can embolis or blood clots block the eye blood vessels and cause blindness? what are the chances? or is there some other mechanism by which this can happen? this would be the WORST complication ever.
I read some online reports of something like this but it was a rare case. but what are the chances? what are we willing to risk just to be 2 inches more?
on wikipedia it says fat embolism can cause vision problems. but they are not stating how much are the odds. Very worrying this is. Wish someone could clarify this for us.
Quote from: ReadRothbard on December 24, 2021, 08:07:45 AMFat embolisms are very rare with LL, especially given a competent surgeon.
some 4-5 patients of paley are known to have had fat embolism. We don't know how many are not known. it's not exceedingly rare
Quote from: ReadRothbard on December 24, 2021, 07:43:30 PMPaley has performed tens of thousands of LL surgeries, so that still comes out at a very low percentage. Besides, they give you drugs to prevent embolisms.
We know of 2 cases. We don't know about those who did not write on this site. The real percentage is 4%. Please do not make false assumptions. And we don't know what percentage of this 4% leads to vision problems. It's not documented anywhere.
There are not drugs to prevent fat embolism. All doctors do bone venting but still the rate of fat embolism is 4%.
Quote from: Masteryourlife on December 25, 2021, 09:02:33 PMWhere did you get the 4% ?
Because I believe the ones we know from Paley are from his admission not from the forum .
limblengthening.org/complications
I think most fat embolis gets resolved easily. But which % of it results in vision impairment in my concern?
morthoj.org/2010v4n1/Cortical_Blindness.pdf
They don't mention the probability of this complication but its a paper about it
They says its very rare but still its scary af. Most doctors say "you can die from LL" but few go into specifics like this. We should take all possible steps to prevent embolism.
Quote from: Masteryourlife on December 26, 2021, 01:44:15 PMI read it but idk why I had the feeling that he meant 4% rate of complication for FA,PE and DVT meaning that all together had a 4 % not just FE.
Anyway , FE seems to be 4% , DVT 1% , but what about the more concerning PE?
He does not mention the % of it and the deaths we know from LL are both from PE .
Paley it's a salesman (also a great surgeon) so I wonder if he is hiding that number on porpuse in order to not lose /scare perspective patients .
At least he has listed something. most doctors don't even have this numbers.
PE happens only after DVT so the number must be much smaller than 1%. Like 0.1% or something.
but fat embolism leading to vision impairment is most scary.
Quote from: Masteryourlife on December 26, 2021, 08:36:20 PMSo FE is more common then PE ? Wow from what I heard/read it looked the other way.
Btw I read the story of the guy with dr.D but not to attack anyone but there are few members here that suffered from other problems then pure height .
One panicked for everything and was depressed before and after LL etc.
No one ever mentioned this problem besides that diary so idk man ..we should be carefull because sometimes u feel symptoms that they don't exist or were there before too but u just look for them after such a big surgery .
Even nose filler can cause lose of ur eye function and it happened but...the odds ?
I am not the type of guy to say "this surgery is risky deal with it" but ppl forget that any other Cosmetic surgery/treatment have risks and LL have severe ones like future walking etc. But as far as PE/FE they can happen with other surgeries too or simple fractures or traumas surgery and so with the problematic u are bringing it which is legit and scary .
I believe u should try to understand if u can live without this surgery and the height it brings to u ; if the answear is no you are just worrying about something u will eventually end up doing/accepting down the line .
I learned it the hard way by trying to find alternatives and forget about it .
So in the worst case scenario, if LL is NOT an option for you (hypothetically speaking). What will you do? Seriously.
Fillers is a good question. We should do some research and find how many documented cases exist. I read in a paper that in 2015 there were 98 documented cases of this but I do not know how many people got fillers in total to calculate the risk.
Quote from: Verumontanum on December 26, 2021, 08:59:59 PM4th year medical student here
This is something known in the literature as Purtscher's retinopathy.
It is rare; there is no good data on the absolute risk, but based on the anecdotal evidence, it is not common enough to be of paramount concern.
You have to have Fat Embolisation Syndrome (FES) to get Purtscher's. In other words, the fat has to go into the systemic circulation and reach the vasculature supplying the eye (not only the retina). However, it is unlikely that fat per se is the only culprit of causing ischemia because you need other things to form a sufficient enough clot to block all blood.
Acutely, most patients are visually asymptomatic.
If you are concerned about FES and the sequalae involved, I would highly recommend you do the following:
1. DO NOT VAPE OR SMOKE AT LEAST 2 WEEKS BEFORE SURGERY
2. When medical staff are not around and you are resting post-op, monitor yourself for the following signs/symptoms: dyspnea (difficulty breathing), tachypnea (breathing fast aka shortness of breath), hypoxemia or low oxygen presence in blood (as measured by a pulse oximeter; there will be a pulse-ox on you after your surgery, just make sure it's on your finger and measuring your oxygen appropriately. Anything below 90% is alarming)
3. Do not excessively research rare conditions as this will only add fear and anxiety
**You are most likely to get FES 24 to 72 hours after surgery**
Also, please be wary of case reports in the literature as these are often only published if they are unusual outcomes and exceedingly rare events. This is not to say that they are not clinically valuable; just don't hang your hat up on something you read in a case report.
Sources:
https://europepmc.org/article/PMC/2398519
https://pubmed.ncbi.nlm.nih.gov/21532048/
https://pubmed.ncbi.nlm.nih.gov/8766666/
THANK YOU so much for writing this!!
I wish we had some data on this and how many people end up with vision impairment after FES.
As for informing medical staff, there is not much that can be done to save vision isn't it? They can only help you oxygenate. But they can't do anything about stuff blocking blood supply to the eyes. even with facial fillers if there is vision impairment they say it cant be reversed.
Agreed though that it's still important to inform them to save your life.
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