Can Retinal Surgery Be Performed on Both Eyes Simultaneously?

Can retinal surgery for both eyes be performed consecutively?

Hello Doctor, my mother has experienced retinal detachment in her left eye and underwent surgery on April 8.
Her post-operative condition was good, and about a month later, the doctor informed us that the retina had adhered, and she no longer needed to sleep in a prone position.
However, within less than a week, she noticed a dark spot in her left eye, and upon follow-up, it was discovered that there was partial detachment of the retina again.
Shortly thereafter, within less than a week, her right eye also began to show symptoms such as flashes, floaters, and shadows.
After examination, the doctor informed us that there was a retinal tear in the right eye, but he suggested waiting until the right eye develops a retinal detachment before proceeding with surgery.
I would like to ask: 1.
In the absence of trauma, myopia, or diabetes, is it possible that the sequential occurrence of retinal detachment in both eyes could be due to other underlying conditions? (My mother has had floaters prior to this.) 2.
After surgery on one eye, why is it not possible to perform surgery immediately on the other eye, which has a known retinal tear, to prevent further deterioration? What considerations are involved? Thank you for taking the time to respond.

echo, 40~49 year old female. Ask Date: 2015/05/22

Dr. He Jianxian reply Ophthalmology

1.
If there are other lesions, the examining physician should explain this to your mother.
Although it is uncommon for both eyes to experience detachment sequentially, it is still a possibility.

2.
Since it has been confirmed that there is a retinal tear in the right eye, why was laser treatment not performed first to prevent detachment? Why wait until a true detachment occurs before proceeding with surgery? This should be confirmed with your mother's physician!

Reply Date: 2015/05/22

More Info

Retinal surgery is a critical intervention for conditions such as retinal detachment, and the decision to perform surgery on one or both eyes simultaneously involves careful consideration of various factors. In your mother's case, where she experienced retinal detachment in one eye and subsequent issues in the other, it raises important questions regarding the management of her condition.

1. Possibility of Other Pathologies: The occurrence of retinal detachment in both eyes, especially without external trauma, myopia, or diabetes, can indeed suggest the presence of underlying conditions. Conditions such as lattice degeneration, which is a thinning of the peripheral retina, can predispose individuals to retinal tears and detachments. Additionally, systemic conditions like Marfan syndrome or Ehlers-Danlos syndrome, which affect connective tissue, can also increase the risk of retinal issues. Your mother's history of floaters (myodesopsia) could indicate changes in the vitreous gel that may contribute to retinal problems. It is essential for her ophthalmologist to evaluate her thoroughly for any systemic or hereditary conditions that could be contributing to her retinal issues.

2. Timing of Surgery: The decision to delay surgery on the second eye, even when a retinal tear is identified, is often based on the risk-benefit analysis performed by the ophthalmologist. If the second eye has not yet developed a full detachment, the surgeon may choose to monitor it closely rather than proceeding with immediate surgery. This approach can be influenced by several factors, including the overall health of the patient, the severity of the tear, and the potential risks associated with operating on both eyes simultaneously. Performing surgery on both eyes at once can increase the risk of complications, such as infection or systemic issues, and may complicate postoperative recovery. Additionally, if one eye is already compromised, the surgeon may want to ensure that the first eye heals adequately before addressing the second eye.

In summary, while it is technically possible to perform retinal surgery on both eyes simultaneously, the decision is highly individualized. Factors such as the specific nature of the retinal issues, the patient's overall health, and the potential risks involved all play a crucial role in determining the best course of action. It is vital for your mother to have open communication with her ophthalmologist, who can provide personalized advice based on her unique situation and ensure that she receives the most appropriate care. Regular follow-ups and monitoring are essential in managing her condition effectively and preventing further complications.

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