Cataract Surgery

Miscellaneous and Personal Stuff I Must Share
101

Another bumpdate:

I had let them know at the doctor’s office that I’d be just thrilled if they had a cancellation - strictly financial reasons, as we hit our out of pocket (plus I’m pretty sure we’ll itemize medical this year “thanks” to some very unusual expenses for my daughter).

And I got a call this morning!

Next Thursday - 7:45 AM.

This is nearly perfect; a week later and I’d have been out of town, and the followup for eye #2 is 2 weeks, so I’ll be back by then. If they’d gotten me in this week, the 2-week checkup would have been a problem.

I see the doc tomorrow anyway - 1-week checkup and will have questions galore.

102

Interesting take-away from today’s visit: apparently my non-sedation during the laser portion was an anomaly. My doc actually prefers to have the patient loopy during that part. He said it’s up to the anesthesiologist - and there’s some argument (some worry that the patient will not be able to cooperate / stay still, and also the logistics of transferring from one table to another). He’s putting a note in my file to remind them that I should be sedated from the beginning this time.

And if they don’t, I’ll argue.

I honestly don’t know why they don’t use the same table for both. Yes, the laser table has a special headrest - but they have to immobilize the head for the other part anyway.

The one good thing about this anesthesiologist: he was quite familiar with Restless Legs Syndrome. He knew the only antinausea drug to give (if needed) would be Zofran. He glanced at my feet and saw they were not moving. He discussed the sedation meds (Versed and Fentanyl) to make sure they were OK (they are fine; benzos are often used for RLSers and Fentanyl is an opioid and those also help RLS).

The surgeon is also familiar with RLS - he’s had patients going through near-full-body movements, which is apparently quite a treat to deal with.

Got a new bottle of the antibiotic / NSAID / steroid eye drops and of the dilating drops - the person I spoke with said the doc does not want to reuse the dilating drops from before (though the damn bottle is nearly full) due to concerns over contamination. And apparently I MUST keep both bottles of triple eye drops separate, and continue to use the old one only in the left eye, and continue using the new one only in the right eye. :rolleyes: I sort of understand - but I’m pretty careful about not touching that dropper - and for about 10 days that means I’ll have to grab 2 separate bottles every time I need drops, and make sure I don’t use the R bottle in the L eye or vice versa. Pretty silly and somehow I expect i’ll botch it. I asked for a Sharpie right there and labelled the new bottle.

103

3 days away. Started the drops for eye #2 today. I’ve got those (plus the new dilating drops) in a little zip-loc, separate from the older bottle (which may not last another 10 days - may have to ask for another one - boo!). Getting very familiar with that faint nasty taste I get an hour or two afterward (as it works down through the nasal passages and post-nasal drippage).

I got an email survey about the recent experience, and checked ‘No’ for “did they make you comfortable?” - and explained just why, at the end. Also complimented them on the efficiency, anesthesiologist’s knowledge of RLS, and their letting me have my iPod.

Here’s a horror story: an acquaintance of ours had eye surgery recently - something to do with a hole in the macula or whatever. The repair work done means he’ll need cataract surgery in a few months - evidently it causes cataracts. I assume because a laser was used; I once asked my now-ex doc about laser treatment for persistent floaters and she said it causes cataracts.

Anyway - this guy is VERY eye-phobic. And the doctor insisted on attempting the surgery without sedation. And when that was impossible, evidently he got REALLY light sedation. :eek::eek::eek::eek::eek::eek::eek::eek::eek: I told the mutual friend who filled us in on this that the doctor was a complete ass - and he should definitely find someone different for the cataract work. Poor guy :(. The closest I could compare this to would be if someone tried to do a root canal on me with only local - which has indeed happened, and was pretty horrifying.

104

My daughter-in-law has VMT (Vitreomacular Traction Syndrome) in one eye, which has led to a hole in the macula that happens to be dead center in her vision. She’s going in for surgery this week, which apparently results in having to remain face down for two days. The surgeon told her that it will likely lead to cataracts, which will mean additional surgery at some point.

