Post-Retinal Detachment Surgery Care: Key Questions and Concerns

Q: Post-Retinal Detachment Surgery Care: Key Questions and Concerns

Hello Mr. Huang： If you follow all the precautions to prevent retinal tears and detachments, the likelihood of experiencing another tear or needing surgery again cannot be estimated. You must take care of yourself and be vigilant. 1. After applying eye drops,

Post-operative care after retinal detachment surgery?

Dear Doctor,
Thank you very much for taking the time to clarify my concerns regarding the retina.
I have some additional questions.
Currently, my right eye has a prescription of -700 diopters (post-retinal detachment surgery with scleral buckle), and my left eye has -750 diopters (post-retinal tear treated with laser).
Based on this information, if I adhere to all precautions to prevent further retinal tears or detachments, what is the approximate likelihood of needing another surgery?
I have been feeling very anxious and worried about the possibility of undergoing surgery again due to retinal detachment, which would require a long recovery period.
Despite my efforts to avoid risky activities and habits, there are still some necessary daily tasks that make me feel at risk, such as driving a truck (which has poor shock absorption and often shakes), jogging, and occasionally lifting around 20 kg.
Will these activities potentially lead to another surgery?
I also have a few specific questions:
1.
After applying eye drops, I noticed a small amount of pinkish blood-tinged fluid in the conjunctiva or lower eyelid area.
This is the first time I have experienced bleeding since the surgery.
Is this normal?
2.
If I need to undergo surgery again in the future, can I request that the doctor perform a scleral buckle procedure to avoid the need for prone positioning during recovery?
3.
What is the longest duration you have seen patients remain free from surgery due to retinal detachment issues after their initial surgery?
4.
I read online about recent advancements in retinal regeneration technology, with reports of breakthroughs in stem cell techniques in Hualien, Taiwan.
Will this technology potentially improve conditions related to retinal detachment or tears?
5.
If I have regular fundus examinations at a clinic every two months and at National Taiwan University every six months, is this frequency sufficient to catch any issues that might require surgery? Should I consider shortening the interval to monthly check-ups to be safer?
6.
It has been one week since my surgery, and I am currently resting at home.
If my vision and field of view appear stable without any issues, does this indicate that my retinal detachment is recovering well? I am very concerned that during my follow-up appointment, the doctor might tell me that I have experienced another detachment or other complications requiring surgery.
Thank you very much for your responses; your answers are invaluable to patients like me.
I truly appreciate your help.
Thank you!

Huang Guanting, 30~39 year old female. Ask Date: 2020/07/07

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Huang: If you follow all the precautions to prevent retinal tears and detachments, the likelihood of experiencing another tear or needing surgery again cannot be estimated.
You must take care of yourself and be vigilant.

1.
After applying eye drops, I noticed a small amount of pinkish blood in the conjunctiva or lower eyelid.
This is the first instance of bleeding since the surgery.
Is this normal? A small amount of bleeding shortly after surgery is generally considered normal.
2.
If further surgery is necessary in the future, can the doctor try to perform the procedure using scleral buckling (without requiring prone positioning for recovery)? The approach will depend on the extent of the retinal detachment, which may dictate different surgical methods.
3.
What is the longest duration your patients have gone without needing another surgery for retinal detachment after their initial operation? Many patients who undergo successful surgery do not require further procedures.
4.
I read online that there are advancements in retinal regeneration technology expected to emerge in Taiwan within a few years (February 14, 2019, breakthrough in stem cell technology for retinal regeneration at Hualien Tzu Chi Hospital).
Will this technology help improve conditions related to retinal detachment or tears? Currently, it is not applicable for retinal detachment.
5.
If I schedule regular fundus examinations at the clinic every two months and at National Taiwan University Hospital every six months, is this sufficient to prevent any issues that would require surgery? Or should I shorten the interval to monthly check-ups? After your consultation, please follow the physician's recommendations for your next appointment.
The doctor will schedule follow-ups based on your condition.
6.
It has been a week since my surgery, and I am currently resting at home.
If I am not experiencing any issues with my vision or field of view, does this indicate that my retinal detachment is recovering well? It seems you are gradually recovering; congratulations.

Taiwan E-Hospital, Puzi Hospital, Ophthalmology: Monday, Tuesday, Thursday, Friday from 8:00 AM to 12:00 PM; Wednesday from 2:00 PM to 4:30 PM.
Online responses are for reference only; it is essential to seek medical attention at healthcare facilities when necessary.
I hope to have the opportunity to serve you.

Gao Pilin

Reply Date: 2020/07/07

More Info

Post-retinal detachment surgery care is crucial for ensuring optimal recovery and minimizing the risk of complications. Your concerns are valid, especially after undergoing significant procedures like scleral buckle surgery and laser treatment for retinal issues. Let’s address your questions and provide some insights based on current medical knowledge.

Risk of Re-detachment
1. Risk of Re-detachment: The risk of re-detachment after surgery can vary based on several factors, including the extent of the initial detachment, the presence of any underlying conditions, and adherence to post-operative care instructions. While it’s difficult to quantify the exact percentage of risk without a thorough examination, following your doctor's advice on activity restrictions and attending regular follow-ups can significantly reduce the chances of re-detachment. Activities that involve heavy lifting, high-impact sports, or anything that could cause trauma to the eye should be avoided, especially in the early recovery phase.

Post-operative Symptoms
2. Pinkish Discharge: The presence of a small amount of pinkish discharge from the eye can be concerning, but it is not uncommon after surgery. This could be due to minor bleeding from the surgical site or irritation. However, if the discharge persists or increases, or if you experience pain, vision changes, or increased redness, you should contact your ophthalmologist promptly.

Surgical Techniques
3. Preference for Scleral Buckle: If a future surgery is necessary, discussing your preference for scleral buckle surgery with your surgeon is important. Surgeons often consider the patient's history and preferences when planning procedures, but the choice of technique will ultimately depend on the specific circumstances of the re-detachment.

Long-term Outcomes
4. Time Without Surgery: Many patients can go years without needing additional surgery after their initial retinal detachment repair, especially if they adhere to follow-up care and avoid risky activities. Regular monitoring is essential, and your ophthalmologist can provide guidance on what to expect based on your individual case.

Advances in Treatment
5. Retinal Regeneration Techniques: Research into retinal regeneration and stem cell therapies is ongoing, and while there have been promising developments, these treatments are still largely experimental. Current standard treatments for retinal detachment remain surgical interventions, and it’s best to discuss any new therapies with your ophthalmologist to understand their applicability to your situation.

Follow-up Care
6. Follow-up Schedule: Your plan for regular eye exams is prudent. Depending on your specific risk factors and the surgeon's recommendations, more frequent follow-ups (e.g., monthly) may be warranted in the early stages post-surgery. This allows for timely detection of any potential issues.

Recovery Indicators
7. Signs of Recovery: If you are not experiencing any issues with your vision or field of view, it is a positive sign that your retina is healing well. However, it’s essential to continue monitoring your symptoms and attend all scheduled follow-ups to ensure that any changes are addressed promptly.

Conclusion
Your anxiety about the potential for re-detachment is understandable, but maintaining a proactive approach to your recovery—such as adhering to your doctor's advice, avoiding risky activities, and attending regular check-ups—will help mitigate these concerns. Always feel free to reach out to your healthcare provider with any new symptoms or concerns, as they are best equipped to provide personalized guidance based on your medical history and current condition. Your health and peace of mind are paramount, and staying informed is a key part of your recovery journey.

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