Post-Operative Care and Concerns After Vitrectomy Surgery: A Comprehensive Guide

Q: Post-Operative Care and Concerns After Vitrectomy Surgery: A Comprehensive Guide

Hello Ms. Chang： 1. The physician's treatment should be correct. 2. Please visit an ophthalmologist to find out the cause. 3. You should see an ophthalmologist for an examination to determine how to proceed. 4. Unless stated oth

Post-retinal detachment surgery?

Hello, doctor.
I underwent a vitrectomy on my left eye four weeks ago and have some questions I would like to confirm with you.
Post-surgery, I was prescribed "Alcon - Dexamethasone Eye Ointment" and "Yung Shing - Atropine Eye Drops (1%)", to be administered three times a day and before bed.
During my two-week follow-up, my intraocular pressure was found to be "23-25", and the doctor advised to stop the ointment due to its steroid content.
I was then instructed to switch to the newly prescribed "Alcon - Ilevro (for lowering intraocular pressure)" and "Medi-Sun - Anti-Edema Eye Drops", while the original "Yung Shing - Atropine Eye Drops (1%)" was to be used only once daily at bedtime.
So now, I am using "Alcon - Ilevro" and "Medi-Sun" three times a day, and "Yung Shing - Atropine" only at bedtime.
In the third week, I had laser treatment on my other eye, and the doctor mentioned to continue using "Medi-Sun - Anti-Edema Eye Drops", but did not specify for how many days.
I have several questions I would like to clarify:
1.
Are the medications prescribed by the doctor appropriate? Since my left eye's pupil is larger than the right, will daily use of "Yung Shing - Atropine Eye Drops (1%)" cause any paralysis of the pupil or other side effects? Is the current medication regimen acceptable?
2.
Yesterday, I suddenly experienced sneezing and a runny nose (mild cold).
After my afternoon nap, I felt a dull pain behind both eyes, which this morning has shifted to my right eye.
This dull pain is coming from the back of the eye, which I have not experienced post-surgery until now.
Could this be a headache caused by the cold, a reaction to the eye drops, or possibly related to glaucoma or cataracts? How can I alleviate this discomfort?
3.
During my third-week follow-up, the doctor said that the sutures had come loose and that I could be reassured.
However, upon returning home, I noticed that the suture near the upper eyelid covering the eyeball seemed not to have completely detached, leaving a protruding black line (dot) on the surface of the eyeball.
This has caused a foreign body sensation when moving my eye.
How could this happen? Will it improve?
4.
Regarding the third week, after the laser treatment on my other eye, the doctor advised to continue using "Medi-Sun - Anti-Edema Eye Drops", but did not specify for how many days.
How long should I continue using these drops?
5.
At my three-week follow-up, the doctor said that the retinal attachment looks good and that I can read normally now, noting that my vision is not significantly different from before, at most within 50 degrees.
However, there is still gas present.
I asked the doctor if the good attachment is due to the gas helping or if the retina has truly developed good nerve coverage.
The doctor confirmed that there is indeed good nerve coverage, but can this be visually assessed with just a light examination?
6.
During my follow-ups, the doctor has been very optimistic, which is great.
After surgery, the doctor mentioned that I only need to maintain the gas position for "two weeks", but isn't it generally said that one should maintain a face-down or side-lying position for a month? For the right eye that received laser treatment, the doctor said it would not affect normal activities, but I have seen information suggesting to maintain a stable position for two weeks to prevent rapid eye movements.
The doctor said the attachment looks good and that I can read normally now.
There were no specific precautions mentioned.
Is it really as optimistic as the doctor suggests?
7.
Additionally, post-surgery for my left eye, if I use a sticky note to cover the left lens of my glasses while using my right eye to look at my phone or read, keeping a distance of about 30 cm, is this approach acceptable? Or do you have any other suggestions?
8.
Could you please provide information on what to pay attention to after vitrectomy, such as when I can start reading, exercising, lifting heavy objects, or any care and monitoring tips? Thank you for your thorough explanation, doctor.

