Experience with a vitrectomy?

Diabetes Complications and other Conditions Eyes
1

anyone out there had experience with a vitrectomy??? I have one scheduled for next week. Kinda really scared. Been trying to do some research on it. But still feel like I don't really know what to expect. So so many questions!
What is it like being awake during the procedure? I nearly passed just listening to them describe the surgery. I had to ask them to stop and wait for color to return to my face. I can't imagine how i would be during the surgery.
Were you able to see the big needle coming at your eye that they use to inject the local anesthetic? Was that part painful?
I assume they will give me some kind of sedative, along with the local anesthetic. Should i expect some side effects from that?
What was the recovery like?
Could you see ok, still do normal things immediately following surgery? Or will I be sitting around doing nothing but listening to audio books for a while?
Did you have trouble reading out of the eye that had surgery?
I read somewhere that someone experienced a lot of bruising, I didn't even think of that!
They told me not to each before the surgery, did you have a problem with going low during the surgery? do they have a way to monitor that? did you just reduce your long acting?
Where your blood sugars whack afterwards?

Did it effect your vision at all? Did you have any additional problems afterwards?

To list just a few of my questions. ahhh!!!

Any advice or information at all that anyone can offer would be a huge help.

Thank you!

2

I had a vitrectomy a few years ago. My retina had detached. They will sedate you. I did not remember anything, until the very end of the surgey. I could see "something" in my eye but had no pain. The dr injected antibiotics into my eye, which was briefly painful..the next thing i knew, i was back in my room.

DEfinitely don't watch the surgery on youtube. It made me cringe.

Not sure why you are having a vitrectomy. For me.... because my retina detached, I had to remain face-down 24/7 for a week...to put pressure on the back of the eye, to help the retina reattach. I was allowed to be up for 10 minutes every hour, but I only put my head up when necessary. I rented a couple of devices to help maintain my face-down position. ONe was a massage chair..that I could not use. The other fit under the edge of the bed mattress and was similar to a horse-shoe. You rest your head on it and i was able to watch tv and use my computer as long as they were on the floor. I believe you only have to do this if your retina has detached. I actually ended up having to be facedown for 2 weeks.

My blood sugar was high for several weeks afterwards, but I also wasn't active at all.

3

http://www.webmd.com/eye-health/vitrectomy
My bleeding has been controlled with laser surgery.

4

thank you! very helpful. to the best of my knowledge the retina is still attached. i was told they need remove scar tissue and the dead blood vessels from some recently increased retinopathy damage. the vitrectomy will be the right eye only. the left they are doing laser only. the doc also said that the lying face down may or may not be necessary depending on what they find when they get in there.
glad to hear you didn't have problems with lows, that's a concern. don't think my room mate would be able to handle that too well on her own yet. bless her heart :)
also good to know about renting devices just in case. did you find them at a medical supply kind of place?
so you were able to use the eye, watch tv, read etc, yeah?

5

Oh yeah- I've had 5 (yes, five) vitrectomies across both eyes in nmy past. I could see the needle but it was essentially painless. Only after effects was limited peripheral vision...which has been annoying but handleable. All I can say is...relax kiddo, if you ave a good retinal surgeon...you'll be fine! Definitely relax.

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Vitrectomyrs.com is the company i used. (Vitrectomy Recovery Solutions)
Their offices are Wi and FL, but they deliver all over the US. Everythng comes in 1 box. I took Pictures as I removed the items, so I knew how to re-pack the box when it was time to send it back. Insurance covered most, if not all of the rental.

It was not easy to lay face flat 2 weeks. My breasts/ches was so sore from the pressure of laying face down. Because of a brain issue that i have, i would extremely nauseated if i sat with my head down, so that's why i had to lay flat. A friend had this donw and she sat at her kitchen table with her head in her hands. She didn't know you could rent equipment. Definitely worth the price if you need it.

I couldn't read for a day or 2 (maybe longer) because they didn't
want me moving my eyes that much. TV was fine. I could not see out of the operated eye because of the gas bubble that replaces the vitreous fluid. It eventually gets absorbed. As it gets absorbed, you start to see more and more. Initially i couldn't see anything, then t was like looking underwater and then slowly looking over the water. Not sure if that makes sense or not. You could eventually seethe bubble and as you moved, the bubble would move. Th last day or 2, the bubble was the size of a pea and then one day, it was gone.

I developed a cataract within several months. Finally had cataract surgery and immediately had what is referred to as a 2nd cataract. Its not realy a cataract, but scar tissue behind the lens. (If I remember correctly). Had to wait 3 or 6 months before they cold laser the scar tissue. Not a big deal...done in the office. Saw immediate results.

You will be "out of it" when they do all the initial eye stuff. Like I said, I don't remember much of anything. I dont even remember them covering my eye after surgery. I had to have my eye covered overnight. I wore the patch every night for a month (?) and whenever I went out (so no debris would get in it). I rub my eyes frequently, so I wore the patch A LOT, so I wouldn't accidentally rub my eye.

