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Medical Forum / General / Vision / April 2005My cataract surgery
As I mentioned in another post, I had bilateral cataract surgeries in January, 1 week apart, and had the Tecnis Prolate Silicone lenses put in by David Chang, M.D. of Los Altos. I thought I'd give a little summary here of my experiences. I sought out a surgeon who uses small incision technique with lots of experience and chose Dr. Chang because of his credentials (among other things he teaches at UCSF medical school) and his experience in small incsion techniques. Pre-op I was myopic with significant oblique astigmatism and agreed to let him also do a couple of astigmatism "relaxing incisions" while he was at it. The procedures were relatively painless (easier than having my teeth cleaned) and quick, about 12 minutes on the table. What surprised me is that the recovery was so rapid. I was never uncomfortable and was only a bit blurred for a few hours post-op. We targeted -.50 as the resultant refraction, since I've been myopic all my adult life. It ended up -.50 -.75 x 60 20/15. So we shot for 0.00 on the right eye and it ended up 0.00 - 0.25 x 60 20/15. The refraction has changed very little since the procedure and I now like to watch TV without my glasses. I can do lots of things without, but prefer to wear progressives most of the time for the perfection of vision I'm used to, and for the small print. The clarity of the Tecnis lenses is amazing, the prolate surface eliminating most if not all of the spherical aberration of other lens designs. As a 61 year old optometrist, I've learned a few things about modern cataract surgery from this experience, and would be happy to pass along any other info about it that anyone wants to know. William Stacy, O.D. (actively practicing in Folsom California) (please excuse the duplicate post) w.stacy, o.d. thanks for your post. Glad to hear your surgery was successful and your healing immediate. My healing is very slow, and I'm in the small percentage of people who have had complications. My ophtalmologist (sp?) did not warn me (he said how quick and easy this would be - ha!). I've been to another doctor and he diagnosed me as having uveitis - he gave me pred-forte drops to address the inflammation. Do any of the professionals on this forum have an opinion of the emergence of uveitis following cataract surgery? Is it because of something occuring during the procedure or am I simply one of the unfortunate few? Could this be a reaction of my eye to the foreign body (the implant) ? I'm also seeing various visual aberrations that I'm trying to ignore until the capsule completely heals around the IOL (it's been about 3 1/2 months since the surgery). Thanks - Karen > thanks for your post. Glad to hear your surgery was successful and your > healing immediate. My healing is very slow, and I'm in the small [quoted text clipped - 9 lines] > capsule completely heals around the IOL (it's been about 3 1/2 months > since the surgery). Thanks - Karen Hi Karen. Sorry to hear of the complications. Yes, uveitis is a problem probably related to the surgery, and yes, it can be a reaction to an intra-ocular foreign body. One of the reasons I sought out the best surgeon was that I was deadly afraid of complications. I don't know all the particulars, but yes, pred forte is indicated to supress the inflammation. Another reason I went with the Tecnis lens is the square edge that seems to help cause a tight "shrink wrap" around the IOL early on, which helps to prevent any after-cataract problems. Anyway, good luck and keep us posted as to your progress. w.stacy, o.d. >As I mentioned in another post, I had bilateral cataract surgeries in >January, 1 week apart, and had the Tecnis Prolate Silicone lenses put in [quoted text clipped - 29 lines] >William Stacy, O.D. >(actively practicing in Folsom California) Bill, The suspense is killing me. What were your pre-op cylinders? It sounds like you had topical anesthesia? The left eye Rx is impressive. I'am seeing this more often as of late and am amazed at how close they can come to the intended target. Thanks for taking questions. I'am glad to hear that the surgery was a complete success! Respectively, Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical robopt@execpc.com ~~~~~~~~~~~~~~~~~~ "An expert is a person who has made all the mistakes that can be made in a very narrow field." - Niels Bohr >The suspense is killing me. What were your pre-op cylinders? > > That's a very interesting part of my