Miodesopsie.it

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Le testimonianze di illustri medici sembrano confutare i luoghi comuni che si sono venuti a creare riguardo le miodesopsie.



eMail 1 - Ode mnie do doktora

Hello Doctor!

I got your Email from a Czech friend. I decided to write to you, because I am a floater suferer. I am a relatively young person with 24 years of age. And I am highly myopic (-8.75 right and -8.5 left). My refraction defect didn't bother ma at all till the moment I got the floaters. This happend almost 4 months ago very suddenly. I just woke up with some of them on Monday before going to work. But they have grown bigger for this 4 months and became darker (especially in my right eye). I had 3 ultrasounds made and everything turned out to be fine. The first one from October singalized a PVD in my right eye, but the next two didn't show it...? Maybe my floater line was similar to the PVD line? The examinations were made by the same doctor, so we had the possibility to compare.

I have visited many eye docs here in Poland, but noone was able to explain me what actually happend, so I searched by myself and came to the point, the the floaters may accompany my for the rest of my life. One of the eye docs I
have visisted told me, they may fade with time, but I hardly believe that

The reason I write to you is VITRECTOMY. I have heard, that you are a surgeon who is very sympathetic with floater sufferers and willing to help them. That is why I wanted to ask you, if there would be a possibility of undergoing a FOV (floater only vitrectomy) performed by you? Are the risks
for a highly myopic person much higher than for the one with less or no myopia? Do you perform FOV on young patients? How many did you perform actually?

I'd be very grateful for any info from you. I'll be waiting for your answer. We are very close neighbours will. I hope this will make answering more pleasant.

Kind regards from Poland

Przemek Sobieszczuk

Odpowiedź 1 - od doktora do mnie

Dear Sir,

I have performed dozens of FOVs, many of them in young patiens without complications. I do not think the risk of vitrectomy is much higher in myopes. I carefully examine the retina before and during the surgery in order to treat all suspicious areas to prevent from retinal detachment. If you cannot live with your floaters (and you are true, they can hardly disappear as they are structural, not temporary), vitrectomy is indicated. You perhaps know that the surgery can be done in a sutureless manner, using 25ga instruments which can shorten the time of healing and rehabilitation.
If you really suffer from your floaters and cannot make friends with them, I am able to remove them for the rest of your life. The surgery represents about three days stay in Prague: the initial examination, surgery on the other day and a check-up on the first post-op day. Of course I would like to see you after a month or so, too. Everything is on out-patient basis. Pre-operative examination can be done in Poland according to our orders. The price of the surgery is approx. 600 to 800Eur.

Looking forward to your answer,

Ivan Fiser, M.D.

eMail 2- od mnie do doktora, wraz z jego odpowiedziami na biało

Dear Mr. Sobieszczuk,

These are my answers. Of course, we cannot discuss everything via e-mail, these are only basic information.

Dear Doctor!

If you'd be so kind to read thorugh the whole text. This should take about 5 minutes. Thank you!

First of all, thank you for you kind answer. This means a lot to me.

Sorry for being curious, but I really need to know what "dozens of FOV's" mean? Was it about 100 or maybe 1000? Please, this is all about how exepreinced you are. Every operation brings some new experience, don't you agree? I have performed thousands of vitrectomies. Out of these, about 20 to 30 were for floaters – but there is no diference in the technique.

COMPLICATIONS. You said you have done many operations without any complications or maybe I understood this wrong? Is it really possible to perform a FOV without any complications, like cataract for example? I have heard that cataract occurs very often and needs to be removed in a surgical way also. Cataract after vitrectomy is NOT a rule, in fact, it is a rare complication. You, however, have to take it into account. This means a second operation on each eye within years or even months after the FOV. What about other possible complications like retinal detachment, macular degeneration, raised IOP (glaucoma) etc.? How often do they occur? No. Can the retina be touched during performing FOV? I don´t touch it. What happens if a RD occurs? Are you able to fix it during the same operation? Yes. Can it be fixed without vision loss? Yes, mostly. Have you ever had such a case to deal with? Not in floaters. And finally - what materials do you use to replace the vitreous? Is it gas, pressed air, silicone oil, tell me please Water, i.e. the Ringer solution.

RECOVERY TIME. How long does it take to return to normal life? Several days, sometimes just one or two. Is the risk of retinal detachment much higher during life then? Much lower. I am not a person who likes the extreme sports or so (bungee jumping). I used to play basketball, ride a bike, drive a car and I really don't need to change it. I just want to know, if I can carry some heavier things (say 30 kg) without a higher risk of retinal detachment then before the FOV. Without risk. How long should be the period between one eye and the other? What do you recommend? 2 to 4 weeks or more.

PRICE. The prices you wrote here are per eye as I suppose? Does this cover the whole procedure (pre-examination) or the operation only? 500 Eur per one operation of one eye. Examination and check-up for 60 to 70 Eur.

Sorry for the lots of question Doctor, but I have to clear some of my doubts...

Thank you for your patience!!! MUDr. Ivan Fišer

eMail 3 - Ode mnie do doktora

Wow Doctor!

This is great news you wrote here. So there is indeed very little to worry about while having vitrectomy performed by a professional like you. This is very good to hear

So now that I've got he basic questions answered, let me ask one more. How is the availability of the procedure? I mean, can I just come to you, make an examination, have surgery and go back home two days after? Is this really so easy? Sounds very optimistic though...

Suppose I'd like to do the surgery next month. Is there such a possibility? If you were so kind to write a few words concerning this.

Kind regards doctor

Przemek Sobieszczuk

Odpowiedź 3 - od doktora do mnie

Dear Sir,

The capacity of our operating room does not allow us to operate on your eye next month as we are full up. I, however, believe that we can do it in March or in April. We are building new operating rooms and we will be able to satisfy more patients since this spring. Please keep in contact, I think that I can give you the term of your surgery during the next – or the next but one - week. You can come to Prague, visit me on the same day, your date of the surgery will already be fixed by e-mail for the other day. The surgery will be done on the out-patient basis, i.e. after the operation you can go to your hotel and have a rest. The next day I will check you up and if everything is okay, you can fly back home with eyedrops applied five times a day for two or three weeks. If you are satisfied, we can arrange the surgery of the other eye abot one month later. I really do not expect complications – although they can happen in medicine, during or after this kind of surgery they are very rare, and moreover, we use the most up-to-date instruments and techniques to minimize any risks.

Thank your for your letter, please write me again the next week to ask for terms.

Sincerely,

Ivan Fiser, M.D.