Post-Retinal Detachment Surgery: Managing Complications and Concerns

Q: Post-Retinal Detachment Surgery: Managing Complications and Concerns

Hello Casper： First, let me clarify that silicone oil is transparent. <br>Generally, if silicone oil is present in the eye for a period of time, it may be considered for removal, unless there is a concern about retinal detachment, in which case it may not be removed. <br>As for w

Post-retinal detachment surgery

Dear Doctor,
I underwent surgery for retinal detachment around the end of September.
After the surgery, I followed the doctor's advice to lie face down, but I experienced significant postoperative bleeding, severe enough that my eye was filled with blood clots, even pushing out my lower eyelid.
During a follow-up visit, the doctor used a cotton swab to reposition my lower eyelid.
During this time, I was prescribed hemostatic medication, and later switched to lying on my side, which helped alleviate the bleeding.
However, the bleeding was so severe that it caused blood clots resembling pooled blood in my pupil, which have not yet been absorbed, resulting in a noticeable dark brown spot in my pupil.
Since there was no significant improvement in my eye condition, the doctor was concerned that the retina might not have reattached properly.
Therefore, on October 26, another surgery was scheduled to clear the pooled blood and check if the retina had reattached, with the possibility of silicone oil being used.
After the surgery on October 28, the doctor informed me that the blood clots and pooled blood in my eye had been cleared, and the retina had indeed reattached, so only gas was injected.
After the postoperative check on October 29, I was discharged.
I have continued to attend follow-up appointments, but new issues have arisen.
Before each visit, some tests are conducted, and it has been found that my intraocular pressure is only around 2 or 3.
I asked the doctor why it remains low without improvement, but the doctor currently does not have a complete explanation, which is very concerning and troubling for me.

I would like to inquire whether the above situation is typical after retinal detachment surgery.
Additionally, I have read that after silicone oil injection, if the retina is prone to detachment and there are no other complications, it may not need to be removed.
In that case, can one see clearly with silicone oil in the eye, despite its opaque nature?

casper, 40~49 year old female. Ask Date: 2020/11/26

Dr. He Jianxian reply Ophthalmology

Hello Casper: First, let me clarify that silicone oil is transparent.
Generally, if silicone oil is present in the eye for a period of time, it may be considered for removal, unless there is a concern about retinal detachment, in which case it may not be removed.
As for why your intraocular pressure is only 2.3, I cannot explain this, as this is not a typical condition.
I hope this information is helpful to you.
Director He Jianxian, Ophthalmology, Nantou Hospital.

Reply Date: 2020/11/26

More Info

Post-retinal detachment surgery can be a challenging experience, and it is understandable to have concerns and questions about the recovery process, especially when complications arise. Based on your description, it seems you have faced significant challenges following your surgery, including severe bleeding and the presence of blood clots in your eye, which can understandably cause anxiety.

Firstly, it is important to recognize that complications such as bleeding after retinal detachment surgery can occur. The presence of blood in the eye, known as a vitreous hemorrhage, can lead to visual disturbances and may require additional interventions, as you have experienced. The fact that your doctor had to perform a second surgery to clear the blood and assess the status of the retina indicates that they are closely monitoring your condition and taking appropriate steps to address any issues.

Regarding your concern about the low intraocular pressure (IOP) readings of 2-3 mmHg, this is indeed lower than the normal range (which typically falls between 10-21 mmHg). Low IOP can be a result of several factors, including the surgical procedure itself, the presence of silicone oil, or other underlying conditions. It is crucial to communicate your concerns about these readings with your ophthalmologist, as they can provide insight into whether this is a temporary situation related to your recent surgeries or if it requires further investigation.

As for the silicone oil, it is often used in cases of retinal detachment to help stabilize the retina and prevent re-detachment. While silicone oil is not transparent, many patients report that they can still see reasonably well, although their vision may not be as clear as it was prior to surgery. The oil can create a visual obstruction, but it is generally a temporary solution until the retina is stable enough for the oil to be removed.

In terms of your recovery, it is essential to follow your doctor's post-operative instructions closely. This includes attending all follow-up appointments, as these are critical for monitoring your healing process and addressing any complications that may arise. If you continue to experience visual disturbances, discomfort, or any new symptoms, do not hesitate to reach out to your healthcare provider for further evaluation.

Lastly, it is important to maintain open communication with your healthcare team. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion or asking for a referral to a specialist who can provide more detailed insights into your specific situation. Your vision and eye health are paramount, and you deserve thorough explanations and support throughout your recovery journey.

In summary, while the complications you are experiencing can be distressing, they are not uncommon following retinal detachment surgery. Continuous monitoring, communication with your healthcare provider, and adherence to post-operative care are essential for optimizing your recovery and visual outcomes.

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