story. My refraction had been stable for about 30 years (not counting the presbyopic add changes): R -1.25 -2.50 x 105 20/15 L -2.25 -2.50 x 86 20/15 Then starting in 2003, my myopia started increasing, and so did the cyl. When I decided to throw in the towel last Dec, it was: R -2.25 -4.00 x 103 20/25+- L -3.25 - 2.50 x 78 20/40+- Dr. Chang based his relaxing incisions on the corneal cyl only, the presumption being that the increase there was totally lenticular. >It sounds like you had topical anesthesia? > > Totally. I did get some IV Versed, which I think "took" for the 1st procedure, as I only remember parts of that one. I think they missed my vein or forgot to put it in, or maybe they "undercorrected'" me the second time, as I remember every tiny little part of that one, and do remember some definite discomfort on that one. Not intolerable, but I guess I prefer a stronger cocktail. >The left eye Rx is impressive. I'am seeing this more often as of late and am >amazed at how close they can come to the intended target. > > I like to think that my pre-op self-refracting was partly responsible, but then Dr. C. has the latest and greatest in autorefraction and axial length measuring equipment. He didn't even have to do an ultrasound scan on me! >Thanks for taking questions. I'am glad to hear that the surgery was a complete >success! > Me too! w.stacy, o.d. > As I mentioned in another post, I had bilateral cataract surgeries in > January, 1 week apart, and had the Tecnis Prolate Silicone lenses put in [quoted text clipped - 27 lines] > William Stacy, O.D. > (actively practicing in Folsom California) You are so forunate that everything turned out perfectly. I had cataract surgery in late January (both eyes, one week apart). The right eye turned out perfect and was totally healed in one week. However, I'm still having problems with my left eye--a smudge-like blur in the line of vision or it could also be described as a little cloud passing in front of my eye (very disconcerting!). I also have what appears to be a shadowed arc at the left of my eye. The doctor said it's a bruise. Shouldn't that be healed by now? According to him, the "smudge" is a normal viscous material that has loosened in my eye and will move....in time. I just fear nothing will ever change. Other than that, I can see well enough in that eye, and now need glasses only for reading so in that respect, the surgery was probably a success. Diane McGill I had > cataract surgery in late January (both eyes, one week apart). The right > eye turned out perfect and was totally healed in one week. However, I'm [quoted text clipped - 3 lines] > shadowed arc at the left of my eye. The doctor said it's a bruise. > Shouldn't that be healed by now? I kind of doubt that a bruise would cause that arc. Sounds more like you're seeing an edge or part of your IOL. I notice something like this when I do an unusual eye movement like "crossing" (voluntary overconvergence) of my eyes, whereupon I see temporal peripheral darkish arcs on both sides. I don't see this under normal visual activities and am not completely sure why it appears then (any ideas, other docs?). And yes, a bruise would normally be gone by now. One of the things I like about my procedure is that the incisions were the "clear corneal" approach rather than scleral, so there was no bruising, no blood, etc. and my eyes looked normal right after surgery (except for the dilation, which took a few hours to go down). I could have gone to work the next day with no problem. According to him, the "smudge" is a > normal viscous material that has loosened in my eye and will move....in > time. I just fear nothing will ever change. Other than that, I can see > well enough in that eye, and now need glasses only for reading so in > that respect, the surgery was probably a success. > > Diane McGill Hopefully he is talking about vitreous material, and not left-behind visco-elastic material (from the surgery). If it's a vitreous floater, you pretty much have to get used to it. I had one of those before surgery and it's still there. The procedure for removal of vitreous materials is pretty invasive and generally reserved for really troublesome problems. Hope your issues clear up soon. If not, go back and ask about them again, or get a 2nd opinion from a cataract specialist (one who ONLY does cataract surgery), or from a vitreo-retinal specialist, who would probably be the one doing any fixes on these problems anyway. w.stacy, o.d. |
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