 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Vision / May 2005Cataract Surgery yesterday
What is fogginess after a cataract operation? And how come we're photo-sensitive afterwards? Yesterday I had cataract surgery at my local public hospital. It was performed under the New Zealand free public health service, and was rather an excellent experience. The most discomfort I felt was in the anaesthetic room prior to surgery where they fitted the block at the side of the eye, somehow seemed like they were manhandling the eye sideways a lot, and that felt awful. I wasn't sedated, and found it very interesting to be awake and having my occasional questions answered as they operated on me. (I wished they'd've hooked up a video feed from the surgeon's eyepiece to a VCR recorder and provided me with a tape like the one I got from my retinal re-attachment op 5 years ago.) They gave me a piece of the IOC packaging: AcrylSof by Alcon, Texas. Model SA60AT Power: 13.5 D. My other eye is -3.50. The aim is to give me an IOC that will result into some myopia, -1.25 or thereabouts. I'm very pleased with that. After the op the eye was covered with full eye covering and shield. That same day I was in slight dull pain after the meds wore off, but nothing much. Day 1 after. I woke up pain free, but very photo-sensitive to light coming in through the (white) eyepatch. I went into the hospital this first morning and they removed the eye covering. However I was greeted by very cloudy vision - like a heavy mist - and extremely sensitive to light. Fairly sharp pain on looking at daylight, say, out the window. Eye pressure was normal (15), and they said the mistiness is also one of the usual responses. Perhaps overnight pressure build up and caused some reaction of the cornea to fog up. Day 1 late afternoon and the mist is clearing. Just a hazy halo effect from any brightly lit parts. What might this fogginess have been? and how come we're photo-sensitive after a cataract operation? Thanks  SignatureAuckland NEW ZEALAND > What is fogginess after a cataract operation? And how come we're photo-sensitive > afterwards? There is some corneal edema (swelling) and your eyes are widely dilated on the day of the surgery. This should be pretty much gone by the next day. > Yesterday I had cataract surgery at my local public hospital. It was performed > under the New Zealand free public health service, and was rather an excellent > experience. The most discomfort I felt was in the anaesthetic room prior to > surgery where they fitted the block at the side of the eye, somehow seemed like > they were manhandling the eye sideways a lot, and that felt awful. It does. When I had mine done, I found a surgeon who used anesthetic drops alone. > My other eye is -3.50. The aim is to give me an IOC that will result into some > myopia, -1.25 or thereabouts. I'm very pleased with that. Good choice. > After the op the eye was covered with full eye covering and shield. That same > day I was in slight dull pain after the meds wore off, but nothing much. [quoted text clipped - 7 lines] > sensitive to light. Fairly sharp pain on looking at daylight, say, out the > window. This needs to be checked carefully. You may have had some corneal damage. Probably will clear up, but I'd stay on top of it. > Eye pressure was normal (15), and they said the mistiness is also one of the > usual responses. Perhaps overnight pressure build up and caused some reaction of > the cornea to fog up. Not if the pressures are 15, which is normal and would NOT cause foginess. > Day 1 late afternoon and the mist is clearing. Just a hazy halo effect from any > brightly lit parts. So it's probably just the dilation taking longer to wear off. > What might this fogginess have been? and how come we're photo-sensitive after a > cataract operation? See above, but still not certain. I'd guess a combo of the dilation and maybe a corneal abrasion. My vision was crystal clear the next morning after both surgeries. But then I had no anesthetic injections and no patching or suturing was required. Did you have any stitches? w.stacy, o.d. >> What is fogginess after a cataract operation? And how come we're >> photo-sensitive afterwards? > There is some corneal edema (swelling) and your eyes are widely dilated on > the day of the surgery. This should be pretty much gone by the next day. The dilation was certainly gone by the next day, when I first had the covering removed. >> I went into the hospital this first morning and they removed the eye >> covering. >> >> However I was greeted by very cloudy vision - like a heavy mist - and >> extremely sensitive to light. Fairly sharp pain on looking at