A Sharp Stick in the Eye

So yesterday, after much waiting and puckering up, I got the cataract removed from my right eye and a replacement lens implanted.

It’s in the Scriptures, you know: If thy right eye offend thee, pluck it out. ;^)

I had it done by an eye surgeon who has done thousands of these operations (she did six others the same day as mine) and, more important, is an old friend. Her daughters were in preschool with mine, and they were friends, and I’ve seen her take care of small children. It turns out that inspires a certain kind of trust.

I showed up at the outpatient surgery at 1:00 pm, sat around for half an hour, and was taken inside and laid out on a gurney. A nurse put stuff in my eye to numb it and to dilate the pupil. I was asked several different times by different people what I was there for and which eye was to be operated on. It’s a system for avoiding horrible mistakes. At some point, someone stuck a sticker above my right eye. But a couple more people asked which eye, even so.

At some point I was lying there with my eyes closed, as per instructions, and I heard Dr. Chang (not her real name) talking with someone about whom to work on next. She said “Whichever one is fully dilated first, I’ll take that one.” I won the race, and was wheeled into the OR.

Now, this was not the kind of OR you see on TV. No cluster of sweaty docs and nurses arguing with each other and waving electroshock paddles around. No one hollering “Push another amp of epi!” The anesthesiologist explained that he was giving me a light dose of sedative, just enough to relieve anxiety. But they didn’t want me to go to sleep, and there would be no pain. They didn’t want me to talk, because that makes the head move, but they wanted me to speak up if I was in discomfort. I could hear Dr. Chang’s voice too, then she came into view in a surgical mask and bonnet, and placed a hood of some translucent plastic over my eyes. She pushed something into place that held my right eyelids fully open, and put in more drops. But from this point on, everything happened from the side and I could only see blurry lights.

At some point I felt some pressure on my eye, nothing worse than when you press the heel of your hand against your eye or rub your eyelid with your fingers. The blurry lights moved around and the blurriness changed, and I could hear people speaking quietly, saying things like “OK, a little more” or “There we go.” Every few minutes a blood-pressure cuff on my arm would inflate.

There was a weird noise, halfway between bad electronic music and whale songs. eeee-yaaaa-woooo-aaaa-waaaaa-yowww-wwwoww-wwoww-yeee-zoop… Later I learned this was audible feedback from the ultrasound machine that was being used to destroy the lens of my eye (with its cataract). Helps the surgeon know exactly what is happening at the tip of the ultrasound probe. This went on for quite a while.

The sound stopped, and there was more waiting while the blurry light moved around.

Dr. Chang had made a very tiny incision at the edge of my cornea, and inserted a thin tube through the incision and through my pupil. All the instruments passed through this tube, including fiber optics so she could see what she was doing. Now (though I didn’t know it yet) she was passing in the new lens, an acrylic plastic jobbie with two springy arms to anchor it within the remaining shell of the lens capsule. It was rolled up like a doobie to pass through the tube.

Suddenly, the blurry lights became sharp images of what I suppose were the actual lamps shining into my eye. I heard Dr. Chang say “There it is.”

When she removed the tube, the incision immediately healed on contact. No stitches required. The plastic hood came off my eyes and I could see — very blurry through the right eye, as I had been told to expect.

I think the operation took about 45 minutes. Half an hour later my wife picked me up and drove me home. The worst discomfort was the tape being yanked off my arm when they removed the anesthesiologist’s IV tube.

My vision in the right eye was quite blurred, because of swelling. I had a good appetite and made up for fasting since midnight before the operation. During the evening the blurring decreased, and by the time I went to bed I was feeling pretty doggone pleased with the results.

This morning (the first morning after) I woke up with the right eye very blurred, but it cleared rapidly over the first couple of hours. I saw Dr. Chang again this afternoon, and she confirmed that everything was going as it should. Right now, my vision is generally better in the right eye than in the left, which also has a cataract (less severe). I fully expect the right eye to be really really good as soon as my glasses prescription is updated in a week’s time.

The thing I didn’t expect is that I am now getting just a lot more light into my right eye. The cataracts came on so slowly that I didn’t notice how dark and yellow everything had gotten. I only noticed the cloudiness and distortion. But now if I close my left eye, everything is bright and white is white. When I switch to my left eye, everything is a lot less bright and white is yellow.

Moral: getting old is still not for sissies, but eye surgery these days is really slick. I have something to add to my Thanksgiving message: Big thanks to all the scientists, engineers, and technological innovators who have so stunningly enriched and improved our lives!

By the way, it’s not cheap, unless you’re on Medicare. I may wait until I’m on Medicare before I get the left eye done.

David