Post-Vitreous Surgery Care for Retinal Detachment Recovery: Key Considerations

Q: Post-Vitreous Surgery Care for Retinal Detachment Recovery: Key Considerations

Hello Mr. Wang： 1. If the attending physician believes that you no longer need to be in a prone position, it indicates good recovery, and since silicone oil has been injected, the duration of being prone can sometimes be shortened. 2. If the attending phys

Postoperative Care After Vitrectomy for Retinal Detachment

Hello Dr.
Tsai,
I am currently living overseas in Poland.
In May, I unexpectedly discovered that my left eye had blurred vision.
After undergoing an examination at a local ophthalmology clinic, I was diagnosed with retinal detachment in both eyes.
The right eye was mildly affected and only required laser treatment to seal the tear and prevent further expansion, while the left eye required surgery.
On May 12, I underwent vitrectomy combined with cataract surgery.
The doctor injected silicone oil into my left eye and implanted an artificial lens.
The day after the surgery, I returned home and lay face down for over ten days, spending at least 10 hours a day in that position.

During my first follow-up appointment on May 25, the doctor determined that there were no abnormalities in either eye.
My right eye's vision is good, but my left eye had issues with visual field loss and blurred vision pre-surgery (even in well-lit conditions, I might not be able to see the outlines of objects).
Post-surgery, it seems that my visual field has recovered; in terms of vision, I can distinguish the outlines of objects in sufficient light, but it remains blurry.
According to my attending physician, my left eye's vision may improve over the next few months, but it is certain that it will not return to normal vision.
I have researched similar surgeries performed in Taiwan and have some questions:
1.
Taiwanese doctors typically recommend that patients lie face down for at least a month.
However, during my follow-up on May 25, my doctor said I no longer needed to maintain that position and deemed me fit to return to work the next day (my job does not involve any physically demanding activities, only office paperwork).
I have already been back to work for a week.
Is this acceptable?
2.
The doctor prescribed me two eye drops, Oftaqiux and Dexaprotect, for post-operative use.
The doctor mentioned that Oftaqiux is an antibiotic.
During my follow-up on May 25, the doctor advised that I no longer needed Oftaqiux.
However, my research indicates that patients should continue using antibiotic eye drops for a month post-surgery.
Is there a possibility that the doctor's judgment is incorrect?
3.
The doctors currently plan to wait "at least" six months before removing the silicone oil.
In Taiwan, silicone oil must be removed within 3 to 6 months.
Could it be that the differences in products lead to varying timelines?
4.
I actually have a habit of working out, focusing on muscle hypertrophy rather than strength.
Unfortunately, I have to pause for a while.
The advice I found suggests that patients should avoid all vigorous exercise for six weeks post-surgery.
However, my attending physician indicated that exercise is less likely to affect the recovery of my left eye, and she mentioned that I could "soon" return to my previous exercise routine.
She advised that I should slow down my movements and avoid lifting and excessive weights, but most exercises, including squats, can still be performed.
Is her advice reasonable?
Thank you, doctor!

Mr. Wang, 20~29 year old female. Ask Date: 2021/06/01

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Wang:
1.
If the attending physician believes that you no longer need to be in a prone position, it indicates good recovery, and since silicone oil has been injected, the duration of being prone can sometimes be shortened.

2.
If the attending physician determines that you no longer need to use eye drops, it means there is no longer a risk of infection, and you can discontinue them.

3.
Sometimes, having silicone oil inside can be safer; if there are no complications, some individuals can retain it for a longer period.

4.
It should be fine, but you must exercise according to the physician's instructions.
Online responses can only serve as references; if necessary, you should seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.

Best regards,
Gao Pilin

Reply Date: 2021/06/01

More Info

Post-vitrectomy care following retinal detachment surgery is crucial for optimal recovery and minimizing complications. Here are key considerations based on your situation and general medical guidelines:
1. Positioning After Surgery: It is common for surgeons to recommend specific positioning post-surgery, such as face-down positioning, to help the retina reattach properly. The duration of this positioning can vary based on the individual case and the surgeon's preference. In your case, if your doctor has assessed that you no longer need to maintain a prone position and has cleared you to return to work, it suggests that your recovery is progressing well. However, always follow your surgeon's specific instructions, as they are tailored to your unique situation.

2. Medication Management: Post-operative medication is essential to prevent infection and manage inflammation. The use of antibiotic eye drops like Oftaqiux is standard practice, but the duration can vary. If your doctor has advised discontinuing the antibiotic, it likely means they have assessed that the risk of infection has diminished. It's important to trust your physician's judgment, as they have the most knowledge of your specific condition. If you have concerns about the duration of antibiotic use, discussing them with your doctor can provide clarity.

3. Silicone Oil Removal Timing: The timing for silicone oil removal can differ based on various factors, including the type of oil used, the surgeon's preference, and the individual patient's healing process. In some cases, leaving silicone oil in longer can be beneficial if there are no complications. Your doctor's recommendation of waiting at least six months may be based on their assessment of your eye's condition and the specific type of silicone oil used.

4. Exercise and Activity Restrictions: Post-operative activity restrictions are generally advised to prevent strain on the eye. While your surgeon has indicated that you can gradually return to your exercise routine, it is wise to heed their advice regarding avoiding heavy lifting and high-impact activities initially. Light exercises that do not involve straining or rapid movements may be acceptable, but always prioritize your eye health and recovery.

5. Monitoring Symptoms: After surgery, it is essential to monitor any unusual symptoms, such as increased pain, changes in vision, or new symptoms like headaches or eye discomfort. If you experience persistent or worsening symptoms, it is crucial to consult your eye care provider for further evaluation.

6. Follow-Up Appointments: Regular follow-up appointments are vital for monitoring your recovery and ensuring that the retina remains attached. These visits allow your doctor to assess your healing progress and make any necessary adjustments to your treatment plan.

7. Lifestyle Adjustments: Given your history of retinal detachment, it may be beneficial to make some lifestyle adjustments to protect your vision. This includes managing any underlying health conditions, such as diabetes or hypertension, and avoiding activities that could increase the risk of trauma to the eyes.

8. Visual Rehabilitation: If you experience ongoing vision issues, such as blurred vision or difficulty seeing clearly, discussing visual rehabilitation options with your doctor may be beneficial. They can provide resources or referrals to specialists who can assist with adapting to any changes in vision.

In summary, while your surgeon's recommendations are based on their expertise and your specific case, it is always prudent to maintain open communication with your healthcare provider. They can address any concerns you have and provide personalized guidance to ensure a smooth recovery. Remember to prioritize your eye health and adhere to the prescribed care plan for the best possible outcome.

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