Need some guidance in making a decision about eye surgery

September 16, 2016 5:49 PM

100000 mile road warrior/contractor facing vitrectomy eye surgery for a detached retina on Monday. Will have to have my head down and be homebound for about ten days and miss five days of work. Prior to the surgery I must choose between having a gas or silicone oil bubble injected into my eye. Help me to frame the issues in a way that will allow me to make a good decision. I have good insurance so that's not part of the equation.

With the inert gas bubble I can't fly for about 8 weeks after which the bubble will be absorbed into the eye. There is a small possibility of a cataract but no other major side effects.

With the silicone bubble I can fly after the 10 day heads down period but will require a second surgery to take the bubble out. Also there is a 90% chance of a cataract.

I only get paid when I work and have to fly to all my work projects. I would lose about $10000 by not being able to fly. I also have two vacations and a professional presentation scheduled, all flying.

posted by Xurando to Health & Fitness (10 answers total)

If the only benefit of the silicone bubble is being able to fly earlier - then the gas bubble wins hands down. $10k is nothing when it comes to your eyes...every surgery comes with a risk of complications...adding an "extra" surgery doesn't see to be worth the extra risk add to that the cataract potential and it seems like an easy choice...
posted by NoDef at 5:56 PM on September 16, 2016 [23 favorites]

I had the gas bubbles. I asked the doctor to make a second pass of laser surgery to make sure the retina stayed in place. It has been ok for the last 20 years or so.

I have pretty massive cataract in that eye now. In a few years, when my presbyopia is complete I'll have the lens replaced and my cornea lasered to compensate. In the meantime I use a high index lens to focus through the cataract.
posted by pdoege at 6:10 PM on September 16, 2016

What's having a third surgery worth to you, monetarily or otherwise? Because that's what a cataract would eventually require, and possibly more than one if the implanted lens detaches (mine did twice before I had it removed). I'd think about what kind of travel or personal insurance you might be able to draw upon, given that this is a medical emergency and all, and personally would go with the gas.
posted by teremala at 6:34 PM on September 16, 2016 [1 favorite]

I agree with NoDef that fewer procedures are better. I've had 5 surgeries, and it was only after the last couple that I started to get the nerve damage that left me with double vision.
posted by The Underpants Monster at 6:45 PM on September 16, 2016 [1 favorite]

Definitely try to minimize the number of eye surgeries and the risk of cataracts you have. It's worth the $10,000 in opportunity cost.
posted by limeonaire at 6:49 PM on September 16, 2016 [3 favorites]

Follow-up question: How do you know when the inert gas bubble has been absorbed? I'm kind of curious, though it likely wouldn't change my assessment.
posted by limeonaire at 6:50 PM on September 16, 2016

If I had the same decision to make, I'd choose the gas even with the loss of income. You really don't want to screw around with your eyes. Focus on the reality, here, which is you are having this surgery to save your vision. Think about the loss of income you'd face if you lost your vision. Health first!
posted by clone boulevard at 7:23 PM on September 16, 2016 [1 favorite]

How do you know when the inert gas bubble has been absorbed?

In my case, I could see the gas bubble getting smaller and smaller until it disappeared.
posted by The Underpants Monster at 7:50 PM on September 16, 2016 [2 favorites]

I had the surgery and a gas bubble last Halloween and I have a VERY impressive cataract. (I get to see the cataract surgeon on Tuesday, finally!)
What kind of work do you do? I ask because if it's remotely physical, you may have trouble because you won't have any depth perception. My depth perception is still pretty bad because of the cataract but when the bubble was still big, I literally could not dip a pretzel in a bowl of hummus. I just kept waving it around in the air near the bowl. Cooking was scary. Just something else delightful to keep in mind. I can parallel park now and I never could before so that's a weird bonus. Feel free to memail me if you need someone to commiserate while you're stuck staring at the floor!
posted by artychoke at 9:09 PM on September 16, 2016 [1 favorite]

I had the silicon oil and did fly with it in. I think the rate at which the gas bubble dissipates is individual and possibly unpredictable.

My recommendation if you can afford it is ask your doctor what they would choose for themselves, and follow your doctor's advice.

Longer term, reducing the number of eye ops you need and preserving as much vision as you can would be my priorities.

Memail me if you would like more info on my experience.
posted by mgrrl at 3:54 AM on September 17, 2016