Cataract info

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kingdragonfly

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#2080799 29-Aug-2018 13:40

Batman: Why did you have an anaesthesiologist when you were awake and had topical drops?

It was injections after the drops I believe, though hard to tell from my perspective. I guess it's because he paralyzed the eye muscles.

kingdragonfly

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#2080808 29-Aug-2018 14:08

kingdragonfly: the lids are kept open with a device, that looks like something from the movie "Mechanical Orange."

I meant "Clockwork Orange." If you remember a different version of this scene, that's means you existed in an alternate reality

afe66

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#2080840 29-Aug-2018 15:12

The most common eye block is a sub tenon eye block, this provides a longer lasting numb eye as well as paralyses the muscles of the eye so that they eyeball can't be moved by anxious patients. They work through a couple of cuts a couple of mm wide where the clear part of the eye connects to the white, and patients moving their eyes can make this difficult.

Often a small amount of anxiolytic (midazolam) and pain killer (fentanyl) is given before the eye block as some patients are anxious about eye injection (and not the operation?!) . The injections can be a little sore but this is for maybe 15 seconds as the injection spreads within the tissue plains. Then patient has a numb eye that can't move for several hours with better immediate pain relief.

Often the surgeons find it easier to delicate this to anaesthetist rather than supervising nurse giving sedation.

Private cataracts are a production line, everything done to allow as many Operations to be completed in a set time.

(if you are fit and well, the risks from general anaesthesia are very low for this type of operation)

(I have some experience. Not all here work in tech fields)

Geektastic

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#2080855 29-Aug-2018 15:37

kingdragonfly: I see several misconceptions in the posts above.

Lasik is nothing like cataracts surgery. I've had both types of surgery.

Lasik uses a laser which tracks the eyes many times a second, hence no need to paralyze eye muscles, or prevent blinking. The laser is simply reacts faster than a even a blink.

First cataract surgery is the most common surgery in the world, so not to worry. recovery is also fast, with some people literally driving home unattended the same day (not recommended).

With cataract surgery, the surgeon sucks out the lens with a small vacuum and two tiny incisions (but not the aqueous humour, the "eyeball juice"). You can see the surgery on Youtube, if you're not squeamish. Personally I found it less stressful to see what would happen.

I'd recommend avoiding general anaesthesia, being "knocked out" if you're not a child, or have mental problems. Ignoring the fact that it's more expensive than local "you're awake" anaesthesia, there's a small chance of dying while knocked out, which happened to a friend of mine.

Your eye muscles are paralyzed, and the lids are kept open with a device, that looks like something from the movie "Mechanical Orange." While it looks unpleasant, it's painless.

Costs also seem off. I paid private 3,480.70 which included a more expensive multifocal lens, the Comfort MF20 Intraocular Lens. It did not include the anaesthesiologist. An eye scan cost $200, and the anaesthesiologist cost $460, for a total of $4,140.70 for one eye

http://www.oculentis.com/lentis-mplus-x.html

In my case, surgery went wrong, through no fault of the surgeon. I was in the 0.01% of people who had multiple complications; someone has to have bad luck. When the surgeon detect a problem, he stopped. I was still under topical anaesthesia, and we discussed how to move forward. Everything worked out in the end.

I won't name the surgeon, because as I say, it wasn't his skills; it was my genetics.

The upside of being under topical anaesthesia is he continued the operation, which only took about 20 minutes longer than the usual 30 minutes.

Obviously different.

The surgeon who did my LASIK also does cataract surgery and if @Rikkitik wants a personal recommendation for a surgeon, I would certainly recommend Mr Hall at least in so far as having a consultation to discuss your particular surgical needs. Clearly I can't speak to his skill as a cateract surgeon but no doubt the internet can assist.

Fred99

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#2081017 29-Aug-2018 19:26

kingdragonfly:

The upside of being under topical anaesthesia is he continued the operation, which only took about 20 minutes longer than the usual 30 minutes.

This seems long. Surgeon advised my FIL yesterday that the procedure should take no longer than 10 minutes. In his case everything is routine. Claimed chance of complications is about 1 in 100.

If/when I need something like this - I reckon I'd be a terrible patient. I had to get a piece of something removed from my eye years ago, no sedation didn't help, but having a registrar poking an assortment of things from magnets (hoping it was a bit of ferrous metal), that failing then digging whatever it was out with more or less a sewing needle while you've got to not flinch and look straight at the thing while he's poking around wasn't a lot of fun. Painless - but a little terrifying.

Batman

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#2081060 29-Aug-2018 19:31

Fred99:

kingdragonfly:

The upside of being under topical anaesthesia is he continued the operation, which only took about 20 minutes longer than the usual 30 minutes.

This seems long. Surgeon advised my FIL yesterday that the procedure should take no longer than 10 minutes. In his case everything is routine. Claimed chance of complications is about 1 in 100.

depends on where you count the time? takes me 2 whole days to fly to australia.

Fred99

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#2081070 29-Aug-2018 19:45

Batman:

takes me 2 whole days to fly to australia.

Yeah - but Jetstar have cheap tickets.

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kingdragonfly

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#2081079 29-Aug-2018 20:14

Fred99: Claimed chance of complications is about 1 in 100.

I don't really want to go into details, but I had the 1 in 100 complication, plus a different 1 in a 100 complication beforehand.

As I said no surgery is without risk, but cataract surgery is the most common surgery in the world. With an aging population, it's a growth industry.

Batman

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#2081098 29-Aug-2018 20:50

Fred99:

Batman:

takes me 2 whole days to fly to australia.

Yeah - but Jetstar have cheap tickets.

But I never fly Jetstar.

