Monday, September 14, 2015

Cataract Journey: Post-Op #2

By the time of my second cataract surgery, I was readier-than-ready. I was so tired of not being able to see clearly out of both eyes, which made depth perception – necessary for driving, pouring water from a pitcher, etc. -- impossible. I was excited rather than anxious, an interesting way to approach eye surgery. My first surgery had been quick, painless, and even a little bit fun, especially the psychedelic lights during the femtolaser portion. The gap was only two weeks, so all the surgery prep was still fresh in my mind. By prep, I mean chatting with the anesthesiologist, starting antibiotic and steroid eye drops several days before, fasting the night before. I strongly dislike sedation and had asked to not be sedated the first time. In the past, it’s taken me a solid week to feel really clear-headed after receiving the drug they use. This time, I was able to tell the second anesthesiologist (a different one) how well it had gone and to reiterate my preference. Very often, patients don’t realize their opinions and prior experiences matter, especially when it comes to medication. Just because the “usual” protocol includes a specific drug doesn’t mean it is required. Often, there are alternatives with fewer of the obnoxious side effects.

The second surgery went just as smoothly as the first and I was soon home, sleeping it off. I was struck, as I have many times in the past, at how powerful sleep is in recovery, whether it’s from surgery, an injury, or an illness. Lying quietly is more effective than sitting up, but there is something about sleeping that is even more potent a restorative.


Even though my second eye was still dilated and there was post-operative swelling, I noticed an improvement right away. As before, I wore a clear plastic eye shield for the first day and then at night for 5 days. It took about a week for the dilation to resolve (at first I didn’t believe this when the ophthalmology folks told me, but I knew it was true the second time!)

The most challenging aspect of this second surgery was coordinating the schedules for eyedrops. The first eye still required some, but not all the ones the second eye did, and on a different schedule (for example, twice a day as opposed to four times a day). Some friends in a similar situation have generated spread sheets, although I found I could do okay. I just had to remember which post-op week which eye was at.

A one-week follow up with my local optometrist, who is coordinating care with the ophthalmology surgeon, showed my eyes to be healing, free of infection (yay, antibiotics and sterile technique!). He measured my first eye, the stronger one, at 20/25 and the second, weaker one at 20/60. This is close enough so I have good enough depth perception to drive if I don’t need to read street signs at a distance. We expect continued change over the next six months. Then, depending on how much improvement there is in the second eye, I can either get LASIK touch-up (which will impair my reading vision) or use spectacles for distance. If I’m uncomfortable visually in the meanwhile, I can get driving glasses, although in all likelihood the prescription will change. The best news is that I have great intermediate-distance vision. That’s what I use for computer work, playing the piano, and social interactions. I am a very happy camper, needless to say!

And it is truly amazing to wake up in the morning and be able to see clearly – no reaching for glasses or going through the routine of hand-washing and inserting contact lenses!

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