What to Expect with Cataract Surgery

For anyone suffering with poor eyesight due to cataracts and who is hesitant about undergoing corrective surgery, here is my story.

It was almost exactly a year ago that my eye doctor leaned forward in her chair and said that she was duty bound to tell me that it was no longer legal for me to drive at night in the state of Maryland, and that was probably true for most other states as well. My eye sight, she said, had deteriorated that much due to the growth of cataracts and both eyes were affected. Furthermore, she went on, they are going to get worse, to the point where I will not be permitted to drive at all, and, subsequently, I would likely be blind. The word “blind” was stunning. I probably gasped when I heard it and I know I gripped the arms of my chair even though, having already gone through ever stronger eye glass prescriptions to the extent that they no longer helped, I expected bad news.

The cure, she told me, was surgery to remove the clouded lenses and replace them with artificial ones. Not a very pleasant prospect, but neither was a future of blindness. Then the doctor explained how cataract surgery works. It is the most commonly performed surgical procedure in the United States, she told me, and the actual surgery takes only fifteen or twenty minutes, so it is done on an out patient basis. This is not a lasik type procedure where the shape of the cornea is altered. In cataract surgery a small incision is made in the cornea through which the doctor inserts an instrument to pulverize the clouded lens with ultrasound energy. She will then remove the debris and, through the same incision, implant a new, clear artificial replacement lens. The incision will usually close and heal by itself and only in rare instances are stitches needed. Best of all, the success rate is very high. We decided to do the worst eye, the left, first and then the right eye about a month or so later.

The thing that seems to concern the doctor the most is infection. Should the incision or the eye itself become infected it is very difficult to treat, therefore infection prevention is important. An infection could result in the complete loss of sight. To guard against it the patient is instructed to use medication for a few days prior to the operation, and then a fairly rigorous regime of medication to not only prevent infection, but also aid healing and manage pain after the surgery. The post-op includes several drugs, each used for varying duration with the last one continuing for about a month.

Advice to those considering this treatment plan for cataracts – USE THE MEDICATION AS DIRECTED! before and after the procedure.

On the morning of the first operation I was understandably nervous. After all, this surgery, despite its success rate, is invasive and is not without risk. If something goes wrong it could result in loss of vision in that eye. That’s why the doctor elected to do one eye at a time with enough delay between procedures to ensure that the first eye is doing well. Besides, if I did not have the surgery the prognosis is a future without sight. So what risk is there, really?

I guess everything went well in the operating room, I don’t remember much of it after I began receiving the first sedative. But I do remember the first moments after I awoke. I will never forget it. The nurse removed the dressing and as I looked around the room I saw a clock on the wall opposite and I think I let out a small shout of, “Oh, my God.” My vision through my left eye was crystal clear. Where before I would not have been able to see the hands of the clock, or even know it was a clock, now I could read the time.

That evening I became alarmed because my eyesight became blurred again and I could see a pink spot as though there was bleeding. I called my doctor. She reassured me that this is normal. The blurring is because the cornea has become swollen due to the trauma of the surgery and the pink probably is some small amount of blood. It should all clear up in a day or two. But, she said, if I experience pain, a fever, both warning signs of infection, or more serious bleeding, I should go to an Emergency Room right away and call her. She would call the ER physician and meet me there, she said. Happily, none of that ever happened to me, but if it does to you go immediately to the nearest ER.

I wore an eye shield while sleeping for a few nights, and did nothing and went no place that might result in dust or dirt entering my eye. Nor did I perform any strenuous activities. I tried to get the doctor to agree, in my wife’s presence, that that included emptying the dishwasher, but the doctor declined to do so.

There was an improvement the next day and by the second day after the surgery the sight in the left eye was clear, the colors were vivid, and the world is a much brighter place than I remembered. To demonstrate my new powers I began reading the numbers on license plates of the cars parked in front of our apartment building to my wife. I would say, “Come on, give me a hard one,” which she would do, and then I would read it. We did this for a couple of days, until, after I had read one that was a fairly good distance away, she muttered something to the effect of, “Oh, ….. yes, I think I remember that one from yesterday.”

The surgery for the right eye went as well as the left.

During the interval between operations I had one good eye and one bad eye, so I could close each and compare. There are no words for it. Now, a year later, my sight in both eyes is 20/20. Not a day goes by that I don’t marvel over it. I treasure my sight.

In the past as I would leave Annapolis harbor on my boat, I could barely see the Bay Bridge the air was so polluted and hazy. As it turns out … no it isn’t!

For anybody considering this treatment, think carefully about the risk, but then if you decide to go ahead, don’t hesitate. Although there is risk in all surgical procedures, the probability of success for this procedure is very high and the result is breathtaking. But follow the directions your physician gives you. Don’t skip anything. Use the medication, don’t touch your eye or the area around it, use an eye shield at night, don’t engage in strenuous activities and enjoy the clarity, brightness and vividness of what you see.

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