105

:frowning: Poor thing. Sounds like it might be the same as our acquaintance had. At least she knows to insist on the sedation!!

And you have good recent advice for her from your wife, on the cataract surgery itself.

106

Bumpdate: had #2 yesterday. Met with the nurse-anesthetist beforehand. She tried insisting that I had had sedation on board for the laser portion. I insisted I had not, and needed something this time.

It seems to have worked - that part seemed to go by much faster.

Though I was definitely less sedated for the eye portion. I think what happened was she decided to give me the same amount in total as I’d had the previous time - and having had some for the laser bit, I had less for the cataract portion. Which wasn’t a problem, except that twice, I jumped a bit (the doc actually warned me he was doing something, the second time, and I jumped anyay). Fortunately it wasn’t something that was an issue!!

Checkin was annoying. Normaly you give your name, and they call you back in a few to do all the paperwork and get your bracelets and make a payment. Well, I had to do the payment and stand around at the desk while she clicked on various things, and get my bracelets, right there standing at the desk.

Then i was taken into a cubicle to do all the signoffs - and that stank. Literally. The cubicle REEKED either of the person having bathed in something nauseatingly sweet, or someone had dropped an entire case of some cheap air freshener. It was vile, and I was frankly a bitch about it. Then she wanted me to sign all this stuff on a tablet - but I couldn’t see anything but the signature page - I was expected to sign without seeing what I was signing. Yes, I was bitchy about that.

The procedure… aside from the inadequate sedation (and the doc today even commented that he could tell I was more aware), no big deal. The nurse doing the preop stuff was the same as before - and went straight for my one good vein (outside of my right elbow). They don’t normally like to use that one but I’ve had to have them go there before.

Afterward, sort of annoying: they had me go to two different places for post-op. Last time, I went to one, where they did everything including getting dressed etc. And no crackers this time, just a little juice.

Saw doc today. All looks good. I don’t have good distance vision in that eye yet though I can tell it’s improving. I’m fairly close to 20:20 in the left eye, which is nice. I picked up some reading glasses beforehand, or I wouldn’t be able to see the computer well at all., I’m hoping the two eyes will learn to work together enough that I can see at computer distance, which was sorta the point of choosing the lens I did.

I have permission to play in the snow next week: we’re visiting our daughter in Vermont, very near a major resort - and while we’re not going to ski for several reasons, they have tubing and a mountain coaster. Doc said that as long as it’s a full week, and I wear goggles, it should be fine.

The one annoying thing when they try to measure how well I can read the chart: Because of the multifocal, there’s some ghosting of the letters that can make it tough. I hadn’t expected that. I assume the brain will learn to work around that.

107

I was having some double vision stuff right after having my second eye done – only while watching TV from bed, a distance of about 17 feet (I have distance only implants) but it has now gone away. The doc told me to NOT use only one eye when that happened. I think it is a matter of retraining the brain.

108

Interesting. I assume that phenomenon is only when you are using two eyes anyway.

I’ve been told it can be months to a year before the brain is fully rewired. Us younguns might have a slightly easier time of it.

My double vision is clearly (hah) just one eye at a time - and even then, only noticeable with things like eye charts.

The haloing around traffic lights is very noticeable now. Before #2, I saw some with the left eye but more with the right eye - I am thinking that cataract was beginning to advance also. Now I see very definite haloing - but it’s more predictable.

I think my night vision has improved a lot (ignoring the haloing). I felt like when I was going about with only 1 bionic eye, my night vision hadn’t improved as much as I expected. But today leaving a movie after dusk, it felt better. Also the other day, I asked my husband whether he’s changed a lightbulb in our bathroom - as the room seemed so much brighter. He looked blank and said it had been quite a while. So clearly the second eye being finished made things improve a lot more!

109

My opthamologist/retinal specialist gave me interesting advice this week when I asked about lens options - I prefer to wear glasses only for distance and can read printed material/screen just fine without correction.

