After retinal detachment surgery (vitrectomy) an intravitreal gas bubble may be injected into your eye. I’m not quite exactly sure of the purpose of the gas, but it might be used to put added pressure on the retina to hold it into the proper position, acting as a clamp. A web site says the gas may be used to keep the wound site dry, aiding wound repair. The gas should naturally be reabsorbed by the body in 1-3 months.
My signs that something was wrong included an increased blurriness on the outer edges of my eye, followed by dark blotches in low light. There were no lightening flashes. Over the course of a couple of days the blurriness became worse, slowly moving closer to the middle of my eye. There was no pain. I did start to get a low grade headache as the blurriness increased.
My surgeon used Sulfur hexafluoride (SF6), which he says is fast acting and will clear within 2 weeks. Web searches say reabsorption occurs between 10-20 days.
The result of the gas bubble is that your vision is extremely blurry. I can only see light, the basic shapes and colours of objects without detail. Objects 2-3″ high may disappear altogether. There is a movement in your vision, such as seeing through jello, jiggling up and down. The colour balance is tinged with slight yellow. There is also a refraction, where objects are moved about 4″ upward to you. The movement is not painful but is distracting and a bit surreal.
Every intraocular gas inserted into the vitreous has three phases: expansion, equilibrium, and dissolution [3]. Air doesn’t expand, with its duration being five to ten days. SF6 duration is 14 days, peak expansion is one to two days, and non-expansile concentration is 20%.
There is a line on top of the field of view, above which looks dark. I don’t know what this is. It shakes and jiggles with head movement. I am assuming this is the top edge of the gas bubble. If you tilt your head the dark line will self-level, so this is interesting.
When you look through a gas bubble, vision is very poor – you can often only see movement. The edge of the gas bubble is seen as a black line at the top of vision. As the bubble absorbs this line descends through the field of vision. Depending on the gas, it can take between 2-6 weeks for the gas bubble to dissolve.
source found on Google Search
As a general rule, retinal detachment occurs in both eyes in about one in ten patients with an initial retinal detachment in one eye. The second detachment in the fellow eye may occur even years later.
One benefit of the vitrectomy is that the vitreous, or the gel in the middle of the eye, is removed and replaced with the gas bubble. This also should also remove the floaters. I will see how many floaters are left.
During vitrectomy, the ophthalmologist removes some or all of the vitreous from the middle of your eye. This vitreous is replaced with either a salt water (saline) solution or a bubble made of gas or oil.
The eye produces no usable images but there is light and a lot of visual distraction. As I cannot see much through this eye, I have opted for an eye patch. Using the computer is somewhat problematic as it strains the other eye. eye patch after retinal surgery
Day 4: The gas bubble line has slightly lowered. I can see more clearly through the gas bubble, and recognize familiar shapes. The vision quality is more like underwater with no goggles. Above the gas bubble line is not clear. If I am patient enough, at a specific angle above the line I can see a little bit of clear image.
When the gas bubble is down to half size, you will see a horizontal line across your vision, bobbing up and down with head movement. This is where the gas meets the fluid which is gradually replacing it. It is just like a spirit level. You will have sight above this line, and blackness below it. Day by day the line will move lower down; the seeing area will get bigger, and the black area will get smaller until it is just a circle at the bottom of your vision, and then it disappears.
Gas bubble inside the eye 0:53 talks about the gas bubble line
As the gas bubble begins to disperse, you will notice a line in your vision that moves, similar to a spirit level.You will be able to see above the line, but under the line the vision will be fuzzy or blurred.
Day 7: The gas bubble has become smaller, allowing me to see somewhat clear vision above the meniscus. When I bend over the gas bubble sometimes breaks into smaller bubbles, but then goes back into one. The smaller bubbles, sitting on top of the meniscus are quite clear to me and reflect what is in front of me. The left and right side of the gas bubble are receding, allowing me some clear vision on the extreme edges. I can now recognize things. The 3 bottles of eye drops are a bit of trouble to keep on schedule. Tomorrow I will end two of the bottles, with the third continuing for another 3 weeks.
Day 14: The gas bubble has been progressively getting smaller, and is now the size of a dime. At Day 12 the bubble was small enough to not get in the way of the windshield, so I thought it ok to drive. Above the gas bubble and meniscus the quality of vision keeps getting sharper and clearer. I don’t see any dark areas on the periphery of my eye, so it is possible that I did not lose any vision, but then again the brain is smart enough to fill in the blanks and fool you. I a day or two I am expecting the gas bubble to disappear altogether.
Day 15: I had a small pea sized gas bubble this morning, but after going to the gym, it was gone. I noticed in the gym that my left eye (operated one) vision is not as clear as before the surgery. There is also a very slight bit of some haze. The vision quality is not as good as my right eye. I think this is expected, as the eye may need more than a month to fully recover.
Day 15/Day 0 It seems like I have yet another retinal detachment. The sight in my left eye is 1/2 white blank. There are a lot of new floaters, and I see flashes of light at night. I went to the local ER but they said to go back to your retinal surgeon. They also gave me an alternative eye doctor, but he seems to be just a generic eye doctor and not a retinal specialist.
