My 2nd cataract surgery isn't going quite as well as the first.

I had a cataract removed Monday morning, and all seemed well until mid-afternoon. The eye started throbbing a bit, not really unexpected, and I popped a couple of tylenol. In a little while I started feeling nauseous, and then I vomited a couple times, and stayed nauseous.

This last was on my list of post-op problems to call about, so I did. I went back into the clinic about 5 PM and they “burped” my eye to remove excess fluid. Meaning they stuck a needle in and drained some goop. That seemed to fix the problem.

Until today, about an hour ago, after a blink and turn of my head. for a moment it seemed as if the new lens had slipped out. No pain or sense of movement, just a total blur instead of the 20/25 vision I’ve been enjoying for the last 24 hours or so. Another slow blink, and near normal vision returned, but noticeably cloudier than a few minutes before.

I’ve talked to the on-call opthamologist, who tells me there’s no need to rush off to the ER. I will be going into the clinic for a check first thing in the morning. The present theory is that this is another variation of an eye “burp”. It turns out that during the surgery they pump some kind of goop into the eye to keep it inflated, and suck it out again at the end, and it wouldn’t be uncommon if some little piece of left-behind goop was working it’s way out from behind the lens. If that is indeed the case, there is no treatment because it has no real long-term bad consequences.

Oh dear Og…Needle…eye…

::shivers::

I hope it all works out for the best, Boyo Jim! Good luck.

Yeesh, I hope it works out OK for you, Boyo Jim. I had to go through this twice when I was a teenager due to congenital cataracts, but my most severe complication was an allergic skin reaction to the eye-patch tape.

Best of luck, man. I’m hoping they get the bugs worked out shortly. I’m guessing the goop they’re talking about is silicone oil, though I could be mistaken.

Unrelated to your situation so don’t worry: I know patients who had it put in their eyes during various surgeries and it’s had to stay there. One of them had the cataract removed but no lens re-implanted, plus other eye problems that required silicone oil in the eye, and he has to avoid sleeping on his back (I think… I’m pretty sure the stuff floats compared to the vitreous gel) or else it’ll get into the front part of his eye and mess with his vision further.

nonacetone - it’s amazing how quickly this sort of thing goes from “worst nightmare” to “common beneficial treatment” when you work in the field. :smiley: I’m trying to figure out if knowing that eyeballs are actually pretty damned tough (comparable to leather) is comforting or even more disturbing…

Hey, a needle in my eye is one of my nightmares, too! And I don’t otherwise have a problem with needles.

I’m not sure which is worse…needles in eyes or bugs in eyes.

Anyway, Boyo Jim, good luck. Here’s mud in your eye.

Boyo Jim, we’ve been keeping a sharp eye out but haven’t seen you posting yet today. How’s the eye?

Yes, please tell us how you are doing. Please include more about the needles in your eye.

His absence is slightly troubling.

gulp

I’m keeping my fingers crossed that things went well today.

Hello, I’m back.

I lay claim to being one of the most experienced cataract surgery patients ever, having undergone a third surgery rather apruptly last night.

My opthamologist determined the lens had become partially disconnected. There is a circular lens with a couple of wing-like thingies called haptics (sp?) that goes into the eye. The haptics are the things that get embedded into surrounding tissue and fuse into it over a 2-3 week healing process. This locks the whole implant in place. Until it locks in, it’s kind of like a leaf spring, held in position by tension. One of end of the spring came loose.

The surgery not not an emergency of the type that my life or even my eyesight was at immediate risk. Rather that it was important to get the lens back into position ASAP before tissues had healed or scarred up. So he asked me when I last ate – I said noon – and he said we’ll try and arrange a table for you around 6 PM. They needed to wait at least six hours after my last meal due to rules about anaesthesia.

I have to say, one of the strangest aspects for me was that this whole process took place with me never setting foot outdoors after coming into work yesterday morning, at the hospital. I started work at 630 AM. I walked across a skywalk to go next door to the opthamolgist office, and back into my own building to go back to work at my desk until it was time to mosey over to the 4th floor and change into a surgical gown. Got operated on. Got out of there about 730 PM.

Continued.

The surgery seemed to go very well. I was noticeably less sedated this time – I was much more aware of what was being said and done, and of physical sensations during the procedure.

I talked at some length to the anaesthesiologist ahead of time, and learned some new things. I mentioned to him that during Monday’s surgery I had moved around some during the surgery – I don’t know exactly why but I had started to raise my arms, and the surgeon told me that I had briefly torn loose some tape holding my head in place.

