My cataract surgery

As I mentioned in another post, I had bilateral cataract surgeries in
January, 1 week apart, and had the Tecnis Prolate Silicone lenses put in
by David Chang, M.D. of Los Altos. I thought I'd give a little summary
here of my experiences.

I sought out a surgeon who uses small incision technique with lots of
experience and chose Dr. Chang because of his credentials (among other
things he teaches at UCSF medical school) and his experience in small
incsion techniques.

Pre-op I was myopic with significant oblique astigmatism and agreed to
let him also do a couple of astigmatism "relaxing incisions" while he
was at it. The procedures were relatively painless (easier than having
my teeth cleaned) and quick, about 12 minutes on the table. What
surprised me is that the recovery was so rapid. I was never
uncomfortable and was only a bit blurred for a few hours post-op. We
targeted -.50 as the resultant refraction, since I've been myopic all my
adult life. It ended up -.50 -.75 x 60 20/15. So we shot for 0.00 on
the right eye and it ended up 0.00 - 0.25 x 60 20/15.

The refraction has changed very little since the procedure and I now
like to watch TV without my glasses. I can do lots of things without,
but prefer to wear progressives most of the time for the perfection of
vision I'm used to, and for the small print. The clarity of the Tecnis
lenses is amazing, the prolate surface eliminating most if not all of
the spherical aberration of other lens designs.

As a 61 year old optometrist, I've learned a few things about modern
cataract surgery from this experience, and would be happy to pass along
any other info about it that anyone wants to know.

William Stacy, O.D.
(actively practicing in Folsom California)

(please excuse the duplicate post)

w.stacy, o.d.

thanks for your post. Glad to hear your surgery was successful and your
healing immediate. My healing is very slow, and I'm in the small
percentage of people who have had complications. My ophtalmologist
(sp?) did not warn me (he said how quick and easy this would be - ha!).
I've been to another doctor and he diagnosed me as having uveitis - he
gave me pred-forte drops to address the inflammation. Do any of the
professionals on this forum have an opinion of the emergence of uveitis
following cataract surgery? Is it because of something occuring during
the procedure or am I simply one of the unfortunate few? Could this be
a reaction of my eye to the foreign body (the implant) ? I'm also
seeing various visual aberrations that I'm trying to ignore until the
capsule completely heals around the IOL (it's been about 3 1/2 months
since the surgery). Thanks - Karen

(E-Mail Removed) wrote:

> thanks for your post. Glad to hear your surgery was successful and your
> healing immediate. My healing is very slow, and I'm in the small
> percentage of people who have had complications. My ophtalmologist
> (sp?) did not warn me (he said how quick and easy this would be - ha!).
> I've been to another doctor and he diagnosed me as having uveitis - he
> gave me pred-forte drops to address the inflammation. Do any of the
> professionals on this forum have an opinion of the emergence of uveitis
> following cataract surgery? Is it because of something occuring during
> the procedure or am I simply one of the unfortunate few? Could this be
> a reaction of my eye to the foreign body (the implant) ? I'm also
> seeing various visual aberrations that I'm trying to ignore until the
> capsule completely heals around the IOL (it's been about 3 1/2 months
> since the surgery). Thanks - Karen

Hi Karen. Sorry to hear of the complications. Yes, uveitis is a problem
probably related to the surgery, and yes, it can be a reaction to an
intra-ocular foreign body. One of the reasons I sought out the best
surgeon was that I was deadly afraid of complications. I don't know all
the particulars, but yes, pred forte is indicated to supress the
inflammation. Another reason I went with the Tecnis lens is the square
edge that seems to help cause a tight "shrink wrap" around the IOL early
on, which helps to prevent any after-cataract problems. Anyway, good
luck and keep us posted as to your progress.

w.stacy, o.d.

Diane M wrote:

I had
> cataract surgery in late January (both eyes, one week apart). The right
> eye turned out perfect and was totally healed in one week. However, I'm
> still having problems with my left eye--a smudge-like blur in the line
> of vision or it could also be described as a little cloud passing in
> front of my eye (very disconcerting!). I also have what appears to be a
> shadowed arc at the left of my eye. The doctor said it's a bruise.
> Shouldn't that be healed by now?

I kind of doubt that a bruise would cause that arc. Sounds more like
you're seeing an edge or part of your IOL. I notice something like this
when I do an unusual eye movement like "crossing" (voluntary
overconvergence) of my eyes, whereupon I see temporal peripheral darkish
arcs on both sides. I don't see this under normal visual activities and
am not completely sure why it appears then (any ideas, other docs?). And
yes, a bruise would normally be gone by now. One of the things I like
about my procedure is that the incisions were the "clear corneal"
approach rather than scleral, so there was no bruising, no blood, etc.
and my eyes looked normal right after surgery (except for the dilation,
which took a few hours to go down). I could have gone to work the next
day with no problem.

According to him, the "smudge" is a
> normal viscous material that has loosened in my eye and will move....in
> time. I just fear nothing will ever change. Other than that, I can see
> well enough in that eye, and now need glasses only for reading so in
> that respect, the surgery was probably a success.
>
> Diane McGill

Hopefully he is talking about vitreous material, and not left-behind
visco-elastic material (from the surgery). If it's a vitreous floater,
you pretty much have to get used to it. I had one of those before
surgery and it's still there. The procedure for removal of vitreous
materials is pretty invasive and generally reserved for really
troublesome problems. Hope your issues clear up soon. If not, go back
and ask about them again, or get a 2nd opinion from a cataract
specialist (one who ONLY does cataract surgery), or from a
vitreo-retinal specialist, who would probably be the one doing any fixes
on these problems anyway.

w.stacy, o.d.