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Medical Forum / General / Vision / August 2005Upcoming macula surgery-need advice
My wife has been diagnosed with a macular hole which will require surgery. We understand she will be required to be face down for 10 days. She is73 years of age and I'm not sure if she could undergo this regimen. I would like to get input from anyone who has had this surgery and endured the face down requirement. Any information, would be appreciated. Leo Leo May put fingers to keyboard and typed... > My wife has been diagnosed with a macular hole which will require > surgery. We understand she will be required to be face down for 10 [quoted text clipped - 4 lines] > > Leo Occasionally, the surgeon will inject silicone oil to keep the tissue flat - this can be easier to endure during the healing process, BUT another surgery will have to be perfomed to remove the oil.  SignatureShabs. > Leo May put fingers to keyboard and typed... > [quoted text clipped - 8 lines] > - this can be easier to endure during the healing process, BUT another > surgery will have to be perfomed to remove the oil. In my reading, I discovered that the amount of face-down time recommended varied from a few days to a few months, so I suspect that the 10-day estimate is just that -- an estimate. My mom, 86 and claustrophobic, couldn't do it for two minutes. She had a macular swelling in her other eye repaired, but the eye was refilled with water and nothing further beyond eyedrops was required. Originally she thought that she didn't see all that much of a problem in having two more similar operations on her other eye (macular hole), but ultimately lost faith in the ophthalmologists and has decided to leave the hole the way it is and hope it doesn't get worse. The nuisance of the procedure (getting there really early, sitting around for 5 hours after the nominal start time [we spent 12 hours at the hospital], having to take out her bridge) was more of a problem than the actual medical stuff, though. SignatureCheers, Bev ========================================= "Welcome to Hell, here's your accordion." > From: S Akky <nospamforme@themoment.com> > Organization: Your Company [quoted text clipped - 16 lines] > - this can be easier to endure during the healing process, BUT another > surgery will have to be perfomed to remove the oil. Thank you to all for your input. I'm particularly interested in the silicone process. I'm wondering if it is as effective as the gas bubble. I will contact the surgeons office to see if it is available in our area. (Chicago) I'd also like to hear from someone who has had this process done. Thanks again. I will write when we decide and let you know how it is going. Leo May put fingers to keyboard and typed... > Thank you to all for your input. I'm particularly interested in the > silicone process. I'm wondering if it is as effective as the gas > bubble. I will contact the surgeons office to see if it is available > in our area. (Chicago) I'd also like to hear from someone who has had > this process done. Thanks again. I will write when we decide and let > you know how it is going. Please not that some studies have shown that results follwing the use of silicone oil may not be as good as those using gas. Some references: http://tinyurl.com/dmjff http://tinyurl.com/beo5u http://tinyurl.com/b6hc6 http://tinyurl.com/9lfat http://tinyurl.com/a8ha7 http://tinyurl.com/dmjff http://tinyurl.com/8w444 SignatureShabs. > From: S Akky <nospamforme@themoment.com> > Organization: Your Company [quoted text clipped - 23 lines] > http://tinyurl.com/dmjff > http://tinyurl.com/8w444 Thank you so much for the references. Would you happen to know if the eye would get worse without surgery? Leo May put fingers to keyboard and typed... > Thank you so much for the references. Would you happen to know if the eye > would get worse without surgery? That is a question only you doctor could answer, following a thorough examination - depends on what stage the macular hole is at. http://www.patient.co.uk/showdoc/40002429/ http://www.emedicine.com/OPH/topic401.htm SignatureShabs. > Leo May put fingers to keyboard and typed... > [quoted text clipped - 7 lines] > Please not that some studies have shown that results follwing the use of > silicone oil may not be as good as those using gas. The doc at Doheny said that using oil resulted in 5% fewer good outcomes than using gas. He also said that the quantity of <stuff> filling the eyeball was fairly critical. > Some references: > [quoted text clipped - 5 lines] > http://tinyurl.com/dmjff > http://tinyurl.com/8w444 SignatureCheers, Bev ========================================================== There is a fine line between 'hobby' and 'mental illness.' > From: The Real Bev <bashley@myrealbox.com> > Organization: The Vast Right-Wing Conspiracy [quoted text clipped - 17 lines] > using gas. He also said that the quantity of <stuff> filling the eyeball was > fairly critical. Thanks to the references provided and the good comments I have at least a little background to be able to discuss our options intelligently; that is if I can get the good doctor's attention. He does seem to be a bit brusque. Leo > > From: The Real