HOpe this helps. Best wishes.

7

Here's a discussion by one of our members who went through one

https://forum.tudiabetes.org/topics/vitrectomy-advice-please

there's lots of links and info about it. sorry You have to do this! let us know how it goes.

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Hi thisisbs (good name!) - First, sorry you have to have this done. Scary. I've had 2 vitrectomies, one in each eye. Both greatly improved my vision. If you have had trouble with "floaters", little bleeds, etc. they wil all be cleared away! I needed cataract surgery after my first vitrectomy, and for good measure they did both. I can honestly say that my vision is the clearest it's been in decades, except that my peripheral vision on one side is gone from laser, not the fault of the vitrectomy.

The actual process was stressful only because being in a hospital is ALWAYS stressful, right? But I felt no pain and was kind of pleasantly buzzed through the surgery, and I think he knocked me out towards the end of it. I kept the cover on my eye for a couple days, then had to do various drops 4x/day for a couple weeks. Yes it looked like I'd been in a bar fight, but that all healed and as surgery goes, it was not that bad. I did have to limit my activity (no jogging! -But I didn't jog before :-) for a week or two. It helped so much - Don't be scared. I think laser is more horrible than the vitrectomies. My doc puts a huge novocaine needle into my eye socket before laser, and it's all I can do not to punch him out! D-8< Let us know how it goes!

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Hi! I had a vitrectomy some years ago and everything went really well. The only problem was that my cornea was a bit damaged in the surgery and they noticed it only much later. The cornea recovered as well, but took time. It's of course better to prevent any damage, so ask the doctor to control also the condition of your cornea all the time. The general recovery was quite quick and I could do normal things, reading etc. very soon. Also can't remember any strange things concerning blood sugars after the surgery. During the operation my blood sugars did go too low, but they controlled it all the time and helped me directly by giving something to drink. The vitrectomy really helped and my vision cleared, I had had bleedings in that eye for a longer time. All the best and don't be afraid, it will go fine!

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Finally got a chance to read all of your responses today. Thank you all so much for the information and the support. It seems like there is a high likelihood of new problems that weren't there before developing, or trading my current vision (which is actually pretty good) for a greater loss of peripheral vision etc. I'm starting to wonder at the necessity of this. The doctor seemed to indicate that it was something that needed to be taken care of right away. And granted, that was a really rough and overwhelming visit, complete with nearly passing out, so i probably didn't catch a lot of what he told me. and didn't really have the opportunity to ask too many questions. Really i just wanted to get out of there and go home as soon as i could. He seems very skilled in his field but a horrible people person. So perhaps I am just not understanding what is going on and why i even need it.

I am typically a pretty active person. At a minimum, walking or biking to work every day. I have done a few half marathons, and I had big plans to run my first full marathon this year. I have flights planned to see my family this summer. At the moment I am starting to wonder if this is really going to improve my life or add more complications to it. Or if I am jumping to gun to get this done so soon, or if it can be postponed. So much that I don't understand. I am considering not even doing the left eye (laser only). Don't know what to think or what to do from here.

And yes, being in a hospital is very stressful! Nobody wants to wear one of those gowns! :) I don't think I have been in the hospital since my diagnosis 30 years ago. Ever since then I have hated even stepping foot in a hospital. Even just to visit my dad at work, who is in hospital administration. Except for some broken bones, ER visits, and going in for x-rays and stuff like that. But no admissions, thank goodness! Over the year diabetes has given me such a fear and disdain towards doctors, hospitals and pretty much anything medical related. This is really, really hard for me.

Thank you all so much for your help. It so very much appreciated!
Mahalo friends!


Aloha, BS
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thanks, i've always enjoyed having fun with my initials :)

hospitals stress me out so much! i really appreciate your input and sharing your experience

-BS

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I've had two vitrectomies, the last was a couple of weeks ago. My right eye was completely uneventful, the day after they took the bandage off I could see the big E for the first time in weeks! It took a few weeks for everything to settle down, but it wasn't a traumatic experience at all. This was 20 years ago, and I haven't had any problems in that eye since! That is the typical experience, most people recover vision quickly and then are very stable for many, many years.

My left eye a couple of weeks ago I had complications, the trocar (cannula) popped out, so the wound leaked for awhile and it ted to hypotony, low eye pressure, which caused a choroidal detachment. The beginning was scary, because I could see very little and had big black and gray patches. I was taking drops to bring up my eye pressure, and now that my pressure is normalized things are starting to get better. The opthalmologist sounded very optimistic for a complete recovery. Really, long-lasting complications after vitrectomy are very, very rare.

As for the surgery itself, it really wasn't scary at all. Not fun obviously, but not painful, just mild irritation after. They'll probably put you to sleep briefly while they inject the nerve block, so you shouldn't feel that at all. You're awake during the surgery, but it's actually kind of cool, you can see the blood swirling around as they suck it up and your vision starting to clear. I was having a conversation and joking with the doctor throughout (partly because I was loopy from drugs, haha.) I felt drowsy all day, but by the next day felt fine, only had pain when I turned my head quickly.