daylight, say, >> out the window. > This needs to be checked carefully. You may have had some corneal > damage. Probably will clear up, but I'd stay on top of it. Thanks. >> Eye pressure was normal (15), and they said the mistiness is also one of the >> usual responses. Perhaps overnight pressure build up and caused some reaction >> of the cornea to fog up. > Not if the pressures are 15, which is normal and would NOT cause foginess. Might the pressure have been higher o/night? >> Day 1 late afternoon and the mist is clearing. Just a hazy halo effect from >> any brightly lit parts. > So it's probably just the dilation taking longer to wear off. I noticed that my pupil was not dilated the day after. In fact ATM the eye is less dilated than the normal eye. A smaller black dot. Now it's Sunday, the 2nd day after the Friday operation, and the haziness has diminished somewhat to about 15% of what it was. But it's still hazy or foggy. And brightly-lit things seems to spread into the adjacent dark areas. AS IF the pupils were dilated. >> What might this fogginess have been? and how come we're photo-sensitive after >> a cataract operation? > See above, but still not certain. I'd guess a combo of the dilation and > maybe a corneal abrasion. My vision was crystal clear the next morning > after both surgeries. But then I had no anesthetic injections and no > patching or suturing was required. Did you have any stitches? No stitches, I believe, though I didn't actually check afterwards. I asked before the op and the surgeon said stitches were not usually used. Only in difficult circumstances. I believe mine was not a difficult circumstance. Brian SignatureAuckland NEW ZEALAND > >> What is fogginess after a cataract operation? > [...] > Now it's Sunday, the 2nd day after the Friday operation, and the haziness has > diminished somewhat to about 15% of what it was. But it's still hazy or foggy. After a little googling, I'm now wondering if I have posterior capsular opacification' <www.eyemdlink.com/Condition.asp?ConditionID=354>. Brian Since they mentioned the corneal edema as being visible the first day, it is most likely that, and takes a few days to a couple weeks to clear up, usually, Way too soon for posterior capsular opacification at this point. Usually occurs months later. On 5/14/05 6:49 PM, in article 1116122037.5957d73585f5395554d93963578b32c2@teranews, "quattrocchi" >>>> What is fogginess after a cataract operation? >> [...] [quoted text clipped - 6 lines] > > Brian > Might the pressure have been higher o/night? It *could* have been, but if it measured 15 the next day, any fogginess from pressures would already subside. The cornea swells from high pressure, but clears as soon as the pressure drops, unless something else is causing it. > I noticed that my pupil was not dilated the day after. > In fact ATM the eye is less dilated than the normal eye. A smaller black dot. [quoted text clipped - 3 lines] > And brightly-lit things seems to spread into the adjacent dark areas. AS IF the > pupils were dilated. Could be an inflammatory response. You are taking steroid drops, right? And SHAKING the bottle well EVERY TIME YOU USE IT, right? w.stacy, o.d. > > Might the pressure have been higher o/night? > It *could* have been, but if it measured 15 the next day, any fogginess > from pressures would already subside. The cornea swells from high > pressure, but clears as soon as the pressure drops, unless something > else is causing it. > > I noticed that my pupil was not dilated the day after. > > In fact ATM the eye is less dilated than the normal eye. A smaller black dot. [quoted text clipped - 3 lines] > > And brightly-lit things seems to spread into the adjacent dark areas. AS IF the > > pupils were dilated. > Could be an inflammatory response. You are taking steroid drops, right? Yes. > And SHAKING the bottle well EVERY TIME YOU USE IT, right? <ulp> I'll start doing that right away! Thanks. Corneal edema can occur from reasons other than high pressure. A common cause is just from the shock of surgery and the irrigation inside the eye affecting the endothelial cells on the back of the cornea. When they (the endothelial cells) are not working up to speed, fluid passed though them and gets into the cornea. If they recover, the edema goes away in a few days to as much as a few weeks in severe cases. If they were borderline to begin with, and are further damaged, the edema could potentially stay. Those are the very few patients who end up needing corneal transplants for pseudophakic bullous keratopathy. PS: Shake well means about 20 shakes every time the steroid drops are used. On 5/15/05 7:30 PM, in article 