[ol]
[li]He said I will need surgery in 2-3 years[/li][li]No improved multi-focal by then[/li][li]I should decide need for surgery based on how I can see, not what a Dr says[/li][li]Do non-dominant eye first, with reading correction.[/li][li]After a few weeks, if I can still read without issues, do the dominant eye with a distance correction[/li][li]Bingo - monovision with no glasses needed.[/li][/ol]

#3 seemed odd to me. He said I have early cataracts that are darker than normal. They look worse than they are but I still have good vision. He said many optometrists and some MDs would think they were ready for correction.

110

Interesting.

The only consideration is that they no longer want to wait until the cataract is “ripe”; that used to be the case, but with more modern techniques it’s easier to do them earlier vs later.

As long as you can see well enough to do what you need to do - i.e. are legal to drive, can read etc. without needing increasingly stronger lenses, and as long as the cataract isn’t progressing too rapidly (like mine was, and I gather enipla’s was) then there may be no need to rush… but my personal opinion is that if you want it done, there’s no strong need to wait either.

“No improved multifocal in 3 years”: the one comment I have there is regarding my doc’s suggestion of the ReStor vs Symfony: they have more experience with the ReStor material. In 3 years, they may not be making recommendations for that reason.

Monovision has always horrified me. Given the issues I’ve had in the past with differences between the eyes, i.e. completely unable to get used to progressive lenses largely because of the different prescriptions (my eyes were always close to 2 diopters apart), I was convinced this was the path to a constant, unremitting, and UNFIXABLE headache. I’d hear about people opting for monovision when having LASIK, and I thought they were nuts.

Then I began developing that cataract… and found that I’d essentially developed monovision on my own :D.

So when I was trying to make lens decisions, the scenario you describe is pretty much exactly what I’d have wound up doing had I gone with single-vision lenses. The doc would have had me adjust my less-dominant eye (the one with the worsening cataract) as the “close” eye - so I’d have needed distance glasses until the second eye got fixed.

Re my own recovery: We were opening Christmas presents this afternoon - and I received several gadgets which came with very small print - and I had a hell of a time reading the instructions even with reading glasses. Then I used the “reading glasses” app on my phone - and used the flashlight-on mode, and had a lot less trouble :D. I knew the adjustment to nonexistent closeup reading was going to be a challenge, and I can’t complain that it’s truly a surprise, but it’s an annoying reality.

On the plus side: I’m typing this on the computer with no glasses at all. My intermediate vision is definitely improving.

And on the “I’m peeved” side: The doc gave me custom-made eye drops that have the steroid, NSAID and antibiotic all in one. I was assured the bottle would last the full 3+ weeks I needed it to - but if I ran out, they had more at the counter at both of their offices.

So I’ve been eking out the left eye’s drops and finally gave up today. I’d bought a spare bottle, so I brought it out, opened it… and stared blankly at the nonexistent dropper tip. As in, totally unusable.

I had to use the right eye’s bottle for the left eye this afternoon - something they expressly told me NOT to do - and I’ve got to hope their office is open early tomorrow morning as we are boarding a train at 9:05 and I need them to give me a replacement bottle.

111

Forgot to mention this one before I disappeared for the holidays:

We went to see Aquaman 2 days after my second surgery.

Sat through the ads etc., then the theatre went dark and the promos began…

and I panicked and asked my husband and friends “Is this blurry???”! :eek::eek:

I was very, very relieved when they said it was blurry for them too: the projectionist had mistakenly shown a 3D movie promo in the regular theater. :smack::smack::D:D

The eyes seem to be settling down now. Seeing the computer is still a bit tricky - reading glasses do OK most of the time. I can’t see well enough without anything. Distance: the right eye (always better than the left) has settled down to be slightly better, distance-wise, than the left. I’m driving without glasses of course. I see myself settling into one of those people who has reading glasses scattered all over the house, and/or has a pair dangling from a cord around my neck.