My sugars during surgery were on the low side, so I set a temp basal and they came back up gradually. (I'd set a temp basal in preparation, but it obviously wasn't low enough.) If you can't bring your bg up they'll put a little Dextrose in your IV...Just make sure to monitor careful because they did that during my first surgery (before I had the pump) and kept it there for much longer than they should have, even though I told them my bg was rising too fast.

Which reminds me of one more thing. You may not have this issue, but my bg's were fluctuating like crazy after the surgery. I finally looked at my Dex graph and saw it was bumping up every 4 hours, which made me realize it was rising after every dose of my prednisone drops. Steroids raise bg, but I didn't realize they would when applied topically! So now I'm bolusing a half unit right after I take the drops, and it seems to be working well at keeping things steady. If you get whacky sugars, look carefully to see if they're happening around when you put in the drops.

Wishing you the best of luck!

13

Wow that was long, haha. Sorry! This is all just obviously close to me now.

I just read all the comments...Your vision is clear so this isn't because of a hemorrhage? Is he afraid scarring might cause retinal detachment? Make sure you get him to explain more, because you should definitely determine whether it's actually necessary. (I'm sure it is, he wouldn't tell you to get unnecessary surgery, this is more for your own peace of mind and understanding.) Get a second opinion if necessary...

Loss of peripheral vision isn't because of vitrectomy btw, it's because of laser...My peripheral vision is actually pretty good in my right eye. (It's hard to tell with my left since things are still pretty blurry.) You'll be able to exercise as soon as you feel better, so don't worry about that at all. I had to wait because of my hypotony, but when I left surgery (before he knew about the complications) he told me there were no restrictions at all.

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If you get a gas bubble in your eye for the vitrectomy, you CAN NOT fly or go to the mountains, while you have this gas bubble. My understanding us that the gas will expand(when going to higher altitudes) and can result in going blind. Not sure if everyone gets the gas bubble. I think mine took 6+ weeks to finally reabsorb.

I often go back and get a copy of the office visit notes. I am amazed at what I forgot, didn’t hear, or wasn’t told. I have done that with every surgery I’ve had too. It is interesting to read the OR report.

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Elizabeth, thanks for all of the information. it really is helpful. i feel like there is so much i still don't know and don't understand. so thanks for sharing your experience, it's very helpful!
there is hemorraging and scar tissue. In the right eye, where they are doing the vitrectomy, my vision is only very mildly affected. One small fuzzy area and that's it. I was told that they would be doing both laser and a vitrectomy in the right eye. The left has had no change in vision at all. And they said they would only be doing laser on the left. I need to find out more about the necessity of the laser treatment. I'm thinking i'd rather wait if i can. i'm having a hard time imagining riding a bike safely with limited peripheral vision. i don't want to make things worse for myself.

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great idea about the notes, thank you!

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i don't have a pump or a cgm. my insurance won't cover a cgm unless i get a pump, and i don't want a pump. although I really think a cgm would be a huge help to me. guess i'll have to cut back my morning long acting. although most morning include a decent amount of activity and the morning of surgery will not. such a delicate balancing act. good to know that were able to monitor that. and good tip about the steroid drops!

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Talk to your endo, he'll give you tips on how much to cut back. Try to have the surgery scheduled for as early in the morning as possible...You'll be in the hospital for awhile prior to surgery, and they'll be able to keep an eye on your sugars and raise them if necessary. It's better to stay slightly high that night than to get low, because you won't even be able to eat glucose tabs after midnight.

Per your other comment, the laser is necessary if they're seeing macular edema, to keep it from getting worse. If there haven't been hemorrhages in your left, and you don't have macular edema, I don't see why laser would be necessary. My dr's opinion is that even after PDR shows up, you can wait for hemorrhaging (if it even happens) before starting laser, that there's no reason to laser before that. There are also anti-vegf shots that can slow or stop neovascularization and bleeding.

My understanding is also that vitrectomy is only necessary if there's so much blood from hemorrhaging that they can't do laser. (Or if you have a retinal tear or detachment, in which case they wouldn't let you wait a week, that's an emergent situation.) So there must be something going on that he hasn't made clear to you. Definitely get as much info. from him as possible before scheduling surgery!

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Do you have any updates? Hope you're doing okay!

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I'm back where I have access to my computer again. I have the surgery on Wednesday morning. I was surprised at how quickly it went. Everything went very smoothly! They didn't even need to do the gas bubble! I was so relieved. So far so good. My post op appointment went well yesterday. Just have to remember to take it easy, not lifting and bending etc. And to make sure to keep it dry. It felt so good to finally take a shower today. I am, however, going to get my hair washed at a salon, I think I deserve it :)
I can tell it will be a very gradual process for my vision to come back in that eye, and it throws me off a little bit. But over all getting around really well. Not sure how things are going to go when I try to go back to work, but I won't worry about that today. Right now i just want to get my hair clean!
Thank you so much for checking on on me! I appreciate it so very much!