Question: Dear Dr Misra,

Thanks for your early advice re. the thread
https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=387643
I have scheduled ERM surgery on 23 April
I just got flu and bronchitis for two days, have cough, now on antibiotics. my erm surgery will take place on 23 april ie two days later. General anesthesia.

I wonder if i am suitable to proceed to surgery given my physical conditions. Will there be increased risk? Is it advisable to postpone my surgery?

I am also concerned if i will have an increased risk of infection to my surgery eye if I proceed to surgery as scheduled?

2.     If I still have mild cough when doing surgery, under general anesthesia, will I cough involuntarily? If I get better but still have mild cough or sore throat only, should still postpone surgery until full recovery?


3.     I am now on antibiotics for two days and my GP will probably prescribe 2 – 3 days more antibiotics, which means that I am still taking antibiotics on the day of my surgery. From your experience, is it more safe to postpone my surgery until I have completed the antibiotics course?

4.     I am weighing the risks and benefits of proceeding with surgery. My thinking is that if the consequences of the risks of going ahead with surgery as scheduled could be very severe, I dare not bear the risks. Any advice? If I postpone for one to two weeks, do you think my ERM will become worse given my rapid progression in just two months.


May i have your expert advice . Many thanks.

Dear Dr Misra,

Thanks for your early advice re. the thread
https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=387643
I have scheduled ERM surgery on 23 April
I just got flu and bronchitis for two days, have cough, now on antibiotics. my erm surgery will take place on 23 april ie two days later. General anesthesia.

I wonder if i am suitable to proceed to surgery given my physical conditions. Will there be increased risk? Is it advisable to postpone my surgery?

I am also concerned if i will have an increased risk of infection to my surgery eye if I proceed to surgery as scheduled?

2.     If I still have mild cough when doing surgery, under general anesthesia, will I cough involuntarily? If I get better but still have mild cough or sore throat only, should still postpone surgery until full recovery?


3.     I am now on antibiotics for two days and my GP will probably prescribe 2 – 3 days more antibiotics, which means that I am still taking antibiotics on the day of my surgery. From your experience, is it more safe to postpone my surgery until I have completed the antibiotics course?

4.     I am weighing the risks and benefits of proceeding with surgery. My thinking is that if the consequences of the risks of going ahead with surgery as scheduled could be very severe, I dare not bear the risks. Any advice? If I postpone for one to two weeks, do you think my ERM will become worse given my rapid progression in just two months.


May i have your expert advice . Many thanks.

Thanks for your advice. I have rescheduled the surgery to two weeks later. I am concerned that further delay would make my ERM worse, causing more complications to the surgery and poorer outcome. My questions/queries –

1.     Do you think 2 weeks is sufficient for clearing my infection and proceed to surgery?

2.     From my latest OCT report done in end March, lamellar holes can been seen. Will prolonged ERM lead to macular hole?

3.     Given my rapid progression from early February to end March comparing the two OCT, I am worried that further delay would cause more complications to my surgery and post surgery recovery. Any advice

4.     My current vision is about 20/40, what is the expected improvement after surgery?

May I have your advice and can you share your clinical experience? Thanks a lot.

Thanks for your advice. I have rescheduled the surgery to two weeks later. I am concerned that further delay would make my ERM worse, causing more complications to the surgery and poorer outcome. My questions/queries –

1.     Do you think 2 weeks is sufficient for clearing my infection and proceed to surgery?

2.     From my latest OCT report done in end March, lamellar holes can been seen. Will prolonged ERM lead to macular hole?

3.     Given my rapid progression from early February to end March comparing the two OCT, I am worried that further delay would cause more complications to my surgery and post surgery recovery. Any advice

4.     My current vision is about 20/40, what is the expected improvement after surgery?

May I have your advice and can you share your clinical experience? Thanks a lot.

Dear Dr MIsra,

Apart from the above queries, I have one more question. I now have bronchitis and severe cough in these few days. Wonder whether severe cough would cause my ERM to progress to macular hole or even retinal detachement? I do not want to have further complications to my eye conditions during this healing period for my flu and bronchitis.

Thanks for your advice

Dear Dr MIsra,

Apart from the above queries, I have one more question. I now have bronchitis and severe cough in these few days. Wonder whether severe cough would cause my ERM to progress to macular hole or even retinal detachement? I do not want to have further complications to my eye conditions during this healing period for my flu and bronchitis.

Thanks for your advice

Dear Dr Misra,

Thanks for your advice. Currently, I have enlarged and distorted images for my right eye (not present before ERM found). This imbalance of image sizes makes my vision strange, sometimes with distance disparity, and I feel very uncomfortable. Is this imbalance called aniseikonia? I am currently quite upset by this problem. Will this problem be completely removed after erm surgery?


I also have some questions regarding cataract development after ERM surgery. I know that Cataract will soon develop after vitrectomy. If cataract surgery is subsequently performed on my ERM eye (right eye), I will have great differences between LE and RE in terms of myopia. I do not want to replace my LE lens together with my RE lens as the lens of my LE still clear. But how to overcome the vision imbalance (LE is about -9.00 myopia) without replacing my LE lens?

Doctor said I could leave about -2.00 for my RE upon cataract surgery, and then wear contact lens for LE only. But my question is will I feel very uncomfortable or even dizzy with such great differences? Any suggestions and advice?


Thanks much for your expert advice.

Dear Dr Misra,

Thanks for your advice. Currently, I have enlarged and distorted images for my right eye (not present before ERM found). This imbalance of image sizes makes my vision strange, sometimes with distance disparity, and I feel very uncomfortable. Is this imbalance called aniseikonia? I am currently quite upset by this problem. Will this problem be completely removed after erm surgery?


I also have some questions regarding cataract development after ERM surgery. I know that Cataract will soon develop after vitrectomy. If cataract surgery is subsequently performed on my ERM eye (right eye), I will have great differences between LE and RE in terms of myopia. I do not want to replace my LE lens together with my RE lens as the lens of my LE still clear. But how to overcome the vision imbalance (LE is about -9.00 myopia) without replacing my LE lens?

Doctor said I could leave about -2.00 for my RE upon cataract surgery, and then wear contact lens for LE only. But my question is will I feel very uncomfortable or even dizzy with such great differences? Any suggestions and advice?


Thanks much for your expert advice.

Thanks Dr Misra for your reply.

I want to go to hair salon to perm my hair, which involves use of chemicals. If I do this before the surgery, is it OK or it will have impact on my disease or ERM surgery?

What if I perm my hair after the surgery? When is the appropriate timing? Should I wait for complete recovery of vision?

Thanks.

Thanks Dr Misra for your reply.

I want to go to hair salon to perm my hair, which involves use of chemicals. If I do this before the surgery, is it OK or it will have impact on my disease or ERM surgery?

What if I perm my hair after the surgery? When is the appropriate timing? Should I wait for complete recovery of vision?

Thanks.