Ms. Zhang, 20~29 year old female. Ask Date: 2022/02/07

Dr. Gao Pilin reply Ophthalmology

Hello Ms.
Chang:
1.
The physician's treatment should be correct.

2.
Please visit an ophthalmologist to find out the cause.

3.
You should see an ophthalmologist for an examination to determine how to proceed.

4.
Unless stated otherwise, just use it until your next appointment or until it runs out.

5.
After the examination, the physician should inform you of the results, and I cannot make a judgment here.

6.
I cannot provide advice without an examination; it is best to follow the recommendations of your attending physician.

7.
Actually, you can use both eyes to see things.

8.
You can refer to: https://www.eck.org.tw/wp-content/uploads/2020/06/BN000E073-01.pdf

Reply Date: 2022/02/07

More Info

Post-operative care following vitrectomy surgery is crucial for ensuring optimal recovery and minimizing complications. Vitrectomy, a surgical procedure to remove the vitreous gel from the eye, is often performed to treat various retinal conditions. Here’s a comprehensive guide addressing your concerns and providing additional information on post-operative care.

1. Medication and Eye Care: The medications prescribed by your physician, including the use of "艾力根-艾弗目P" for lowering intraocular pressure and "麥迪森-舒腫眼藥水" for reducing inflammation, are standard post-operative treatments. The use of "應元-安妥眼藥水（阿托品1%）" at bedtime is also common to help dilate the pupil and prevent adhesions. However, it is important to monitor for any side effects, such as prolonged pupil dilation or discomfort. If you notice significant changes in vision or increased discomfort, it’s essential to contact your healthcare provider.

2. Symptoms of Discomfort: The sudden onset of pressure or pain in the eyes, especially after experiencing cold symptoms, could be due to several factors. It may be related to sinus pressure from your cold, which can cause referred pain to the eyes. However, it’s also important to rule out any complications from the surgery, such as increased intraocular pressure or inflammation. If the pain persists or worsens, seek medical attention promptly.

3. Suture Concerns: If you notice a visible suture or a foreign body sensation in the eye, it’s important to follow up with your ophthalmologist. Sometimes, sutures can dissolve at different rates, and if a suture is still present, it may need to be removed. The sensation you describe could also be related to healing tissues or inflammation.

4. Post-Laser Treatment: After laser treatment on the other eye, the duration for continuing the "麥迪森-舒腫眼藥水" should be clarified with your doctor. Generally, it may be used for several days to weeks, depending on the individual’s healing process and the physician's recommendation.

5. Vision Recovery: The presence of gas in the eye post-surgery is a normal part of the healing process. It helps in the reattachment of the retina. Your doctor’s optimism regarding the healing process is based on clinical assessments. However, it is essential to follow their advice regarding activity restrictions to ensure proper healing.

6. Activity Restrictions: While your doctor may have indicated that you can return to normal activities, it’s generally advised to avoid strenuous activities, heavy lifting, or rapid eye movements for at least a few weeks post-surgery. This helps to ensure that the retina remains stable during the healing process.

7. Using Eye Protection: Covering the left lens of your glasses to avoid strain on the operated eye while using your right eye is a practical approach. However, ensure that you are not straining your right eye by reading or using screens for prolonged periods. Taking regular breaks and maintaining a proper distance is advisable.

8. General Post-Operative Guidelines: After vitrectomy, it’s typically recommended to avoid reading or using screens for at least 1-2 weeks, depending on your comfort level and the surgeon's advice. Light activities can usually resume after a couple of weeks, but avoid heavy lifting or vigorous exercise for at least a month. Always follow your surgeon's specific recommendations regarding your recovery timeline.

In summary, while your doctor’s optimistic outlook is encouraging, it’s crucial to remain vigilant about your symptoms and adhere to post-operative care instructions. Regular follow-ups with your ophthalmologist are essential for monitoring your recovery and addressing any concerns that may arise. If you have any doubts or experience unusual symptoms, do not hesitate to reach out to your healthcare provider for guidance.

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