Silicone Oil Injection Visibility for Monocular Patients

Visibility of silicone oil injection in monocular patients?

Dear Doctor Wang,
Due to a retinal detachment in my left eye at the age of 17 that was not treated promptly, I now have only hand motion vision in that eye and rely on my right eye, which has a vision of 0.8.
I do not have diabetes or hypertension.
On October 2nd of this year, I discovered a retinal detachment in my right eye (with a tear at the 3 o'clock position).
On October 5th, I underwent a scleral buckle procedure, cryopexy, and gas injection.
On October 13th, the detachment recurred, and on October 15th, gas was injected again (which can remain for 4 weeks).
I have also undergone multiple laser treatments.
Currently, the retina at the 3 o'clock position is attached, and my vision has improved significantly, with color and visual field nearly identical to pre-surgery (presumably because the macula was not affected).
However, there is fluid accumulation in the lower retina, and my attending physician mentioned that the laser cannot reach that area, and the gas cannot exert pressure there.
If fluid accumulation or detachment persists after the gas dissipates, I may need to undergo a vitrectomy and silicone oil injection for several months.
I would like to ask the following questions:
1.
Since I only have my right eye for vision, I am concerned about my ability to live independently after the silicone oil injection (for activities such as using the restroom, eating, and even reading).
What is the visibility like with silicone oil? My attending physician has been conservative and brief in his responses, only stating "a little." I have found descriptions online from other patients who likened it to seeing through water.
2.
Are there any hospitals in Taiwan that are using newer vitreous substitutes?
3.
Are there other cases like mine, where patients have successfully undergone vitrectomy with only one functioning eye?
4.
Assuming the surgery goes well, is there a chance that my vision could return close to pre-surgery levels? Patients with one eye often experience greater psychological stress.
Thank you for taking the time to read my concerns and respond.
I wish you all the best!

A De, 30~39 year old female. Ask Date: 2015/11/06

Dr. Wang Zhishun reply Ophthalmology

Hello, silicone oil injection is generally considered a last resort in retinal detachment surgery.
As far as I know, there are currently no alternatives.
The success rate of this surgery is quite good.
As for the extent of vision recovery, there is no definite outcome, but many patients do experience significant improvement.
Since you only have one eye left, the doctor will likely pay special attention to your case.
Wishing you a speedy recovery!

Reply Date: 2015/11/06

More Info

When considering the visibility and quality of life after silicone oil injection for monocular patients, there are several important factors to discuss.
1. Visibility with Silicone Oil: Silicone oil is often used in retinal surgeries as a tamponade to help keep the retina in place after a detachment. Patients often express concerns about how well they will be able to see after the injection. While silicone oil can provide structural support to the retina, it does not have the same optical clarity as the natural vitreous gel. Many patients report that their vision can appear somewhat distorted or hazy, similar to looking through water. However, the degree of visibility can vary significantly from person to person. Some individuals may adapt well and find that they can manage daily activities such as eating, reading, and personal hygiene, while others may experience more significant challenges. It’s essential to have realistic expectations and to communicate openly with your ophthalmologist about your concerns and needs.

2. Newer Vitreous Fillers: In recent years, advancements in retinal surgery have led to the development of alternative tamponade agents, such as perfluorocarbon liquids and gas mixtures. These materials can sometimes provide better optical clarity than silicone oil and may be used in specific cases. However, the availability of these newer agents can vary by region and hospital. It would be beneficial to inquire with your healthcare provider about the options available in Taiwan and whether any local institutions are using these newer materials.

3. Success Stories: There are indeed many cases of patients who have undergone vitrectomy and silicone oil injection successfully, even with only one functional eye. Each case is unique, and outcomes can depend on various factors, including the extent of the retinal damage, the timing of the surgery, and the individual’s overall health. Support groups and forums can be valuable resources for connecting with others who have had similar experiences, providing both emotional support and practical advice.

4. Post-Surgery Vision Recovery: The potential for vision recovery after surgery varies widely among patients. Some individuals may regain vision close to their pre-surgery levels, while others may not experience significant improvement. Factors influencing recovery include the condition of the retina, the presence of any underlying eye diseases, and how well the retina adheres post-surgery. Regular follow-ups with your ophthalmologist are crucial to monitor your recovery and to address any complications that may arise.

In summary, while silicone oil can provide necessary support for the retina, it may affect vision clarity. It’s crucial to maintain open communication with your healthcare provider about your concerns and to explore all available treatment options. Additionally, connecting with others who have faced similar challenges can provide valuable insights and emotional support. Remember that each patient’s journey is unique, and ongoing medical care and support are vital for the best possible outcomes.

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