So I thought I needed more anaesthesia for this next time. But what he hold me is that I probably needed less. He said it’s pretty much like getting drunk – you’re calmer and relaxed with 1 or 2 drinks, but some people who have 3 or 4 start to have behavioral problems. They gesticulate, they get insistent, they lose ability to focus. Anyway, I was probably able to be intelligibly conversant at any point during the procedure, but I was being careful not to start chattering, as I was warned not to move or say anything unless I was directly asked a question.

The procedure itself was to put the haptic edge back under the tissue, and then to rotate the whole assembly a bit to lock try locking it in place more firmly. Kind of like a self threading screw. By all indicators it went well, and only took about 20 minutes.

This morning about 2 hours ago, back at the clinic, they took off the patch and tested the eye – which tested at 20/25, exactly the same as it tested after Monday’s surgery.

We’re glad you’re okay, Boyo. Collective release of breath!

Thanks for the kind comments and thoughts sent my way.

I’ve just crawled out of bed briefly to check email and get some food in me. I have some Tylenol and codeine pain pills that I’m using pre-emptively just to knock myself out and sleep. I have little to no pain. Lucky for me, even when the lens came loose, there was no physical sensation at all, just a visual shock having a totally blurred vision, as if the surgery hadn’t taken place on Monday.

My doctor said that he hasn’t had a failure like mine in 27 years practicing. He has had other lenses come adrift in other slightly different procedures. The type and location of the cataracts will determine slightly different procedures and/or lenses to deal with them, but my particular combination hasn’t failed him this way before.

There is a protocol when a surgical resident is assisting or observing, that both the surgeon and the resident look at the final position through a scope and agree that the placement is correct and the flanges are properly seated. This happened in my case Monday – the term used was “in the bag” – meaning it was embedded in the eye capsule.

Then my surgeon told me another story about a previous resident, who looked at someone’s lens and DIDN’T think it was properly set, but he kept his mouth shut. He mentioned it afterward while the patient was in recovery, so they had to drag the poor guy back into the OR and resedate him so he could be checked again. Turned out the resident was wrong, and the second trip into the OR wasn’t necessary – but it was the surgeon’s way of telling me that he checks all these things very carefully before he lets someone out of the OR. He didn’t want me to think he’s botched the original surgery.

Which I don’t – I had this very specific visual episode 4 days after the surgery, with no forewarning at all. My head was cranked to the right about as far as it would go, and my eyes were turned to the right as far as they could swivel, and I squinted and blinked. Given the physical conditions he said would be necessary to cause a problem like this, the circomstances fit perfectly. The necessary condtions were unusual compression of the eye, and a pressure diferential. The fluid behind the eye was squeezed and forced the lens out of its way.

Glad you got it fixed! Keep us posted.

Boyo, I need one but have postponed it for years now. The other one is starting to have diminished vision so I’ve got to get the bad one done soon. Haven’t seen the eye doctor in 3-4 years.

How long were you/will you be out of work?
How soon did they let you drive afterward?
How long did you wear the eye patch?
Do post-op routine procedures require a second person (eye drops, personal care)?
Any other suggestions to alleviate my concerns?

Both cataracts:
Had surgery Monday morning. Had patch removed Tuesday morning. Drove Tuesday morning. Back at work Wednesday morning.

(Second cataract): Lens apparently popped loose Wednesday night. No pain. Exam Thurday afternoon. Surgery Thusday evening. Patch removed Friday morning. Drove Friday morning. Pretty much stoned on Tylenol and codeine since, not that I really need to, but because I can. :stuck_out_tongue: I do feel a little extra beat up this week having two surgeries, one of them by surprise.

They also provide a kind of hard plastic shell/patch that they suggest you tape over your eye for sleeping, the first couple of nights. I am using that, as I am a little worried one of my cats might put a paw in my face as I sleep. Otherwise I probably wouldn’t bother with it.

Really, despite this complication, which seems to be fixed rather simply, this has been a very smooth process. Very little pain, very big gain.

Good to hear that it sounds resolved.

Sorry, I forgot other post op stuff.

They require someone with you at the surgery to drive you home. There are a bunch of drops to put in, after they take the patch off the next day. They insist you wear UV protective shades for the next 2-3 days. And drops go in every 3-6 hours for the next couple of weeks. If you’re good at that your don’ need anyone to help you.

You are not supposed to bend down from the waist for a couple of weeks – this is about keeping pressures from building in the eye. Also, no lifting more than 10-20 pounds for a couple of weeks.

There are also several visits over 2-3 weeks post-op, at any of which they might dilate your eye and driving might be a problem for a while after.

So, except for getting home immediately after surgery, odds are you can do this entirely solo and miss 2 days of work. My “make good” surgery would also have cost me 2 days, but the 2nd day turn out to be a Saturday.

If this was a weekday, I’d be at work today, unless I wanted to milk it for an extra day, which I’m sure I could have.