Retinal Detachment and Cataract Surgery Options

Silicone oil injection for retinal detachment and cataract surgery in one eye?

Hello Doctor, I would like to ask you a question.
I have a vision of -900 diopters in both eyes with -120 degrees of astigmatism, and I wear glasses with -850 diopters for my myopia.
My right eye has a vision of 2/6 and has undergone two surgeries in the past two months due to retinal detachment, with the second surgery involving silicone oil injection in March.
Recently, in October, due to the silicone oil, my right eye now requires cataract surgery first, followed by silicone oil removal.
The doctor has advised that since the silicone oil is still in my right eye, after the cataract surgery with artificial lens replacement, my right eye will retain a vision of 200-300 degrees to avoid becoming temporarily farsighted due to the silicone oil.
After the silicone oil is removed in the future, my right eye is expected to have a vision of 200-250 degrees.
As for my left eye, it can maintain -900 diopters, and I usually wear contact lenses, or I am considering laser surgery for my left eye to correct myopia.
I would like to understand if I only have the following options, and which option is more suitable.
If considering that the difference in vision does not affect normal life, would the third option be the best? Thank you.

1.
After the cataract surgery, my right eye will have a vision of 200-250 degrees, and I will wear contact lenses for my left eye to correct it to 200 degrees.

2.
After the cataract surgery, my right eye will have a vision of 200-250 degrees, and I will undergo laser surgery for my left eye to correct it to 200 degrees.

3.
After the cataract surgery, my right eye will remain at -900 diopters, and my left eye will also remain at -900 diopters, continuing to wear glasses with -850 diopters.

Calvin, 40~49 year old female. Ask Date: 2016/10/24

Dr. Cai Wenyuan reply Ophthalmology

Based on the situation you described, I also recommend retaining a prescription of 200 to 300 degrees for the right eye.
Thank you.

Reply Date: 2016/10/24

More Info

When considering options for cataract surgery following retinal detachment and the insertion of silicone oil, it is essential to understand the implications of each choice on your vision and overall quality of life. Your situation involves complex factors, including high myopia (900 degrees), astigmatism (120 degrees), and the recent history of retinal surgery.

Understanding Your Options
1. Right Eye with Artificial Lens (200-250 degrees) and Left Eye with Contact Lenses (200 degrees): This option allows for a significant reduction in the refractive error of your right eye after cataract surgery. The left eye would be corrected with contact lenses to match the right eye's new prescription. This approach can create a balanced visual system, but it may require some adaptation, especially if the two eyes have different focal points.
2. Right Eye with Artificial Lens (200-250 degrees) and Left Eye with Laser Surgery (200 degrees): Similar to the first option, this choice aims to correct both eyes to a similar prescription. Laser surgery on the left eye could potentially provide a more permanent solution compared to contact lenses. However, it is crucial to consider the risks associated with laser surgery, especially given your history of retinal issues.
3. Right Eye with Artificial Lens (900 degrees) and Left Eye with Glasses (850 degrees): This option maintains your current level of myopia in both eyes. While it may seem like the simplest choice, it does not address the potential for improved vision through surgical correction. Additionally, having both eyes at such a high degree of myopia could lead to increased visual strain and discomfort.

Recommendations
Considering your circumstances, the best option largely depends on your lifestyle, visual needs, and how comfortable you are with potential adaptations. Here are some factors to consider:
- Visual Balance: Having both eyes at similar prescriptions (Options 1 and 2) may provide better depth perception and overall visual comfort. This is particularly important for daily activities such as reading, driving, and working.

- Quality of Life: If you are active and require clear vision for various tasks, reducing the refractive error in both eyes could significantly enhance your quality of life.
- Surgical Risks: Given your history of retinal detachment and the insertion of silicone oil, it is crucial to discuss the risks of further surgeries (like laser surgery) with your ophthalmologist. They can provide insights based on your specific case and the stability of your retinal condition.

- Long-term Vision Goals: Consider what you want your vision to be like in the long term. If you prefer to minimize dependence on glasses or contact lenses, pursuing options that provide better correction (like laser surgery) may be beneficial.

Conclusion
In summary, while all three options have their merits, Options 1 and 2 may provide a more balanced and functional visual outcome compared to maintaining high myopia in both eyes. It is essential to have a thorough discussion with your ophthalmologist about the potential benefits and risks associated with each choice, considering your unique medical history and lifestyle needs. They can help guide you toward the best decision for your vision and overall health.

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