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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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How does it take for the visual scotoma to disappear after

Resolved Question:

How long does it take for the visual scotoma to disappear after vitrectomy surgery with ILM peel?? This is second surgery on same eye within 6 weeks for full thickness macular hole.
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. James replied 7 years ago.

How long long ago was the surgery?
What was your visual acuity before the surgery?
Was the first surgery for a macular hole as well?
Click on the below link and tell me what you see?
Customer: replied 7 years ago.

Second surgery was Nov 3/09 (PPV with ILM peel), first was PPV only with hyaloid peel on Sept 22/09 in same eye for same hole. Surgery# ***** was because of failed closure after #1 (hole in fact ended up a bit larger). Initial loss of central vision was Aug 4/09, so both surgeries were done within 3 months of original symptom.

Visual acuity in right eye was 20/20 with myopia correction to -6.75 diopters.

On Amsler grid I see periphery normally, no wavy lines or distortion. I do not see centrally and have a central scotoma that is kidney-shaped at present.

My C3F8 bubble is still at 15 - 20% of full volume by visual estimation.

Expert:  Dr. James replied 7 years ago.

The scotoma in a macular hole can be due to two things. The first is the defect due to the hole itself. The second can be damage to photoreceptors in that location. With 20/20 vision, it appears your second surgery was a great success.

An OCT scan can detect if there is still a small defect relating to the kidney-shaped scotoma. If there is a small defect, there is still a chance that it may close up. If the macular hole is already fully closed, then the scotoma may be due to photoreceptor damage in that area. In that case, the scotoma may be permanent.

Remember to press the green ACCEPT button. It was a pleasure helping you with your question. Best wishes to you. Feel free to ask any additional questions.
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Customer: replied 7 years ago.
Unfortunately, the changed scotoma represented a persistence of the hole and vertical extension. Now all to do is manage expectantly