If all goes according to plan, this will be my penultimate posting on the subject of my cataract surgery. The second (left eye) procedure has gone even more smoothly than the first. Intra-ocular pressure didn’t fluctuate, and recovery was uneventful. At the end of my post-op checkup on Wednesday, they tested my vision as 20/20 in both eyes. I asked if they could flip the chart to the 20/15 page, and rattled off the last line without any hesitation. I have another checkup scheduled next Tuesday; in a couple of weeks I’ll have a final meeting with my ophthalmologist, followed by a session with the optometrist to design the right reading/computer glasses for my new eyes.
During the last year, my cataracts had become significantly worse. I remember back in August, walking through the cafeteria at Yahoo!, looking out for friends whom I might join for lunch, and not being able to make out a single face. They were all just face-shaped blurs. And so I was expecting that the surgery would restore my vision to what it was before the cataracts became intrusive. What I hadn’t anticipated was that I would wind up with vastly BETTER eyesight than before. I started wearing glasses at the age of 4, and even with correction my vision was never better than 20/20. Now… well, it’s a revelation. I hope I don’t get used to it too quickly: I’m enjoying the experience too much!

This morning I had the second cataract surgery, replacing the lens of my left eye with a synthetic replacement. It was uneventful, which is — in its way — an interesting comment on human adaptability. I was surprised by how a procedure that I had experienced for the first time in my life a few weeks ago could feel routine. Of course I’m not planning to do this again, so this learning and adaptation is largely wasted, but even so….
The process was not exactly the same, of course. I had a different anesthesiologist who dialled in a slightly lower level of sedation. This meant that I was much more aware of things: while I didn’t feel any pain, some steps were slightly uncomfortable, and therefore more distinctive. So I could tell when the broken-up remains of my lens were being aspirated, and the way the doctor “polished” the capsule prior to inflating it and inserting the new lens.
After the first procedure on my right eye, the contrast between “old” and “new” was so startling that I overlooked the fact that my eye was quite uncomfortable for a couple of days, and it took over 24 hours for all of the effects of the procedure to subside. Unrealistically, I expected the second operation to give me perfect eyesight immediately, and I was briefly disappointed. But over the rest of the day things settled down nicely.
One consequence of the second operation is that I can no longer cheat: I really need reading glasses for all close work. During the period between the first and second procedures, I could read things by bringing them close to my “old” eye, even without glasses. That’s over, for ever. I’m not sure exactly how I will organize my life going forward; right now, my impulse is to leave reading glasses all over the apartment, just in case I unexpectedly need a pair! (Don’t worry, Kate — I won’t!) Perhaps I’ll switch from wearing t-shirts to shirts with front pockets, just to carry my glasses. I certainly don’t like wearing them around my neck on a lanyard….
Tomorrow morning I have my first post-op checkup. Hopefully my intra-ocular pressure will return to normal more quickly than with my right eye. I’ll be working at home for a couple of days, since I don’t want to drive until everything’s settled down. When I do, I’m looking forward to improved twilight and night driving. Even with glasses, my cataracts used to cause glare from headlights and streetlights, which was becoming quite stressful. And now… well, I just looked out of the window (it’s 11:30pm here), and light sources were beautifully clear, with no glare at all. Let’s hear it for bionic eyes!

Yesterday I had the last post-op inspection for my right eye, and got the paperwork for the countdown to next Tuesday’s procedure for my left. By now, two of the eye drops had run out, but I was still taking the steroid Durezol. My doctor decided that by now it was doing slightly more harm than good (probably elevating the intraocular pressure a bit), and so I’m finished with it. My vision continues good — better than 20/20 — and there are no complications. I’m still getting some eyestrain from sustained reading, which means taking regular breaks (which is advisable for all sorts of reasons), and when I’m tired my asymmetric vision is a bit unpredictable, but overall things are going fine. As I mentioned before, the biggest issue is driving in twilight or darkness – DON’T.
On Saturday I’ll start on two of the eye drops — the antibiotic Vigamox and anti-inflammatory Nevanac — in my left eye, three times a day. Kate will drive me in to the Surgecenter (such a clumsy name!) on Tuesday at 7am, and I should be home by lunch.
This morning I was belatedly going through the materials I’d brought home from the Surgecenter, and found a laminated card and a booklet. The latter was the “Product Information” for the synthetic lens. It advised me (in tiny print) that I should keep the card and show it to any eye doctor that I encounter in the future. (What, no micro-RFID tag embedded in the lens?) Reading the booklet reminded me of one of the things that has impressed me about all of this. The surgical techniques are wonderful, and I’m very grateful for the skill of my ophthalmologist, and the way this procedure has been made simple and painless. However all of this medical wizardry would be nothing without the extraordinary materials science that has gone into the creation of the lens. Think about it: a clear, plastic lens, with carefully calibrated UV filtering, refractive index and curvature, designed to remain crystal clear for many years, and capable of being rolled up so that it can be inserted through a 4mm incision and allowed to unroll into place. It’s an acrylate/methacrylate copolymer; the lens is 6mm across, and the diameter across the “legs” is 13mm. That’s impressive….