Following your Operation

Immediately after your epiretinal membrane surgery
The day after your epiretinal membrane surgery
How quickly will your vision improve?
When can you resume normal activities?
Driving and travel
What can you do to help make the operation a success?
What are the risks and complications?

 

Immediately after your epiretinal membrane surgery

After the operation you will return to the ward with a pad and plastic shield covering the operated eye. This remains in place overnight. You will be given a combination antibiotic and anti-inflammatory eye drop to take home, with written instructions on how to instil this and the frequency with which it should be used. We will make sure you know how to care for your eye when you get home.

Whilst resting after the operation you will be offered refreshments. You may leave the hospital when you feel ready.

During the first few hours after your operation the eye may feel sore. This is nothing to worry about and your normal headache tablets should settle any discomfort.

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The day after your epiretinal membrane surgery

The pad covering your eye can be removed on the morning after your surgery. You do not need to use it thereafter, although some patients prefer to wear the clear plastic shield for the first few nights for peace of mind.

You may find the eye is a bit sticky and there might have been a slight discharge overnight. This is quite normal and you should cleanse the eye only if necessary, by wiping gently across your closed eyelids with cotton wool dampened with clean water.

You will then need to start your eye drops, following the detailed written instructions given to you before you left hospital.

If you are running out of drops before your appointment at the clinic, you can request a repeat prescription from your GP.

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How quickly will your vision improve?

Successful peeling of the epiretinal membrane is almost always achieved. This usually leads to a reduction in distortion and visual improvement over time, particularly in the way the two eyes function together. Recovery depends upon the duration of symptoms and your visual acuity prior to surgery.

For the first couple of weeks the retina may be slightly swollen, an inevitable effect of the mild trauma associated with the peeling process. This may cause a temporary worsening of vision. Thereafter steady improvement is expected.

Your final visual result however, may not be known for several months and occasionally patients may still be aware of some distortion and visual limitation if permanent retinal damage occurred prior to removal of the epiretinal membrane.

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When can you resume normal activities?

You may return to your normal daily activities as soon as you feel ready to do so, but specific written instructions will be given to you on discharge from hospital. As a guide, however, for the first two weeks you should refrain from swimming, strenuous activities, high impact sports, heavy lifting and wearing eye make-up.

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Driving and travel

Your ability to drive will depend upon a number of factors including the vision in your other eye and the level of your vision when using both eyes together. This will be discussed with you following your operation prior to discharge from hospital. If you are in any doubt regarding your visual status you should refrain from driving until you have been seen for review in the clinic.

It is acceptable to travel (including by air) following routine surgery for epiretinal membrane. All vitrectomy surgery, however, carries a small risk of inducing a retinal tear, for which the eye may be filled temporarily with a gas bubble. For this reason, you should not plan to travel by air for one month after your operation. Please also remember that you will need to continue putting drops in the eye for approximately three to four weeks.

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What can you do to help make the operation a success?

Following your epiretinal membrane peeling procedure it is very important that you instil the eye drops as instructed as this will help prevent any complications such as infection or inflammation in the eye.

You should avoid knocking or rubbing your eye, but you may touch the surrounding area. Although it is safe to have a shower or bath, take care when washing your hair to avoid getting soapy water in your eye.

The eye can seem more sensitive to bright light for the first few days and you may find dark glasses helpful, especially in strong sunlight.

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What are the risks and complications?

The aim and potential outcome of your epiretinal membrane peeling will be discussed with you in clinic and again prior to your operation.

Our team operates from modern private hospitals where the equipment and products used in the operating theatre are of the highest standard. Every effort is made to minimise risk and ensure your operation is safe. Serious problems during or after surgery are rare, however every surgical procedure has risks and potential complications.

Complications early in your recovery:

  • Initial poor vision. All vitrectomy surgery carries a small risk of inducing tears in peripheral retina. To prevent subsequent retinal detachment, laser may be used and a bubble of gas injected into the eye. It is not possible to see clearly through a gas bubble and vision will be compromised until spontaneous re-absorption occurs. Specific information will be given after surgery should this be necessary.

  • Bruising of the eye or eyelids. The local anaesthetic may cause some bruising around the eye, particularly on the lower lid. The sclera may be red where the tiny incisions are made into the eye. This usually resolves completely within the first month.

  • Double vision. The local anaesthetic injection used to numb your eye takes some time to wear off and this may leave one or more of the muscles around the eye weak for the first few hours. This causes double vision, which resolves spontaneously.

  • A temporary increase in the intra-ocular pressure in the eye. This necessitates an additional course of eye drops or tablets. If a gas bubble is used, these treatments are given routinely as a precaution.

  • Allergy to eye drops. Ocular allergy typically causes lid swelling, itching or redness. If this happens please let us know and we can prescribe an alternative. Some patients are allergic to the preservative used in eye drops and if you have previously had a reaction, please inform us prior to surgery so that we can prescribe a preservative-free option.

  • Endophthalmitis. Infection in the eye is a very rare, but potentially devastating complication affecting fewer than one in a thousand cases. Increasing discomfort, increasing redness of the eye or worsening discharge should be reported immediately.

  • Cystoid macular oedema. Swelling of the central macular area of the retina causes blurred vision. This usually resolves within a few weeks of using additional eye drops.

Complications late in your recovery:

  • Retinal detachment. Vitrectomy surgery involves the insertion of instruments into the vitreous cavity of the eye which carries a small risk of tearing the peripheral retina. Although normally identified and treated at the time of surgery, retinal detachment can occur months or even years later. Any increase in floaters and flashing lights, or the appearance of a shadow spreading inwards from the edge of vision, should be reported urgently.

  • Post-vitrectomy cataract. This is an inevitability following vitreous surgery. It can develop as quickly as a few weeks after surgery, or may take several years to become significant. In some cases patients may be offered phaco-emulsification (cataract surgery) combined with the vitrectomy procedure to avoid the need for further surgery at a later date.

  • Glaucoma. Any ocular surgery can increase the risk of glaucoma in later years. Glaucoma is damage to the main optic nerve of the eye, caused by an unsuitably high pressure. It can nearly always be controlled with eye drops, although prolonged or even indefinite use may be required.

  • Dry eyes. This is a common symptom with increasing age, for which many sufferers use simple lubricating drops. Interfering with the conjunctiva on the surface of the eye can upset the production of mucus, which is an important constituent of the tear film. In most cases this is temporary, responding to simple measures such as ocular lubricants and warm compress bathing. We will advise you on a treatment regime if required.

Information explaining how to care for your eye together with contact telephone numbers will be given to you on discharge from hospital.

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