Post-Surgery Concerns After Macular Hole Vitrectomy: What to Expect

Q: Post-Surgery Concerns After Macular Hole Vitrectomy: What to Expect

Hello： Based on the situation you described, it is normal to still see a bubble about 6 cm in size one month after your macular hole vitrectomy. <br>During the macular hole vitrectomy, the surgeon injects gas into the vitreous cavity to help close the macular hole. <br>The gas wi

Postoperative issues following macular hole surgery?

Hello, Doctor: I underwent a vitrectomy for a macular hole one month ago, and I still have a bubble in my eye measuring about 6 cm (with a transparent center and a dark peripheral shadow that moves with my heartbeat).
Sometimes it carries small bubbles, and the bubble has remained the same size daily without signs of shrinking.
I would like to ask: 1.
Is this bubble normal? Is it possible for it to disappear over time? If so, how long might that take? 2.
I have had two follow-up visits, and the doctor said the hole is healing well, but I need to continue sleeping on my side.
Would lying face down be more effective for the bubble's resolution? 3.
Could having the bubble for an extended period affect other eye issues (e.g., cataracts, glaucoma)? 4.
During this period, is it safe for me to drive (including long distances) or ride a bicycle?

Pan r, 60~69 year old female. Ask Date: 2024/04/01

Dr. Gao Pilin reply Ophthalmology

Hello: Based on the situation you described, it is normal to still see a bubble about 6 cm in size one month after your macular hole vitrectomy.
During the macular hole vitrectomy, the surgeon injects gas into the vitreous cavity to help close the macular hole.
The gas will remain in the eye for a period of time and will gradually be absorbed by the body.
The time it takes for the gas to be absorbed varies from person to person, generally taking several weeks to months.
Before the gas is fully absorbed, you may see a bubble in your vision.
The size and shape of the bubble may change and it may move with the movement of your eye.
These are all normal phenomena.
1.
Is the bubble normal? Will it eventually disappear over time? How long will it take? Yes, the bubble is normal.
It will gradually disappear over time.
Generally, the bubble will completely disappear within three months after the surgery, but it may take longer in some cases.
2.
I have had two follow-up visits, and the doctor said the hole is healing well.
Should I sleep on my side? Would lying face down be more effective for bubble elimination? Sleeping on your side or face down is not significantly related to bubble elimination.
The gas will rise in the eye, so sleeping on your side or face down may help the bubble reach the macular area more easily, thus promoting the healing of the macular hole.
3.
Can the bubble's prolonged presence affect other eye issues? (e.g., cataracts, glaucoma…) The presence of the bubble may lead to the following issues: * Blurred vision * Visual field loss * Increased intraocular pressure * Cataracts If the bubble has not completely disappeared six months after surgery, it is advisable to consult your doctor.
4.
Can I drive (including long distances) or ride a bicycle during this period? It is not recommended to drive or ride a bicycle until the bubble has completely disappeared, as the bubble may affect your vision, increasing the risk of traffic accidents.

Reply Date: 2024/04/01

More Info

After undergoing a macular hole vitrectomy, it's common for patients to have various concerns regarding their recovery and the presence of gas bubbles in the eye. Let's address your questions one by one.

1. Is the presence of the gas bubble normal, and will it eventually disappear?
Yes, it is normal to have a gas bubble in the eye after vitrectomy surgery. The gas is used to help flatten the retina and promote healing of the macular hole. Typically, the gas bubble will gradually decrease in size over time as it is absorbed by the body, which can take anywhere from a few days to several weeks, depending on the type of gas used. In your case, if the bubble has remained the same size for a month, it is advisable to follow up with your surgeon to ensure that everything is progressing as expected.

2. Is side sleeping more effective for gas bubble absorption than lying flat?
Your surgeon's recommendation to sleep on your side is likely based on the position of the gas bubble and the macular hole. Sleeping on the side opposite to the surgery can help the gas bubble come into contact with the macular hole, promoting better healing. While lying flat may also help, it is essential to follow your surgeon's specific instructions regarding positioning, as they have the best understanding of your individual case.

3. Can the gas bubble's prolonged presence lead to other eye issues, such as cataracts or glaucoma?
Generally, the presence of a gas bubble itself does not directly cause cataracts or glaucoma. However, prolonged gas retention can lead to increased intraocular pressure in some cases, which could potentially contribute to glaucoma. It is crucial to have regular follow-ups with your ophthalmologist to monitor your eye pressure and overall eye health during the recovery period. If you notice any changes in vision or experience discomfort, you should contact your doctor immediately.

4. Is it safe to drive or ride a bicycle during this recovery period?
Driving and riding a bicycle may not be advisable while you still have a gas bubble in your eye. The bubble can distort your vision, making it difficult to see clearly, especially in low-light conditions or when adjusting to different distances. It is essential to prioritize your safety and the safety of others on the road. Your surgeon will provide guidance on when it is safe to resume these activities based on your recovery progress.

In summary, while the presence of a gas bubble is a normal part of the healing process after macular hole surgery, it is essential to maintain regular communication with your ophthalmologist. They can provide tailored advice based on your specific situation, monitor your recovery, and address any concerns you may have. Remember to adhere to the post-operative instructions provided by your surgeon, including positioning during sleep and activity restrictions, to optimize your recovery and visual outcomes.

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