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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11002
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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A couple of weeks ago I wrote to an eye specialist at JA about

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A couple of weeks ago I wrote to an eye specialist at JA about a macular hole. I've had the vitrectomy, and I am about 10 days out. Unfortunately my hole is still there and my gas bubble is nearly gone. My doctor had bad news in that I will require a second surgery, striping the limiting membrane, another 2 weeks on my face etc. My questions: Why didn't my hole close? What happens if I don't have the second surgery? Is it worth getting a second opinion? How long should I wait before having the second surgery, will it matter if I wait 2-3 weeks or should I have it right away?? What if the second surgery does not work?
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Dr. Rick :

Hi. I'll be happy to help you.

Dr. Rick :

I'm sorry that your first surgery didn't work. That happens sometimes with macular hole surgery.

Dr. Rick :

Stripping the internal limiting membrane is a very difficult thing to do and might not have been able to be done during your first surgery. However, the surgery and the gas will have, most likely, made it easier to strip.

Dr. Rick :

You can press the "chat" button/icon on your page to talk with me.

Dr. Rick :

Why didn't the first surgery work? The most common cause is a piece of the ILM is in the way, there is a fibrous plug in the way or the tissues are no longer healthy, or the gas bubble didn't stay in place over the hole.

Dr. Rick :

If you don't have the second surgery you will continue to have the same blind spot in the center of your vision. It will not be any better and it, most likely, will not be any worse.

Dr. Rick :

Should you decide to have a second surgery usually the sooner the better. The quicker that there is anatomical closure of the hole the better the chance of you having improvement in your vision. I have had patients who had an excellent surgical result ( the hole was closed) and yet no improvement in their scotoma.....I'm sure your surgeon discussed this with you.

Dr. Rick :

If the second surgey doesn't work, and you have no surgical complications, you should be no worse off then you are now.

Dr. Rick :

I always believe it is a good idea to get more then one opinion on important issues and, as such, I would encourage you to speak to another retina specialist. However, if you trust this doctor and get along with her, I wouldn't change horses in the middle of the stream just because the first surgery didn't go as planned. Failure to close a macular hole could have happened to Dr. Don Gass, the doctor who invented macular hole diagnosis and treatment.

Dr. Rick :

I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.

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