112

I’m back. My turn for a bumpdate, because my cataract surgery is scheduled for next Wed 16 Jan. Left eye, and only 1 eye will be done, because it’s the same eye where I had a torn retina about 3 years ago. I’m 57 and my R eye is fine. The cataract that developed in the last 3 years, a result of the L eye vitrectomy, and SF6 gas bubble (sulfur hexafluoride) injected into my L eye to repair the retina tear. The retina doc said a cataract will almost certainly develop because of the retina repair. Well, here we are, and all systems are a Go.

Gee, since this thread started at the end of June 2018 we’ve not only had enipla have his cataracts done (he’s the OP), but we’ve since also had Mama Zappa’s, Turble’s, Chefguy’s wife’s, and jasg’s cataract surgeries. Also, my mother-in-law had one eye done about 3-4 weeks ago, and today she’ll have her second eye done. She loved it so far! Also, carnut said he’ll need his done soon, but I don’t think it is scheduled yet. Did I miss anyone else? Calling all cataracts!

I went in yesterday for my pre-surgery check and had lots of measurements taken. They’ll remove the cataract using phacoemulsification, the usual and standard process for 90-95% of cataracts. It will require a 1/8th inch incision above the lens, and ultrasound and a needle to break up and suck out the cataract and lens.

Because of my astigmatism, I will then have a toric monofocal lens, a toric IOL (intraocular lens) put in. I’m expected to miss work on Wed 16 and Thu 17 Jan. On Fri 18 Jan, depending on how it’s going, I might be able to work, we’ll see, although I told my boss I might be out also that day. In either case I should be back to work on Mon 21 Jan.

Last week I had my primary doc, my PCP, give me a pre-surgery authorization and labs. Like another poster above, my cataract surgeon said if they don’t receive the clearance from my PCP, they might not do the surgery. Anyway, that’s done. Everything checked out fine, and my labs were normal except my platelet count is a little high. It is 414, where the normal range is 150-400. So my PCP is going to recheck in a month or two and monitor that. High platelets — I wonder what that means?

I’m a regular platelet donor at my local blood bank, I have about 175 donations, blood and PLTs over the years. My PCP said I should stop donating until we get this checked out.

Anyway, back to the cataract — I am very excited about having this done! As I said earlier above, my eyesight had been excellent, corrected with eyeglasses to 20/15, but in the last 2 years as the cataract developed my vision has been slowly degrading. Night driving is fine still, but I’m a software engineer and it’s getting harder and harder to read my laptop screen, and in conference rooms it’s harder to see the screen. And I’m one of those who prefers to sit in the back of the room!

So, yeah, looking forward to this next week!

113

Good luck!!

I’ve read (here and elsewhere) that cataracts often develop after a vitrectomy. I wonder why that is…

You’re close to my age, as is enipla. We’re all looking at a high chance of posterior capsule opacification. Supposedly if that happens it usually shows within a few months.

At my 2-week followup, the doc told me that he’s done cataract surgery on toddlers: in that case, the incidence of PCO is basically 100%.

114

Thanks!

I asked my surgeon and he said it’s due to the vitrectomy invading the eyeball — between the needle going in and the SF6 gas bubble, the stable equilibrium of the eye’s innards has been disturbed, and foreign bodies have entered in. Tht once stable environment has been disturbed, and the lens and other parts have been exposed to oxygen,

We all have a 20% chance of developing an EPO? That is a high chance, indeed.

115

I had mine today, about 6 hours ago, and so far so good.

I showed up 2hrs before surgery time. Signed a lot of papers, put on the lovely gown (they let me keep my shorts on, I didn’t have to totally strip down). Much of the prep was them putting lots of drops in my eye — left eye, the only one I’m having done. Oh before that was no eating or drinking — the last meal I had was dinner at 8 last night. This morning, just a sip or two of water while teeth brushing and taking meds.

The entire staff was polite, professional, and friendly — receptionist, nurses, anesthesiologist, and the surgeon who was the only one I’d met before. A pleasant enough group.

I was awake and alert throughout, except towards the end when they must’ve given me more happy gas because I don’t remember some things they said we’d discussed. The entire thing was comfortable throughout. Even with the surgeon working on my eye, even though it might seem like an icky squicky thing to be alert for, it wasn’t at all because I did not feel a thing — only a sense of pressure during some parts of it. Not a problem, not bad at all.

