bleeds a few months after the surgery - this wasn't as a result of the surgery but from proliferative retinopathy. The blood dispersed quickly from my eye and didn't obscure my vision as the bleeds had pre surgery. The issues I've had with my sight since the vitrectomy haven't been from surgery but from scar tissue pulling on my retina from all the laser I had. I also had a cataract develop as the vitreous jelly provides the lens with nutrients and once my jelly had been removed my lens went opaque quickly.

Over time without surgery and without any further bleeds the grey discoloured veil may start to lift but I remember being told there was always some degree of blood and debris trapped in the jelly.

If you had useful vision in the eye in question before the retinal haemorrhages then hopefully that useful sight will be there once the grey veil of vitreous jelly has been removed and light can reach your retina again.

Apart from all the usual things we juggle for diabetes, good control, cholesterol, blood pressure etc and apart from laser treatment for the retinopathy there isn't an alternative to a vitrectomy apart from wait and see if things clear but my surgeon told me the longer I went on without light reaching my retina the worse things could be for me getting some sight back. All this was 20+ years ago but I don't advice has changed.

Absolutely no regrets in having the surgery in both eyes and as @mikeyB says they don't suggest a procedure unless there is good reason to benefit you. Best wishes 🙂
 
TrophyW, the idea of a video is quite interesting, the information I received was not very informative so all the comments have been most enlightening. I did [against my better judgement really] went on utube and watched the procedure and put the fear of god up myself lol and the idea of asking for some form of sedation is quite appealing as this would also help to keep the Bp down.
Flower, the grey has lifted a couple of times in the past and I thought it would again but it seems to be more consistent this time. I think the lesson to all this is to really work at control of all the factors you mention plus in my own case, pay particular attention to the question of the stress factor, but this must take place after the procedure. The eyesight prior was not brilliant in the left eye but it has always been the poorer of the two. I feel at the moment after reading the various posts [which have really been so helpful] that on balance I am starting to lean towards having the procedure. So once again thank to you all for your very valued posts, they have been a great help.
 
My friend said when he had an eye test six months post procedure his visual acuity had improved slightly that he put down to remnants from a previous bleed and laser being cleared out!
 
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