Rikkitic

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#2236147 13-May-2019 17:24

So I had the surgery today, at a private eye clinic but referred there by the public hospital. One eye done under local anaesthetic. It was what I guess you would call an 'interesting' experience. Lots of very nice personnel being busy around me and catering to my every whim. I really felt special. They spent a lot of time on prepping and going over details and informed consent forms and recovery afterwards with tea and more forms, so altogether it probably took more than an hour, but the surgery itself was about 20 minutes. Brief mild discomfort at times but no pain. I tend to blink and fidget a lot, but apparently the anaesthetic and whatever mechanical contraption they were using to hold my eye open compensated for that. A nurse held my hand throughout so I could signal if I needed to cough or anything. It is important to hold still and I have real trouble with that, but apparently it went okay. Preparation included a long series of eye drops to numb and dilate. After awhile the eye went out of focus but nothing too dramatic.

During the procedure I had to stare into a bright light. I could pretty much see what was going on out of the corner of my eye and sometimes in my field of vision, though that was also taken up much of the time with a shape that seemed to look a bit like a scalpel but there was nothing around it or in the background. I could hear the lens (presumably) being suctioned out but I don't know when it was actually replaced. I thought there was still a way to go when the surgeon said we were finished.

A transparent cup was taped over my eye. I have to leave it until tomorrow. After that I am supposed to put it back on every night before bed for two weeks. Eyedrops four times a day for four weeks.

After release I felt I could have gone straight to work at a typical job if I absolutely had to, but I really wouldn't have wanted to. For a few hours, vision from the operated eye was pretty blurry. It is gradually improving and is probably better than the untreated eye without glasses by now, but it hasn't completely settled yet. The biggest difference so far, and the one I noticed first, is how bright everything looks. I hadn't realised it, but everything had turned a dirty brown hue, like an old sepia photo. The difference in sky colour is pretty striking.

Today my eye felt sore, not so much gritty, but more like I had a wood chip in it. I have had a slight headache all day, that clearly is being caused by the eye. Not bad, just enough to be irritating. Worse for me was the constant tear formation, not a huge stream but enough to be damp and unpleasant. Fortunately that is also now better. So a few hours of minor discomfort. To get through it I spent the day under blankets on the couch. I'm glad I was able to but like I said, I didn't feel completely disabled and I could have done something more ambitious if I had needed to.

I spent odd moments on-line today but the teary blurriness of the right eye made that difficult. It is better now and I suspect it will feel almost normal tomorrow. Not sure what the focus will be when the eye settles. I can see outside and the TV reasonably well, but the computer screen is a hopeless blur. Now it is annoying trying to see through the transparent cup, which distorts. It is also hard to leave it alone when the tape itches and tears leave the corner of my eye wet. I guess the biggest challenge will be remembering not to rub the eye when it itches.

Plesse igmore amd axxept applogies in adbance fir anu typos

kingdragonfly

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#2236351 14-May-2019 07:28

Good news.

I understand that you should know within a day how your vision will be.

You may have double vision, diplopia, due to dry eyes, so give a couple of weeks,

Regarding the computer vision, the way I solved it was getting a bigger monitor. They're cheaper than even a new pair of glasses.

I love my Philips 30". Elive and Ascent are selling it for ~$340. Note it's maximum resolution is 1920 x 1080, which is HD

https://pricespy.co.nz/product.php?p=4000575

wazzageek

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#2236484 14-May-2019 10:04

One thing after my wife had her cataract - if something doesn't seem right, give the surgeons a call!

My wife had a retinal detachment shortly after the surgery - and that has to be followed up quick smart. (Not to scare you - best to be safe than sorry!)

Hope your recovery is positively smooth!

Rikkitic

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#2236772 14-May-2019 16:49

My eye has really settled down in the past couple hours. I think it is close to how it will always be. It is still an effort to see the laptop screen, but no longer impossible. Distance vision is clear and bright. Like most older people, I will probably need reading glasses, but I can manage without if I have to.

I had a few rough moments last night and this morning. I found the plastic protective cup impossible to use. It is just taped in place, the tape gets wet from tears and itches, you can't remove it and put it back as instructed after the first day without a new tape supply, and it is just a really stupid design. I swapped it for a pair of wraparound sunglasses, which are perfect and allow me to sleep comfortably. That stupid plastic patch really is one of the dumbest things I have ever seen. It is my only complaint about an otherwise excellent procedure.

I woke up a few times in the night, which is normal for me, but I took a couple Panadeine tablets before bed and slept better than I usually do. Normally I am a foetal sleeper but I made myself sleep on my back, sitting slightly, and it worked surprisingly well. The only thing was that my eyelids were glued together every time I woke up and I had to carefully separate them. In the morning I had some alarming stabs of pain every time my eyes moved, which eyes do all the time, but a nurse I rang reassured me and I took some Ibuprofen and the pain subsided over the next hours. It seems nearly gone now.

I still don't feel quite 'normal' but I'm close. I think the main thing is the difference in visual acuity between the two eyes. It is a little disorienting but can be got used to. Fortunately I have lots of cheap glasses and sunglasses so I removed some lenses to get a better balance. It is worth stocking up on $2 sunglasses in particular if you are facing something like this. The operated eye is much more sensitive to light anyway so removing the other lens makes things more even while keeping the operated eye protected. I did the opposite with a regular pair of glasses so I can watch TV.

I have gone into detail on this because it is what I would have appreciated and maybe it can serve as a useful reference for anyone else facing such a procedure. Cataract surgery is pretty routine these days but it can still be intimidating contemplating someone slicing into your eyeball. At least it was for me. Maybe this can help a little. You do need to be alert to possible complications but don't panic if you feel some strange pains the first day or so.

Thanks to everyone who gave advice and helped me along the way on this. It makes a real difference.

Plesse igmore amd axxept applogies in adbance fir anu typos

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