I got a toric IOL because of my astigmatism, and since the surgery I’ve been wearing an eye shield to keep me from rubbing it so as to not disturb the angle it was inserted at. I’ll wear the shield tonight while I sleep. After a couple of days the IOL will take hold and won’t drift.

I’m pretty sure I could have driven myself home, I felt that good and could see well enough. But my wife drove me.

I have a follow-up tomorrow morning. Right now I feel fine. It’s 2130 here in California and I’m ready for bed.

My vision is blurred. I can see how many fingers I’m holding up, but can’t make out much more than that.

I never asked about EPO. I might, tomorrow.

116

Good thing you didn’t drive yourself home - it’s surprising how impaired you are even when you feel fine (judging by my own experience with numerous sedation procedures where I feel OK… then go home and crash).

I got lucky in that I only had to arrive an hour before the procedure both times.

As a side note: I think the hospital screwed up the billing for my extra lens… I paid 790 the morning of the procedure… and got a bill for 790 the other day. Now I have to remember which credit card I used and complain to them. I think it was probably related to their doing the steps differently: usually they take you into a cubicle to do all the paperwork and make a copay, but this time around the receptionist did that part.

117

It’s been 9 days since surgery and everything is great. After 2 follow-up exams my L eye is nearly 20/20 uncorrected! Call it 20/25. I haven’t worn my eyeglasses since the surgery., and after wearing eyeglasses since I was 18 (I’m 57) it is a weird sensation not having them on.

I will need eyeglasses, mostly for my R eye but the L eye will have a minor correction… I’ll order that prescription after my 1-month exam shows that my eye is stable and healthy.

So far so good, and I am very happy with the result.

118

Shweet!!!

I too keep reaching for my glasses at the wrong time, and forgetting them at others. I keep my readers on a cord around my neck. Sooooo cliche, but it works. And I’ll try walking with them on, or forget to put them on and wonder why I can’t read the computer :D. It’s been 10-15 years now where I’ve had one pair of glasses for driving, and another for everything else, and I still try to swap glasses when I get into and out of the car.

I’ve been a bit disappointed in my intermediate vision - I really can’t see the computer without the readers, and I’d hoped that would be covered by the multifocals. Oh well; I guess I couldn’t read the keyboard without them. And I can manage to see the car dashboard and the phone’s nav display, which were both issues when I was using single-distance driving glasses.

What kind of haloing etc. are you seeing? I still see some shadows at night - e.g. if I see a speed limit sign, I see a ghost of the sign below and to the left of it - just the edge, as if there were a translucent version offset by about a foot. Headlights tend to give some ghosting as well… from a distance, I see a ghost image to the lower left AND the lower right. That disappears as I get closer.

Still some haloes around lights at night, but overall not troubling and no worse than before surgery, just different.

119

I’m jumping onto this thread because I had cataract surgery two days ago. My eye (the right one) is great. Colors bright and vivid. No pain or discomfort. I’ll probably still have to wear glasses, but I love my glasses, so no prob.

The bummer is the aftereffects of the anesthesia (Versed), which I started a threadabout this morning.

Bullitt, what kind of anesthesia did you get? You said “awake and alert” and “happy gas,” so would you go into a bit more detail? I want to have the other eye done, but I don’t want to go through the anesthesia ordeal I did yesterday.

120

Thanks! And yeah, I just got readers too, temporarily until I get my new Rx. I considered the cord too, actually had it in my hands, but then decided naah, I’m NOT going to walk around with readers on a cord around my neck. I’ll deal with carrying them.

I actually don’t get any haloing, and I wonder why that is? I’m sorry you’re dealing with that. I hope it’s temporary and goes away!

I really don’t know what they gave me. I use ‘happy gas’ as a slang. I’m pretty sure it was administered through the IV. Talk to your doc about it to see if they will change what they used. Good luck, ThelmaLou, I hope you can avoid that again. Sounds very unpleasant.