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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
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Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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I had cataract surgery on March 22nd. At the post-op on March

Resolved Question:

I had cataract surgery on March 22nd. At the post-op on March 30 the doctor told me I wasn't seeing as well as I should because I have a membrane on my retina. I will be seeing a retinal surgeon on April 22nd, but in the meanwhile I have a question. Did this membrane grow after the cataract surgery? If not, why wasn't it detected prior to the surgery? I paid $1,500 for an astigmatism correction (on top of what my insurance company paid for a monofocal lens. Now, unless I have surgery to remove the membrane I will have to continue wearing glasses and so have wasted $1,500.

Additionally, I had melanoma in the retina of that eye. I underwent radiation treatment (with a patch) for this in Nov 2009.

Thanks for any help you can give me.

Dorothy Kane
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 3 years ago.
Hello and thanks for your question. I will be typing my response to your question as you read this so please stand by.
Expert:  Dr. Dan B. replied 3 years ago.

Retinal wrinkling, also called macular pucker or epiretinal membrane is a phenomenon which can happen spontaneously (for no apparent reason), or can also occur in response to any eye surgery or significant medical treatment, eye inflammation, or eye trauma. Your radiation for ocular melanoma certainly qualifies as a possible reason why this epi-retinal membrane may have formed.

 

Your question about whether this could've formed since March 22nd is a good one. These membranes do not form that quickly and this is something that takes several weeks to months to form. One reason why this membrane or wrinkling may not have been noticed by your surgeon is the cataract, which causes a hazy and/or decreased view to the retina, may have been limiting the view of the retina enough that the membrane was not detectable on exam. Sometimes when these membranes are severe and expansive in area, they are easily seen whether there is a cataract or not. This is the exception rather than the rule. Usually, they are much more subtle and a significant cataract can certainly make it difficult, if not impossible to see the membrane.

 

Now, that being said, it is entirely possible that this is just something your surgeon missed, or if they did see it, they may have failed to mention it to you; that is an entirely plausible scenario. If that is the case, then that is information that you should've been provided with so you could've made a more informed decision. That being said, this wrinkling of the retina is usually something that is not corrected by using glasses. It causes decreased vision that cannot be corrected by a change in glasses and/or it causes altered shapes to objects (metamorphopsia). If you have a significant need for glasses and/or there is still significant astigmatism leftover after the surgery then there is likely another reason why you still have that glasses need after the surgery. It is quite unlikely that you need glasses after surgery just because you have this epiretinal membrane.

 

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

 

I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.

 

If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.

 

Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!

 

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Customer: replied 3 years ago.
Thank you, XXXXX XXXXX One more question: what are the risks involved in having the epiretinal membrane removed?
Expert:  Dr. Dan B. replied 3 years ago.

The risks are thus: pain, infection, bleeding (all three are common to any surgery, but pretty low risks in eye surgery, infection being the most concerning of those three), persistent symptoms after the membrane is removed, inability to remove the entire membrane, a hole or tear being made in the retina during or after the surgery, retinal detachment, need for further surgery, swelling in the retina causing decreased vision that may need to be treated with drops and/or injections.

 

Those are the prominent risks.

 

Does that help?

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3205
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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