Macular hole surgery - will it stop the problem from getting worse?

Discussion in 'Laser Eye Surgery' started by Doug McKenzie, Feb 21, 2005.

  1. I am still in a dilemma as to whether to have surgery for my macular hole.

    I understand that there is a good chance that it will improve my vision by a
    reasonable amount, though it will not completely solve the problem. If I
    was unlucky, and did not gain any significant improvement from the surgery,
    could I at least be sure that the surgery will stop the macular hole from
    increasing in size. And if I was luckier, and had some significant
    improvement, is it likely (disregarding the cataracts) that this will be
    just a temporary improvement.

    I would appreciate hearing from any readers of their experiences after

    Doug McKenzie, Feb 21, 2005
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  2. Doug McKenzie

    cl Guest

    I didn't have the surgery, but my mother did, in 1998. Just to be
    sure we're talking about the same thing, she had a gas bubble injected
    into her eyeball and had to stay face-down for six weeks. It nearly
    drove her (and me) crazy, but she did it.

    The result: her eyes are pretty darn good. She drove for a short
    while afterward, against everyone's advice, but she did okay. She has
    since stopped driving, thankfully. She's had three Visudyne (I think)
    procedures since, and her vision and macular hole appear to have
    stabilized. She still has glaucoma in both eyes, cataract in one.

    Personally, I consider the surgery almost a miracle. It had been ten
    years since her last exam before the hole was caught, and I have
    little doubt she'd be blind by now without the surgery. I don't know
    if it will improve your vision, but I think it will stop, or at least
    slow, the onset of blindness.
    I don't know.
    Again, I don't know. My mother's experiences would seem to indicate a
    permanent improvement with a LOT of maintenance. She sees her doctors
    about every three months but has not had a change in her eyeglass
    prescription for at least five years. It took her a while post-op to
    adjust to her new vision (she complained of straight lines looking
    "crooked", for example, a square looking like a parellelogram) but she
    seems to have made it through.

    Bottom line--I'd have it done if I thought I could stand to keep my
    head down for a month and a half. Only you can make the call, but if
    my mother's experience counts for anything, it's worth it. She's seen
    a lot of things she'd otherwise have missed because she had it done.
    cl, Feb 22, 2005
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  3. Doug McKenzie

    The Real Bev Guest

    My mom (also with a macular hole) has to have it done, but due to her
    claustrophobia she was going to have the oil-filled option, which is
    only slightly less good than the gas-filled option and doesn't require
    the face-down thing but does involve a second surgery to remove the
    oil. Last time we went to see her doc, he said he'd been talking to a
    doc in San Diego who's been doing vitrectomies for 3 years involving
    hundreds of patients BUT using air AND not requiring the face-down
    positioning -- with results the same as if they had spent time face
    down. This seems to square with the discussions of vitrectomy I've seen
    on the web, which prescribe positioning for anywhere from a few days to
    a few months -- if you don't need it it doesn't matter how long you do

    If it doesn't work as well as expected, she can still have the oil
    treatment, which involves two more surgeries. She's going to make her
    decision (probably in favor of air/no positioning) on March 1 and the
    surgery will probably take place the following Friday.
    The doc says that without the surgery hers will probably get worse.
    With the surgery it will probably get better. There seems to be no real
    downside to having it done, assuming money isn't part of the equation.

    When cryptography is outlawed, only outlaws will
    qwertzuio asdfghjk pyxcvbnml -- M. O'Dorney
    The Real Bev, Feb 22, 2005
  4. Doug McKenzie

    g.gatti Guest

    Macular holes are cured by sungazing and palming.

    That is, by rest methods.

    Discarding of any type of glasses is particularly mandatory.

    Treatment should be done properly many hours a day.
    g.gatti, Feb 22, 2005
  5. Doug McKenzie

    cl Guest

    On Mon, 21 Feb 2005 22:11:20 -0800, The Real Bev

    I wish that option had existed for Mom; it would probably have been
    better for her to get the second surgery than to suffer with the
    face-down positioning. She was pretty unhappy, and the stooped
    posture didn't do much for her arthritis, either.
    Why doesn't this surprise me? Pressure, after all, is exerted equally
    in all directions.
    I wish you both well, and I'm glad to hear of the advances made in the
    last few years.
    cl, Feb 23, 2005
  6. Doug McKenzie