Day 1 (Thur): I pleaded with the retinal office to get looked at, and got an afternoon appointment. The second retinal specialist, after consulting with my original surgeon, recommended to give me yet another fast acting gas bubble. He froze my eye and the second gas bubble was put in. I was instructed to position as before, face down or on my side. A surgical date would be after the weekend, and in 4 days. The gas bubble would push the retinal back to position and should restore my sight. This proved to be the case. In this state I should be stable until my surgery. I started on two eye drops that I already had, 4x per day. This gas bubble will dissipate in 14 days or so.
This second gas bubble is smaller than the original one, and does not encompass the whole eye. It looks more like a flower, with one large central bubble surrounded by much smaller “petal” gas bubbles. When motionless I can see the gas bubble move with every heartbeat. This movement gives me a bit of motion sickness, which is somewhat relieved by an eye patch.
Day 2: My original surgeon called and suggested two options: 1. As the gas bubble was already working he would use laser eye surgery to stick my retinal back down. The laser surgery would go through my iris, but it would need to be somewhat extensive. The fast acting gas bubble would dissipate within 2 weeks. This, he said, should be 85% effective, but tricky to do technically. 2. I would opt for traditional surgery. The fast acting gas bubble would be removed and replaced with a slow acting gas bubble. This would allow the retinal more time to heal. The slow acting gas bubble would dissipate in 3 months, with no sight for 8 weeks. I opted for the option 1 laser surgery.
It seems like a second retinal detachment, in a different part of the retina, occurs in about 12% of cases, so not common but also not uncommon.
Day 3 (Sat): The laser surgery was 15 minutes long, which I did not realize was quite long. As I had local freezing, it did not hurt. There were some bright lights, but not as radical as my cataract surgery. The gas bubble would hold my retina in place. He would laser through the iris, through the gas bubble to the retina. Afterwards I had a massive headache, but opted to just sleep through it, which took 3 hours. Sight went, in time, from dark blue, to red-yellow, to clear. It takes 5 days for the retina to heal from laser surgery, so I must be patient and continue positioning.
Day 4: My sight was restored to before the second retinal detachment. I kept strict positioning, as best as I can. The vision quality seemed to be improved from just using the second gas bubble.
Day 5 (Mon): Post-surgery visit. He opted for just a little more laser surgery, in total one minute. This time there was no local freezing, so I felt it a lot more. Some needles, I winced near a nerve. Afterwards I had issues with balance and weakness. The surgeon felt that i was susceptible to another retinal detachment, so he opted to be a little more thorough. Though this surgery was a mere 1 minute total, it felt like a surgery. My vision quality deteriorated just a little, with the addition of some white fuzziness. The eye drops stopped today. The five days of retina healing starts today. After a short nap I felt much better.
I again confirmed with the surgeon that strength training did not make me more susceptible to a retinal detachment, and that I could resume strength training two weeks after surgery. I will be much more conservative and give my retina more time to heal before pushing as hard as I used to. I am trying gentle stationary cycling, such that I am well supported, leaning against a wall and my gas bubble hardly moves. I find this light movement heats me up and makes me feel better.
While in the waiting room I met a guy who lost complete vision, but then regained 60% of his sight. It was a remarkable story and made me appreciate what I still have. Appreciate your good fortune.
Day 6: The gas bubble is going down, slowly. I notice that there are some vertical lines from reflections, which hopefully are coming from the gas bubble and therefore should go away. Sight quality seems to have a slight white tinge, not as good as yesterday. I am losing sleep because I cannot maintain the proper positioning. My left shoulder aches after 3 weeks of sleeping on it.
Day 8 (Thurs): The gas bubble became smaller, pea sized, and at around 10:00 it disappeared completely. Sight quality remains very good, just with a little white tinge. Hopefully tonight I’ll be able to get a good night’s sleep. I have been having slight headaches these last couple of days, but don’t know the reason. With the gas bubble gone I hope that I don’t need the eye patch. Floaters remain unchanged but present.
Day 11: Vision has stabilized for a couple of days. No new floaters. Vision quality is good but there is some light whiteness, like a thin fog. I rarely but sometimes see a border on the left side but cannot detect it when I try. It is a little puzzling, but does not affect my vision. Tomorrow is the 7 day surgeon checkup.
Day 12 (Mon): Post-surgery 2nd laser surgery checkup was today. No additional laser surgery. All is well, healing properly and no rupture of the retina. Vision quality is still a little white but this I confirmed will go away, as will the slight decrease in very low light vision sensitivity. The border issue, which happens when going from markedly different light amounts, the surgeon confirmed is due to the laser surgery, and is permanent. He was surprised that I could even see this, as most people cannot. I continue to heal. Strength training, he confirmed can restart 2 weeks after the last laser surgery.
Day 19 (Mon): The eye seems stable. At times it is not as sharp as it was before, sometimes with a very slight white tint, but stable. No new floaters. Brightness sensitivity is not as good as the other eye. I rode my bike back to the gym today, with glasses to protect form the wind. Strength training was 30% less than normal. While the surgeon said I can restart strength training, I will give it another 2 weeks before going back to where I was before. So far so good. Sight quality is somewhat blurrier than before. I hope this will improve in the future. Otherwise everything else was normal.