1116210734.690da66a47e23bd162cf3fdea4677474@teranews, "quattrocchi" >>> Might the pressure have been higher o/night? > [quoted text clipped - 24 lines] > > Thanks. > Corneal edema can occur from reasons other than high pressure. A common > cause is just from the shock of surgery and the irrigation inside the eye > affecting the endothelial cells on the back of the cornea. > When they (the endothelial cells) are not working up to speed, fluid passed > though them and gets into the cornea. If they recover, the edema goes away > in a few days to as much as a few weeks in severe cases. Thanks for that explanation. I can now report that today (day 6) I woke up to very litle haze and was also experiencing, understandably, clearer focus. Wonderful. Last night (day 5) I'd noticed with some anxiety that the haziness was still at about the 10%-15% level of day 1. Then such a marked improvement happened overnight. I wonder what my new Rx will be. The surgeon had said she was aiming for around some residual myopia of -1 in the IOL, so yesterday I'd replaced my previous glasses lens (sph -4.50; cyl -3.25) with a -1.00 to try to give me some basic focus. But now that I can see better with almost zero haze the -1.00 lens seems too strong. Or might that be the astigmatism. Brian SignatureAuckland NEW ZEALAND While the cornea is healing, it changes power, especially if there is some edema. Which is why a refraction to order glasses is usually about 4 weeks postop, not a few days. Also, the "aimed for" power is only a estimate - once it heals you can easily be +/- 0.50 to 1.00, mainly because the instrument and equations don't know where the IOL will heal in the eye until it does., so it uses averaged estimates. > Then such a marked improvement happened overnight. > [quoted text clipped - 7 lines] > > Brian > While the cornea is healing, it changes power, especially if there is some > edema. > Which is why a refraction to order glasses is usually about 4 weeks postop, > not a few days. > Also, the "aimed for" power is only a estimate - once it heals you can > easily be +/- 0.50 to 1.00, mainly because the instrument and equations > don't know where the IOL will heal in the eye until it does So, does the IOL heal in the capsule into a permanent position which might be slightly variable, unpredictably, WRT distance from the cornea/retina, within certain parameters? Interesting. I naiively assumed first that the natural lens was free inside the capsule, and second the IOL sits inside the newly vacated capsule. I find it all very fascinating, and thirst for more details. > ., so it uses averaged estimates. I shall wait the prescribed 4wks with bated breath. Brian Signaturewww.adam.co.nz > So, does the IOL heal in the capsule into a permanent position which might be > slightly variable, unpredictably, WRT distance from the cornea/retina, within > certain parameters? Interesting. I naiively assumed first that the natural lens > was free inside the capsule, and second the IOL sits inside the newly vacated > capsule. The capsule actually can "shrink wrap" around the IOL and little or no movement takes place, except maybe the crystal lens which is designed to move a little. Jury still out on that one. w.stacy, o.d. On 5/19/05 2:08 AM, in article 1116493871.48e6734c23beda609c58b3ef915d80ae@teranews, "quattrocchi" >> While the cornea is healing, it changes power, especially if there is some >> edema. [quoted text clipped - 9 lines] > slightly variable, unpredictably, WRT distance from the cornea/retina, within > certain parameters? Answer: YES. > Interesting. I naiively assumed first that the natural > lens > was free inside the capsule, NO. It has attachments to the capsule that have to be lysed to make the lens mobile. >and second the IOL sits inside the newly vacated > capsule. CORRECT. > I find it all very fascinating, and thirst for more details. > [quoted text clipped - 3 lines] > > Brian > Then such a marked improvement happened overnight. Glad to hear it. Always helps to shake the pred forte. > I wonder what my new Rx will be. The surgeon had said she was aiming for around > some residual myopia of -1 in the IOL, so yesterday I'd replaced my previous > glasses lens (sph -4.50; cyl -3.25) with a -1.00 to try to give me some basic > focus. But now that I can see better with almost zero haze the -1.00 lens seems > too strong. Or might that be the astigmatism. Could be. If you didn't have astigmatism relaxing incisions, you'll still need a significant cylinder in your glasses, unless that was late developing astigmatism (lenticular as opposed to corneal). Either way, you'll do fine. w.stacy, o.d. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.