Final Retina Ablasio Surgery Experience Part 13 - Just Menong

It feels like we both deserve to be named the most chattered-about patient in the world. Because I have a repetitive retinal ablation surgery experience, everyone will do routine control, and I always prepare questions. This is one of the reasons we choose to occasionally control in a pavilion clinic so that we can freely consult a doctor subspecialist in the retina.

Retinal ablation is a condition of detachment of the retina, or the mesh membrane, from its original position that can cause permanent blindness because the retina gets less oxygen and nutrient intake. In total, Zauji is already in the operating room as much as 7x, from the installation of 1300 cSt silicon oil, 5000 cSt, scleral buckle, CF6 gas, and HD silicon.

After the seventh operation, doctors only monitor, so we are only required to control every month. including conducting an optical coherence tomography (OCT) examination. OCT is a medical diagnostic imaging technique that utilizes photonics and optical fibers to obtain images and characterization of the tissues of both eyes.

This time we have made a friend of the question we will ask the doctor. Thankfully, Dr. Made Indra Widyanatha, SpM (K), answered all Our questions are friendly and clear.

Hard lenses or glasses?

Hard lenses, or rigid gas-permeable contact lenses (RGPs), are a type of contact lens that is harder and stiffer than soft lenses. Hard lenses can let oxygen enter the eye and generally provide clearer and sharper vision than soft contact lenses.

The hard lens does not work to replace the glasses. In Zauji's case, the right eyeglasses will be made the same as the left eyeglasses that have lower minuses. The rest of the right eye will be fulfilled using a hard lens.

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In general, the hard lens is more durable, of higher quality, more comfortable, and certainly more expensive. The use of hard lenses is not much different from soft lenses; patients must be painstaking and clean because the hard lens is inserted manually with the help of hands and, of course, will feel more complicated for those who are not used to it.

Based on experience, the hard lens can be used for up to 2 years. The price is certainly more expensive; a few years ago, it ranged from 3 to 4 million per pair. After discussing, we agreed to postpone this option because Zauji is still comfortable using ordinary glasses, and it feels more troublesome when he has to unload the hard lens at any time.

Is Glauceta Safe to Drink Every Day?

Glauceta, or trademark Cendo Glaucons, is an eye drug containing 250 mg of acetazolamide. Glauseta is used to help lower eye pressure. It is usually used for glaucoma patients.

One of the effects of installing HD silicone to attach the retina is the pressure of the eyeball that rises and falls. The condition of the eye pressure that rises, the toleration limit for patients with postoperative retinal ablation is a maximum of 24, which is of course dangerous because it can cause glaucoma.

In addition to Thiol and Glaucen drops, doctors prescribe Glauceta that Zauji should take every day. In theory, the use of Glauceta is not recommended for more than 2 weeks. After consulting a doctor, Zauji is allowed to take Glauceta only when the timol and glaucen can no longer provide the effect of lowering eye pressure. If necessary, glauceta can be drunk at a later time or not continuously.

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Glauceta itself gives a tingling effect due to a lack of potassium, so it must be helped with other drugs, like Aspar K. Doctors also provide solutions; as long as Zauji can still withstand the tingling that often appears, Zauji is allowed not to need to drink Aspar K and advised to eat a lot of bananas.

Papil conditions are getting more numerous.

The papilla is the tip of the eye nerve. Papillae can shrink, called papil atrophy. This condition causes the nerves of the eye to be damaged and unable to transmit impulses or stimuli like normal eyes, and blindness occurs. This condition is terminal or irreversible, which means the damage is permanent and cannot be returned to normal conditions, in contrast to retinal ablation that can be repaired through surgery.

In Zauji's case, the condition of shrinking the papilla is due to a history of repeated operations and the installation of HD silicone. This is what we often call simalakama fruit; without surgery, of course, the retina cannot be repaired, while surgery (especially repetitive) will cause damage to other parts, including the papil.

The doctor himself explained that the damage to the pupil will take a long time. The grace and trust became a full weapon for us. At most, take an eye and leave it all to the All-Powerful, everything including the eyes, the pupil, the retina, and others, namely Allah SWT alone.

How to Keep Eyeball Pressure Stable

Silicon can move with unexpected movements and press the eyeball, which causes the eyeball pressure to rise. When sleeping, the silicone eye will press on the pupil that is at the bottom; this is what causes damage to the pupil. In accordance with the force of gravity, logically, the sleeping position parallel to the floor will cause the silicone to press the nipple so that the recommended sleeping position of the head should be higher.

In addition, doctors also recommend that the position of the prostrings is not too long because silicon tends to move forward (distal, away from the retina that should be suppressed by silicon due to the absence of obstructing lenses).

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Overcoming Swollen Eyes Due To The Allergy Of Drops To Raise Papil

When the visus examination is passed, all patients will test the eye drops first to raise the pupil, which will be easier to check. Allergies this drop feels like it only happened 6 months ago; usually the effects of allergies in the form of red and swollen eyes are felt a few hours after.

The doctor suggested that at the next time of control, we ask the nurse what eye drops were used, whether mydriatil or efrisel, so that we could check the reaction afterwards.

Frequent gla gla lot and gle.

Sometimes Zauji complains of frequent glare when exposed to sunlight. In a flash condition, the eyes will automatically close, which is certainly dangerous because, until now, we are both still traveling using a motorcycle.

We also began to be able to predict the conditions that make the glamour of the morning sun, especially when we crossed the Pasopati kit road when Zauji drove me to work, or the glamour of the vehicle lights that we anticipated by slowing the motor.

Doctor Indra explained that this condition occurs because the retina is in an abnormal state, so it is easier to feel gummy. The solution that can be done is to use hats and glasses that are a bit dark.

Another condition that Zauji often feels is that he often feels slippage. Doctors make sure the condition is not caused by broken silicone but rather by Zauji eye factors that are not yet in normal condition.

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Silicon HD or Gas

Silicon Ocsana HD is a mixed silicon that has a viscosity of > 5000 cSt silicon. Silicon oxyana HD is commonly used in cases of retinal ablation that cannot be handled with 5000 cSt silicon. The operation of the installation of silicone HD was carried out a year ago. Generally, silicone must be evacuated or removed from the eyes before 3 months.

But in the case of Zauji, who has experienced repeated tearing, it is decided that HD silicon has not been evacuated to date. This is certainly not a risk-free thing. As the doctor has explained many times, this condition is like a simalakama fruit because the risk of the retina that is released back will always be there if the evacuation of silicone is done, as is another risk if silicone is still maintained, namely damage in other parts of the eye.

I was able to question: if there is a tear back after the silicon is removed, can it be replaced with CF6 gas as we experienced in the third retinal ablation surgery?

In the condition of Zauji's eyes, the retina is mostly good except for the lower part, which will certainly be difficult to see except during surgery. Silicon gas or ordinary silicone naturally will move upwards because it has a smaller density (BJ) than water so that the bottom of the retina cannot be pressed to the maximum.

Another case with HD silicon that has a BJ heavier than water so that it will gravitationally press towards the bottom, which will automatically press on the retina. This is the reason why silicone evacuation has not been carried out. The results of the control are good and stable, so when brained, Atik is feared to damage stable conditions.

Alhamdulillah, until now Zauji can still do normal activities except for reducing driving at night. The maximum of God’s grace will continue to be done. Whatever happens, that's what's best for us. The experience of retinal ablation surgery makes us more reminded to always be grateful for all circumstances. Thank goodness for the cool thing. And of course the next anniversary is still done.