Post-Surgery Vitreous Opacity: Concerns and Management After Retinal Detachment

Vitreous opacities after surgery?

Hello Doctor,
1.
I previously underwent scleral buckle surgery and gas injection due to retinal detachment, which resulted in significant vitreous opacities postoperatively (sometimes covering more than two-thirds of my vision).
I experience both white haze and black spots.
The surgeon did not recommend any follow-up treatment.
My vision improved by about 300 degrees after the surgery (overall reaching 2000 degrees), and with correction, my vision can reach 0.9 to 1.0.
However, when the opacities cover my vision, it significantly decreases my visual acuity.
Since it has been over a year post-surgery and the condition remains the same, I would like to ask if this situation is of no concern and if there is no possibility for improvement.
Will the opacities continue to enlarge?
2.
In my other eye, which has not undergone surgery, I recently noticed flashes of light when moving my eye.
Could this be due to vitreous traction on the retina? I have had it checked by a doctor, who confirmed there are no retinal tears.
I would like to know if this ongoing traction could lead to a tear or detachment.
Is it necessary to consider laser treatment to vaporize the vitreous to relieve the traction on the retina? What are the other risks associated with such a procedure? Thank you for taking the time to respond, I appreciate it!

vanish, 30~39 year old female. Ask Date: 2017/12/28

Dr. He Jianxian reply Ophthalmology

1.
The opacity should not increase; if it does not continuously obstruct vision, it likely does not require treatment.
If treatment is necessary, surgical intervention may be the only option.
2.
There is no such thing as a laser that vaporizes the vitreous.
As long as regular check-ups are conducted and no holes are present, there is no need for concern.

Reply Date: 2017/12/28

More Info

Post-surgery vitreous opacity following retinal detachment surgery can be a significant concern for many patients. Your situation, involving a combination of scleral buckle and gas injection surgery, has led to the development of substantial vitreous opacities, which can indeed affect your visual clarity and overall quality of life. Let’s address your questions in detail.

1. Vitreous Opacity and Visual Acuity: The presence of vitreous opacities, especially if they cover a significant portion of your visual field, can lead to fluctuations in visual acuity. It is not uncommon for patients to experience an increase in refractive error post-surgery, as you have noted with your vision increasing by three diopters. While your corrected vision is quite good (0.9 to 1.0), the opacities can still obscure your vision, particularly in low-light conditions or when the opacities are more prominent. Unfortunately, if your surgeon has indicated that no further intervention is necessary, it may suggest that the opacities are stable and not likely to improve on their own. However, it is essential to monitor these opacities over time, as they can sometimes change in size or density. If you notice a significant increase in the opacity or a change in your vision, it would be prudent to consult your ophthalmologist for a reevaluation.

2. Flashes and Floaters in the Unoperated Eye: The flashes you are experiencing in your unoperated eye could indeed be related to vitreous traction on the retina. This phenomenon occurs when the vitreous gel pulls on the retina, which can sometimes lead to visual disturbances such as flashes of light or floaters. While your doctor has reassured you that there are no retinal tears at this time, it is crucial to remain vigilant. Continuous vitreous traction can potentially lead to retinal tears or detachment, especially if there are pre-existing risk factors.
Regarding the use of laser treatment to vaporize the vitreous gel, this procedure, known as vitreolysis, can sometimes alleviate symptoms caused by vitreous traction. However, it is not without risks. Potential complications include retinal tears, intraocular bleeding, and even cataract formation. Therefore, the decision to pursue this treatment should be made in consultation with your ophthalmologist, weighing the benefits against the risks based on your specific circumstances.

In summary, while your current vitreous opacities may not pose an immediate threat to your eye health, ongoing monitoring is essential. If your symptoms worsen or if you experience new visual disturbances, do not hesitate to seek further evaluation. For the flashes in your unoperated eye, maintaining regular follow-ups with your eye care provider is crucial to ensure that any changes in your retinal health are promptly addressed. Remember, proactive management and communication with your healthcare provider are key to navigating the complexities of post-surgical recovery.

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