Eye News #8 – The Gas Menace, Episode II

First, the good news:

I saw my retinal surgeon, and he didn’t say,
    “Tom, you need to have one more operation on your eye.”

Isn’t that splendid?  I think that’s splendid. 

Now, the bad news:
    He did say, “Tom, you need to have two more operations on your eye.”


The operations are not scheduled yet. He wants to wait until I’m fully recovered from the earlier operations (which I assume means gas entirely gone and not taking any medications). I’m down to putting in one kind of eye drops (Cosopt) once a day, and the gas looks like it will be gone in about two weeks. I don’t know yet how long he’ll want to wait after that before the cutting begins.

The first problem is that the cataract is getting worse now, and will just continue to get worse. The whole cataract thing is a fairly common result when they have to use the gas in the eye. In fact, it’s my understanding that 35% of operations that involve the dread gas end up with patients getting cataracts. My retinal surgeon doesn’t do cataract operations, but I’m sure that he can recommend someone.

The second problem is that I’m seeing a nonlinearity, a permanent waviness, in my vision (as opposed to a shimmering waviness). This is a macular pucker, a thin membrane of non-retinal cells that have found their way to the top of the retinal layer (probably as a result of the previous detachments and surgeries, although that is not the only situation that can give rise to a macular pucker). Anyway, this membrane is growing on my retina (as opposed to shrinking, or remaining the same size), which is bad, of course, and plus, it has an inherent tension and strength which causes it to pull the retina toward it, much as if you grabbed a portion of your shirt in your fingers and bunched it up. So, this membrane is incredibly thin, and what they will do is to wait for it to “mature”, and then they’ll go in there and peel off the errant membrane. Spalding Gray has done a fairly hilarious monologue on the subject of his macular pucker (see his video, “Gray’s Anatomy”), which was actually the source of that 35% statistic that I mentioned above. My retinal surgeon WILL do this procedure himself.

Dr. Tran, my retinal surgeon, told me: “You know, by an astonishing coincidence, I had a guy like you last summer, also a programmer, and who needed several surgeries to correct his retina, and developed a cataract and macular pucker, and I ended up getting him back to 20/20,” so don’t lose heart.