Final Ablasio Retina Surgery Experience Part 19 - Just Menong

2024 became the fifth year for the two of us to share the experience of retinal ablation surgery. Sometimes, we still talk about how this journey started.

Early Ablatio Retina

Not much was felt after we fell and hit the asphalt road except the arms and legs were bruised. And it turns out that it is only the beginning of our 'friendship' circuit with retinal detachment, a decrease in vision due to the release of the retina from its position that causes the retina to lack oxygen intake and nutrients that automatically interfere with its function as the center of vision.

One of the signs that we didn’t understand before was the reduced area of view. Because it was too late to be taken to the eye hospital, qodarullah, Zauji's retina was released, and the operation became the only effort to restore Zauji's vision. Initially we were treated with a self-meal fee, but doctors suggested we undergo treatment at the National Eye Center, Cicendo Bandung Hospital, with the help of BPJS.

Treatment of Ablatio Retina

Fear and confusion—that's what we feel. Alhamdulillah, Allah still provides convenience through one of my friends who is diligent in helping me during Zauji to complete 7 actions in 10 months (September 2019-June 2020).

This action is carried out gradually from the installation of 1300 cSt silicone oil (silionage with the lightest viscosity), 5000 cSt silicone oil, CF6 gas injection, scleral buckling (the installation of silicone connective on the sclera or the outer part of the eye), and silicone HD (silicone with the heaviest viscosity).

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At the beginning of the preparation for the operation, the doctor stated in theory that the silicon that has been installed will be evacuated or re-excreted 3-6 months post-surgery. But until recently, January 2024, all doctors agreed to maintain HD silicone oil as long as possible in the hope that the retina is firmly attached and strong.

This decision itself has other consequences. Doctors have several times referred to the examination of optical coherence tomography (OCT) and electroretinography (ERG), which turned out to show a decrease in the quality of eye tissue (including increasingly pale papil) and a weakened eye nerve response.

Zauji himself had felt a vision that had disappeared entirely since last year. Only the shadow of the object is able to distinguish light and dark that Zauji can now feel.

Previously, Dr. Rova Virgana, Sp.M.K., who handles Zauji at this time, once planned to perform laser action in the right eye as a form of anticipation of strengthening the retina. When one day the HD silicone must be evacuated, the retina remains firmly attached. However, this laser action is undone.

In addition to not returning vision function, laser action with the condition of the right eye cornea of Zauji that has been cloudy (keratopathy) will make the laser difficult to do and will even be given in excess so that it has the potential to make the retina perforated, which will certainly worsen the current condition that is already stable.

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At the end of 2023, Zauji’s eyeball pressure suddenly rose to 36 when Zauji didn’t feel any complaints like pain in the eyes, red eyes, or nausea and vomiting. It seems that Zauji’s body has begun to adapt to the high pressure of the eyeball. But based on a doctor's examination, there are physical changes in the cornea.

Based on the experience of retinal ablation surgery that we have gone through, this abnormal condition is certainly very worrying. Doctors refer Zauji to a glaucoma clinic to consider certain actions, such as laser action or surgery, to make a sodetan to lower eye pressure.

High eye pressure will make the cornea prone to blisters that result in inflammation and make the cornea of the eye white. The cornea part of the eye will thin and make the cornea break.

In the interim, doctors give eye pressure-lowering drops, namely timol and glauca, because Zauji does not match the oral eye pressure-lowering drugs—glaucons and aspar K—which often cause nausea, vomiting, and tremors in the hands.

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Alhamdulillah, these two drugs function so that two weeks later, when examined, Zauji's eye pressure returned to normal in the range of 11, so that doctors did not refer Zauji to glaucoma. The doctor directed me to finish the remaining drops.

The doctor also assured us, although still given the timol, the pressure of the eyeball will not drop <11 and will remain in the normal range. Low eye pressure causes the eyeball to deflate because it does not contain fluid.

Function and structure of the eye

Doctors do not provide any restrictions or prohibitions on the activity, including riding a motorcycle, swimming, and working using a computer, as Zauji used to do. With the eyes, of which now only one functions, the left eye, of course, there are limitations, especially blind spots that must be watched out for.

It is God who created the human body. Zauji has begun to adapt to circumstances, including getting around so that the limited area of view of the eyes does not harm yourself and others.

Since the beginning of 2023, doctors only recommend Zauji for control every 6 months only to monitor eye pressure that must remain in the normal range, 10–24. In fact, he suggested that we control it once a year unless there is an emergency such as very high eye pressure, tremendous pain, or rupture of silicon.

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And it turns out that although the condition can be said to be stable, in the sense that Zauji does not feel pain, the pressure of the eyeball is normal, or the condition of silicon is not broken or damaged, there is an 'enemy lurking' among us. Although the function of the eye is no longer there, the doctor still strives to keep the structure of the eye to remain like a normal eye.

Silicon HD forms the space in the eyeball so as to keep the eye structure in normal or round or round or not kences or deflated.

Finally, we understand the reasons why doctors keep up with HD silicone and the importance of maintaining eyeball pressure. Although functionally it cannot be attempted medically, structurally, doctors still try so that Zauji's right eye has a normal shape.

We also keep trying to keep Zauji’s left eye functioning normally. Honestly, we were both a little paranoid. From the explanation of the doctor, although now the left eye alone functions, that does not mean the left eye is more capable because it bears the burden of both the right and left eyes, so we do not need to worry too much. Currently, Zauji routinely conducts acupuncture in a clinic in Bandung to maintain health, especially nerves.

Normal eye structure (image: Canva)

From the experience of retinal ablation surgery many times that Zauji has undergone, we are grateful that we can still get through it until now. May this quilted experience give a happy end in this world and the hereafter. Al-Greetings, a'la kulli thing.