    The Real Bev Guest

    I looked at the vitrectomy furniture and happened to see that one of the
    massage chairs out at the LA County Fair looked a lot like one. I tried
    it out. I can't imagine having to spend 2 months like that.
    The gas is slowly replaced by water, so I would guess that there is a
    certain amount of upward pressure, making it desirable for 'upward' to
    be the area of the eye that needs the pressure. The doc said that
    getting the pressure right is part of the operation -- if it's too low
    the result won't be as good; he didn't say what would happen if the
    pressure were too high, but I envision something like that cheesy sci-fi
    movie where the aliens had huge protruding eyeballs.
    It's probably always better to delay irrevocable treatment as long as
    possible on the theory that what happens today is obsolete next week.
    Like computer stuff...
    The Real Bev, Feb 23, 2005
  7. A macular hole does not make one blind. It stops when it involves the
    central macula, leaving a blind SPOT in the center of the vision. The rest
    of the retina normally stays intact - you can see around it, as 99% of the
    retina is uninvolved. Can't read with that eye, though, or recognize faces.
    But one is not totally disabled either.
    David Robins, MD, Feb 23, 2005
  8. Doug McKenzie

    g.gatti Guest

    The fact that the center of vision becomes destroyed while the rest of
    the retina is unaffected is clear evidence of the great truth
    discovered by Dr. Bates: the problems of the eye and vision are largely
    MENTAL and not related to physical causes.

    When your profession will wake up from your own nightmares, we do not

    It will be too later, either.
    g.gatti, Feb 23, 2005
  9. Doug McKenzie

    The Real Bev Guest

    If you live alone, have emphysema and can't move around much and can't
    drive any more, reading (including the internet) is about all you can do
    and yes, it IS pretty damn close to total disability.
    The Real Bev, Feb 24, 2005
  10. Note: A macular hole (ONE macular hole) is not macular holes both eyes. It
    will affect 1 eye only. Assuming the other eye is OK, there should not be
    much limitation on reading, etc. Lot of monocular folks our there who
    function just fine.
    David Robins, MD, Feb 24, 2005
  11. Doug McKenzie

    g.gatti Guest

    But one is not totally disabled either.
    The fact that he can cure himself and slip out of that disability does
    not stir in you any sense of sympathy for this poor fellow?

    You choose to continue to condemn him to your own weakness, ad a
    professional, and as a human being as well.
    g.gatti, Feb 24, 2005
  12. Doug McKenzie

    The Real Bev Guest

    Indeed, but my mom has a macular hole in one eye and a supposedly
    repaired macular "blister" in the other (she needs a 6x magnifier to
    read newsprint, and even that's a bitch -- the blister repair left her
    with distorted vision in the center of the macula). If you're lucky
    enough to have only one it's, of course, very different.

    How many people develop holes/blisters in only one eye? If in one, why
    not in the other too?
    The Real Bev, Feb 24, 2005
  13. Doug McKenzie

    cl Guest

    I probably knew that, come to think of it. I guess my confusion arose
    from the emotional intensity my mom displayed after her diagnosis.

    Sorry if I alarmed anyone unnecessarily.
    cl, Feb 25, 2005
  14. Doug McKenzie

    cl Guest

    I did a similar thing just after my mother's surgery, but in my case I
    really did get a massage. I had the same thought--spending much more
    than ten minutes like that would really be awful.
    I'm sure it would be better to have a greater amount of pressure
    exerted in that direction, but have never been convinced the face-down
    bit was absolutely necessary in order to accomplish it. Still, it's
    better to be safe than sorry, especially considering the investment
    and the risk.
    cl, Feb 25, 2005
  15. Doug McKenzie

    Dan Abel Guest

    The gas is absorbed by the body. Different gases are absorbed at
    different rates. I had plain old sterile air in mine (retinal
    detachment), which is absorbed in about five days. It was weird watching
    it slosh around in there. Of course, everything is upside down, so it
    looked like oil drops floating on water. The guy down the hall had a gas
    which took a long time to absorb, but he needed the pressure (also a
    retinal detachment) where it naturally occured anyway, so he didn't have
    to assume any particular position. Mine was on the side of my eye, so I
    spent five days lying on my right side. My brother had a recliner that
    reclined horizontally, so I could watch tv and read. I was only supposed
    to get up to eat and use the bathroom, but I did go on a few short walks
    each day.

    Yeah. I'm convinced the position is necessary, since the whole point is
    that the pressure is exerted where the bubble is. No point in having the
    bubble if it isn't putting pressure where it's needed. The eye regulates
    its own internal pressure, so the bubble doesn't increase the overall
    pressure, just the pressure where it touches the eye.
    Dan Abel, Feb 25, 2005
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