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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10772
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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4 days ago I had laser treatment/surgery for a small retinal

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4 days ago I had laser treatment/surgery for a small retinal tear accompanied by a fluid sac. Today during my recheck I was informed that the fluid sac has about 2 drops of fluid in it and while it may be fine for the rest of my life with the laser scar tissue type fence that was built around it there is also a chance the 'fence' may break/weaken over time causing the risk of retinal detachment. I can take my chances or opt to have an in office procedure done in which the eye is numbed and a small gas bubble is inserted into my eye. I will need to have my head tilted for 3 days and the hope is the gas bubble will somehow get rid of the fluid sac (not sure how all that works). I can only find information about gas bubbles being used as part of the retinal detachment surgeries but I have not been told my retina is detached, I don't think it is. Are you fammiliar with the procedure being used this way? What can you tell me about it? Any questions I should be asking?
Hi. I'm online and happy to answer your question today.

I am a retina surgeon and I do this stuff all the time :)

Did the doctor do the laser treatment in the office?

Did he use a laser on his head or one that you sat in front of?

Do you have any medical problems or take any medication?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 3 years ago.


The doctor did the surgery in his office, I was laying back in a chair and he held my eye open with a poker. His face was close to mine, it seemed like the laster was ih his hand but maybe it was on his head. I think he did have something around his head. I was not sitting in front of a machine.


 


I get panic attacks and take .375 mg of venaflaxine (effexor generic not sure if I am spelling correctly) daily and then just vitamins. I have mitral valve prolapse although no longer need to take the pennicillin for dental work since they changed the parameters several years ago.

Ok Teresa,

I know what the doctor did and the type of tear that you had.

I'm glad you were able to get in for laser treatment before your tear progressed into a large retinal detachment. you are right in what you have learned in your internet research. The tear was most likely caught before your retina detached.

The laser "fence" will take about two weeks to scar down enough where the chance of the small amount of residual subretinal fluid will not tear through and lead to a detachment. In two decades of practice a tiny bit of fluid (which it sounds like you have) will usually absorb (or in some cases just stay there) without causing any problems.

The injection of gas that your doctor is discussing is called a pneumatic retinopexy. He is talking about using a short acting dilute gas, probably SF6. This bubble, when you hold your head in the correct position, will float up and "iron" the fluid out of the area of the tear by putting a liquid free cover of the gas and allowing the natural pumps in the retina to get rid of the tiny bit of fluid present. If patients follow the post gas injection instructions the gas is successful in about 95% of cases in getting rid of the fluid.

This gas injection does, however, carry risks such as infection, bleeding, further retinal detachment and future cataract formation.


So. The what is the big question? It is do you need the pneumatic retinopexy or can the fluid just stay safely behind the laser fence?

If I could examine you I could easily give you an answer. However, it seems from what you have posted that your doctor was not too insistent that you have the gas injected in your eye and was more just reviewing with you what can be done..

From what you have posted, I think you should ask the doctor what he would do if you were his wife...and follow his advice. At this point,my feeling from what you have shared with me is that you can safely go without the gas bubble and just, for the next two weeks at least, take thing very easy.

Of course, if you notice flashes of light, a lot of floaters or a curtain coming across your vision from any direction, get in to see you eye surgeon without delay.

Whew! I'm going to have to give my fingers the rest of the night off lol!

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Have a good evening and let me know if I can do anything else to help.
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Teresa,

I just finished a pneumatic retinopexy and my thoughts turned to you. How is your retina doing? I hope that your laser fence is doing well and your retina is attached.

Take care and let me know if there is anything else I can do to help.

Dr Rick MD FACS