Open Writing

I recently underwent cataract surgery, and in so doing joined the legions of people in my age group who have had the procedure; so it’s hardly noteworthy. Notwithstanding, I wanted to relate my experience for the benefit of anyone anticipating the operation, because all I had to go on was the less than informative accounts of my friends and acquaintances.

My only other encounter with eye surgery was some 60 years ago, when I had an operation to correct a divergence in my right eye. It was a relatively simple procedure that involved shortening the muscles on one side of my eyeball that are used when you look to right or left without turning your head.

Despite its simplicity, I spent a total of 14 days in hospital, eight of them with both eyes covered by a Moorfields eye bandage. The bandage is named for the Moorfields Eye Hospital in London, England, where it originated.

By contrast, my latest surgery was carried out in the doctor’s facility in less than an hour; and 15 minutes later I was sitting in a restaurant eating lunch! If you ask anyone who has had cataract surgery, it is this expediency that they will focus on, but it is really an over simplification of the total experience.

Certainly, the removal of the natural lens and the insertion of the artificial one takes only a matter of minutes, but from the pre-operation check-up to the final discharge, in my case totaled a span of eleven days.

The pre-operation visit involved a series of measurements of my eyeball with an electronic scanner, and a physical check-up: heart, respiratory function, blood pressure, pulse etc.

Along with it, I was quizzed by the nurse practitioner about allergies, current medications and my medical history. Finally, I met with an ophthalmologist who examined my eyes, checked for glaucoma and astigmatism, and went over a list of do’s and don’ts before and after surgery: no food after 9 am on the day, wear loose clothing, no jewelry, and so on. He told me that on the day after surgery I would be able to shower, wash my hair and even swim, as long as I didn’t completely immerse my head!

I returned for the surgery on my left eye two days later; the right eye would be operated on a week later. Thinking I would be the only patient that day, I was amazed to see the waiting room slowly fill up until there were perhaps eight people in all. Each of us received two applications of eye drops at fifteen minute intervals before being taken into what amounted to an operating theater, but with enough tables for all of us, each in a curtained off cubicle!

After that, the experience was like being on a production line. First, I was hooked up to a heart monitor and an automatic blood pressure cuff. Then an intravenous needle was inserted into the back of my hand for administering the anesthesia. Through the curtains I could hear the same phrases being uttered in each cubicle. “Hello, I’m the anesthesiologist. Which eye are we doing today…?

The question had been asked at least four times already, but better safe than sorry. The first time it was asked they marked my left eyebrow with a marker pen. At this point my memory of the procedure becomes quite blurry. I was awake, but not entirely in touch with what was going on. I remember hearing the surgeon introducing himself in the adjacent cubicle, and was vaguely aware of him working on me, but it was not unpleasant.

The next thing I knew I was being helped off the table and led on shaky legs to my waiting wife. After a five minute recovery interval we were out in the fresh air, heading for lunch. Aside from the surgeon’s skill and modern surgical techniques, the key to this almost zero trauma experience is the modern use of hypnotic anesthetics that avoid the deep sleep and post operative side effects of the older methods. This is probably the reason my friends and acquaintances were so vague when trying to relate their own experience.

There are currently two types of procedure. One involves the removal of the natural lens and the capsule containing it. The more usual method is the removal of only the natural lens by emulsifying it with ultrasound pulses, and then inserting a plastic lens into the natural capsule. The latter technique involves microscopic incisions in the periphery of the iris that require no sutures, and is favored for this reason.

The results are quite spectacular. In the period from the first surgery to the second, I was able to compare each eye. The untreated eye saw everything through a nicotine colored film. The vision in the treated eye was clear and startlingly brighter. So much so that I had to reduce the brightness of my computer screen. I can read and type without glasses, and though my distance vision isn’t perfect, it’s manageable.

Is there a down side? Well, yes. I have aged overnight! Surely I never had those brown blotches on my hands before, and my face was never so wrinkled. And where did those jowls and the loose skin on my neck come from?

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