unfamiliar cataract procedure

cheers....


I hope that nobody thought that just because I'd had the surgery, I'd
run out of questions. ;-)


Yesterday the cataract was removed from my left eye.


Today at the post-op, the surgeon told me that he had performed a
"primary posterior capsulorhexis". Yes, posterior. Some of the
lens was sticking to the rear of the capsule, so instead of leaving it
there and YAG-ing it out later, he cut a circular hole to remove it.
Now the only thing keeping my vitreous in back where it belongs is the
overlap between the IOL and the rear of the capsular bag.


Off the cuff, this strikes me as a dare-devil technique, and not one I
am happy with. But I don't really know..


Any reactions?


Also, what can I do to help this delicate healing process?

thanks,
Liz

Indianapolis (now being viewed at two different focal distances)

In article
<de491c55-50d1-4e7a-9266-(E-Mail Removed)>,
Liz <(E-Mail Removed)> wrote:

> Off the cuff, this strikes me as a dare-devil technique, and not one I
> am happy with. But I don't really know..
>
>
> Any reactions?

As I understand the idea is to not have to do YAG laser later.

My reaction. I think I would be annoyed if my surgery had been done
this way without discussing it with me first.

--
Charles

> My reaction. I think I would be annoyed if my surgery had been done
> this way without discussing it with me first.

I am annoyed. He couldn't know how stuck the lens material would be
until he got there, but I would have preferred a heads up about what
might have to be done, since the hardened material was visible to him
during the exam.

:-(
L.

On Apr 28, 9:51*pm, Liz <fraternobom...@yahoo.com> wrote:
> cheers....
>
> I hope that nobody thought that just because I'd had the surgery, I'd
> run out of questions. *;-)
>
> Yesterday the cataract was removed from my left eye.
>
> Today at the post-op, the surgeon told me that he had performed a
> "primary posterior capsulorhexis". * Yes, posterior. * Some of the
> lens was sticking to the rear of the capsule, so instead of leaving it
> there and YAG-ing it out later, he cut a circular hole to remove it.
> Now the only thing keeping my vitreous in back where it belongs is the
> overlap between the IOL and the rear of the capsular bag.
>
> Off the cuff, this strikes me as a dare-devil technique, and not one I
> am happy with. * But I don't really know..
>
> Any reactions?

So what did you want him to do instead? Leave the lens material there
so that the implant wouldn't sit right, your vision would be blurred
and you would need YAG a few weeks after surgery? Makes sense to me
to do it all in one procedure -- you end up with the same result and
are spared months of blurred vision and a second procedure.

Surgeons face minor unexpected difficulties during surgical procedures
and they deal with it.

> Also, what can I do to help this delicate healing process?

Follow your doctor's advice about activities and drops, not the advice
of strangers on the internet.

Judy

> And now that you have an implant, why do you need your posterior capsule?

Only to keep the stuff in the back of the eye back there until
everything heals.
!!

I thought they only opened the posterior capsule *after* the whole
thing had healed & sealed shut. My impression was that creating an
opening there during surgery is usually undesirable. However, since
I have never before heard of this technique, I don't really know what
to think. I know that one of the most experienced cataract surgeons
in Indy does it the way Dr. Judy mentions, leaving the posterior
plaque in and opening a hole later with YAG. That doesn't mean his
way is better - maybe it's outdated and inferior - but this does cause
me concern. Seems like there isn't much holding mine in place.

>So what did you want him to do instead?

Whatever was safest!!!! Is this technique a conservative one?

>> what can I do to help this delicate healing process?

> Follow your doctor's advice....

Am following it. It was sparse - take the scheduled drops, and don't
get water in the eye.

I couldn't ask him the questions I'm asking you all, or I would have.
If you don't know whether the 'primary posterior capsulorhexis'
technique is normal and widely used, or risky and new, or whatever the
case is, that's OK.
(Google was no help.)

thanks,
Liz

> > * My impression was that creating an opening there during surgery is usually undesirable.
>
> Used to be standard procedure.

It did? Tell me more.

> > Is this technique a conservative one?
>
> I think you overestimate the risks. Your vitreous isn't going
anywhere now.

Thank you.... I am relaxing somewhat. My optometrist here also looked
into the eye and said it appeared healthy and the cut clean.

I may have been unclear about what is bothering me.
In few weeks, they'll do my other eye. I had planned to use the same
doc for both eyes, but my impression of him is changing. I am
starting to feel that his approach seems to be the opposite of
conservative. (What do you call that, anyway?)
A number of things gave me this impression before surgery, but I
ignored them because of his reputation. Then when I woke from
anesthesia and learned that I had an unexpected hole in the back of
my eye, I was pretty unsettled, not knowing what to think. I couldn't
ask him - what would I say? Obviously *he* thought it was a good
idea. Even if it had been his own eye, he might simply be more
comfortable with risk than I am.

So part of my assessment of whether I may want someone else to do the
other eye is asking where you think this falls on the conservative to
risky scale.

I already know what I think about everything else that happened.

Hope this makes sense.

cheers,
Liz
Indy

> >> Used to be standard procedure.


> > It did? * Tell me more.


> Before about 1980, it was standard to take out the entire lens.


I see in one of my books that they also used to correct PCO
surgically, before they had YAG. That must've been quite a .... a
way more interesting operation than I ever want to experience.


> > I am starting to feel that his approach seems to be the opposite of
> > conservative. *


> You're looking for "reckless" but it doesn't sound like that to me.


OK. That's what I've been trying to find out.


>It only sounds competent.


Competent is good. Thank you for answering my question.


> Geez, settle down!


This has been really frightening for me... probably the worst two
months of my life in many years... I won't go into details as they are
not s.m.v. related.


thanks,
Liz

In article
<de491c55-50d1-4e7a-9266-(E-Mail Removed)>,
Liz <(E-Mail Removed)> wrote:

> cheers....
>
>
> I hope that nobody thought that just because I'd had the surgery, I'd
> run out of questions. ;-)
>
>
> Yesterday the cataract was removed from my left eye.
>
>
> Today at the post-op, the surgeon told me that he had performed a
> "primary posterior capsulorhexis". Yes, posterior. Some of the
> lens was sticking to the rear of the capsule, so instead of leaving it
> there and YAG-ing it out later, he cut a circular hole to remove it.
> Now the only thing keeping my vitreous in back where it belongs is the
> overlap between the IOL and the rear of the capsular bag.
>
>
> Off the cuff, this strikes me as a dare-devil technique, and not one I
> am happy with. But I don't really know..
>
>
> Any reactions?

Yes, the surgeon sometimes has to make changes in procedure based on
what is found. I had my gall bladder removed in January, and although
the surgeon had a plan, she said it might well change during the
surgery, depending on what was found.

> Also, what can I do to help this delicate healing process?

Best advice is to follow doctor's orders. I don't know about the added
part you had done, but mine didn't seem too delicate.

> Indianapolis (now being viewed at two different focal distances)

Well, hopefully that will get fixed soon.

--
Dan Abel
Petaluma, California USA
(E-Mail Removed)

In article
<2a120919-a315-4b23-8287-(E-Mail Removed)>,
Liz <(E-Mail Removed)> wrote:


> This has been really frightening for me... probably the worst two
> months of my life in many years... I won't go into details as they are
> not s.m.v. related.

Hope things go better. Having surgery is bad enough without other stuff
going on.

--
Dan Abel
Petaluma, California USA
(E-Mail Removed)