Bev <bashley@myrealbox.com> > > Organization: The Vast Right-Wing Conspiracy [quoted text clipped - 21 lines] > little background to be able to discuss our options intelligently; that is > if I can get the good doctor's attention. He does seem to be a bit brusque. Handy hint: don't get up out of the chair until you're satisfied. He probably doesn't want to be intentionally rude by kicking you out of his office, so answering your questions may be the most efficient way of getting rid of you. It's so easy to say "find another doctor," but that isn't always as practical as it should be. SignatureCheers, Bev ************************************************ Horn broken. Watch for finger. >>>> Please note that some studies have shown that results follwing the use of >>>> silicone oil may not be as good as those using gas. [quoted text clipped - 4 lines] >>> was >>> fairly critical. An Update: Our surgeon is adamant that using silicone oil as a tamponade will NOT improve vision after surgery. I quoted some studies that I had read, and his reaction was to tell us that such studies were not currently recognized and any success using silicone tamponade is negligible and his group does not offer it as an option. As a result we have decided to follow his advice and will be having the surgery on 7/22/05. I will write a follow-up with information as to how well we tolerated the face down posturing. Thank you all for your input. Leo > From: Leo May <idylone@earthlink.net> > Organization: EarthLink Inc. -- http://www.EarthLink.net [quoted text clipped - 23 lines] > > Leo The surgery went well with the following day exam showing that the hole was closed with the gas bubble installed. We started a 10 day regimen of face-down posturing with the aid of opthalmic positioning equipment for table, bed, and a special face-down chair with mirror for straight ahead viewing. All went reasonably well considering that my wife has difficulty with this kind of discipline because of short term memory problems which required constant supervision. There is no way the recovery could have been accomplished without the face-down equipment. We see the surgeon again tomorrow to ascertain the degree of success of the procedure. Leo > My wife has been diagnosed with a macular hole which will require surgery. > We understand she will be required to be face down for 10 days. She is73 > years of age and I'm not sure if she could undergo this regimen. I would > like to get input from anyone who has had this surgery and endured the > face > down requirement. Any information, would be appreciated. Her surgeon should have discussed this requirement with her, and she needs to tell him if she really doesn't think she can do it. If she can't, they will not do the surgery. There are special pillows, chairs, book rests etc available for rent during the face down period, she should call the surgeon's office and speak to his staff who should be able to describe the requirements and the locally available supports for her. Dr Judy > Leo > > My wife has been diagnosed with a macular hole which will require surgery. > > We understand she will be required to be face down for 10 days. She is73 [quoted text clipped - 8 lines] > surgeon's office and speak to his staff who should be able to describe the > requirements and the locally available supports for her. And while waiting for hell to freeze over, use the web. There are a lot of rental places that ship the stuff (I couldn't find any local shops -- in Los Angeles, for chrissake), so there's really no need to buy it unless it's covered by insurance, in which case it's still a waste of money. Perhaps the OP will be lucky and find a knowledgable person in the opthalmologist's office, but don't count on it. SignatureCheers, Bev ===========================================n0??=========== There is a fine line between 'hobby' and 'mental illness.' > My wife has been diagnosed with a macular hole which will require surgery. > We understand she will be required to be face down for 10 days. She is73 > years of age and I'm not sure if she could undergo this regimen. I would > like to get input from anyone who has had this surgery and endured the face > down requirement. Any information, would be appreciated. Haven't had this one, fortunately. I had a retinal detachment some years back, and as part of the repair, they put a bubble in my eye. I had to lie on my side for five days, 24 hours a day. I could only get up to eat and use the bathroom. The doctor said that they could use a variety of gases. Some would be absorbed in hours, others would take months. He chose plain old air (sterilized, though) which was supposed to last five days. Sure enough, after five days it was mostly gone. I was staying at my brother's house at the time. He had a recliner which was almost horizontal when all the way back. I spent much of my time watching tv and listening to music. A guy down the hall from me at work had a detachment, and got two bubbles. The first was shortlived, but the second was for months. Fortunately he didn't have to remain in any particular position. SignatureDan Abel Sonoma State University AIS dabel@sonic.net |
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