Monday, May 11, 2009

Arrived at the Lehman Eye Center at 7:00am carrying 2 dozen donuts. (These guys work hard) Actually they had been at it for over an hour. I signed in and had a seat. Even though I am an eye surgeon, and had brought all my own measurement, Bob's technicians repeated all the measurements necessary for selecting the most appropriate power for the implant. Notice I did not use the words correct or exact. There is not one implant power that is perfect; it often comes down to 2 choices that are near plano. (neither farsighted or nearsighted) Bob came in re-evaluated all the math, examined my cataract and retina, and I was ushered into the pre-operative holding area. Multiple consents to operate, insurance paperwork etc. was signed, and IV placed. Great care was taken to ensure the correct eye was selected. A blue dot placed above my left brow, armband double checked, and the time arrived. I was ushered into the operating room. More topical anesthesia applied, my face was scrubbed and the nurse anesthetist introduced himself. Knowing I was a physician he let me know he was injecting 2mg. of Versed IV. I am truly sorry that I cannot described anything else. I was hoping I could walk you through the operation, but, alas the next thing I knew everything was over. I obviously did not feel a thing intra-operatively. For about two hours after surgery I could feel a "scratchy" sensation, which I believe was the incision site as the lid blinks across it. We hit the road about 20 minutes after surgery, my wife driving, of course. Things were blurry in the operative, Left eye. (my non dominant eye) We stopped to have something to eat, since I had nothing since midnight. No problems, but my wife says I was a bit loopy for awhile. Took us about 2 hours + to drive home. About 5 hours after surgery, I was 20 /50 at distance, getting better every hour. Near vision had not kicked in yet. Vision return is very variable, depending on your eye, the degree of density of your cataract, the health of the cornea, and any pre-existing diseases such as Diabetes, Iritis (inflammation) etc. Many people see well the 1st day, but many required several days. Some of my patients have complained of a lateral half moon shape after surgery. I always felt it was the edge of the lens, but could never understand how that could be seen. I just assumed it was a reflection. Now I think I know what they see. I do not think it is the lens, but more probably the edema (swelling) at the incision site. At any rate, my vision is sharpening faster than I previously thought it would. Over the last 20 minutes my near vision has improved to the point where I am now typing without glasses. Not perfect, of course, but good. My pupil is still larger than normal, and that will affect both distant and near. Time will help a lot. More tomorrow on the optical adaptation while at work.

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