Got to have surgery very scared
Posted , 5 users are following.
Been told that I need surgery on my right eye. Ive got cataracts in both eyes but my right eye needs doing. My left eye is a lazy eye so my right eye is my dominate eye. I've decided to go private and am seeing a consultant tomorrow. I want if possible to have a multi focal lens which isnt available on the NHS.
Ive been doing some googling and have read horror stories about surgery, someone said it was like having acid poured into their eye.
Any reasurance about surgery would be appreciated, just thinking about it is getting me very anxious. Don't know what I will be like on the day of surgery.
Thanks
1 like, 15 replies
softwaredev Guest
Posted
In terms of "having acid poured into their eye", that is seriously different than what most people experience. I never felt any pain, I felt the drops going into my eye before surgery just like normal eye drops,or a similar type of sensation during surgery when they rinsed the eye (which due to the anesthetic didn't feel any more uncomfortable than drops without anesthetic) but that was about it, I didn't feel anything at all from the actual surgery. Most places give you sedatives to help you relax, and I just zoned out and didn't really feel what was going on, and mostly just saw a light, though I seemed to see the lens going in a bit. It does take a few minutes so it is natural to be nervous, but the procedure itself wasn't a big deal. For me it was less painful and uncomfortable than any dental work I'd ever had done, mostly fillings/crowns, but even less painful than a rigorous cleaning where they scrape your gum line since in this case there wasn't anything I'd even describe as momentary pain.
A minority of folks experience dry eyes afterwards temporarily, which is the most common source of discomfort, but eyedrops usually relieve that in most cases without problem.
There are > 20 million cataract surgeries worldwide, and > 480,000 surgeries with premium IOLs (mostly multifocals). The vast majority of people, almost all, have great results, including the vast majority of people with premium IOLs. Unfortunately with so many procedures, even a minuscule % of people having problems, e.g. 1 in a 1000, can lead to a noticeable number of people posting about them, and most people only post when they have problems (aside from some who researched issues beforehand, and post afterwards to "give back"
. Most of the problems that do arise are with people who have other eye health issues, and you don't mention any risk factors as I'm guessing you would have if you had them. e.g. although the procedures are low risk, there are slightly higher risks (mostly merely things like the lens power being off) for those who had prior laser surgery or who are highly myopic,etc.
Those getting a premium IOL like a multifocal do need to be prepared that there is a minuscule risk that they will have problematic night vision artifacts that will lead to a desire for a lens exchange, but if so that procedure is also low risk and the vast majority have great results. For some people even that slight risk isn't worth it, though in my case having been atypically young to have a cataract I felt the miniscule risk was worth the potential benefit of having a wider range of vision for the expected next few decades. Some people do temporarily experience night vision artifacts,even with a monofocal lens, the first few months but then see their brain adapt to the lens and tune them out, so that is one potential side effect to be aware of. I personally chose the Symfony due to its lower risk of visual artifacts, but it was a close call between that and a trifocal.
vjl softwaredev
Posted
by my Consultant but you read so many terrible stories I have been worrying about them.I would love to hear about your progress after you had them inserted and when you had the second eye done,
softwaredev vjl
Posted
I had my eyes done on two consecutive days around noon, on a Thursday and a Friday with a bandage on the eye after surgery overnight. The morning following surgery the bandage came off, and distance vision was good with each eye at first, and near vision went in and out over the next couple of days, but was consistently ok by Monday morning, and at the 1 week postop it was 20/25 at best near. A few weeks ago I had a postop check at a bit over 2 years postop and my vision was at least 20/15 at distance (they didn't have a line below that to check, and that was easy), and at 80cm it was 20/20 plus a bit. At my best near its been consistently 20/25. This last time at a different eye doctor they instead measured at 40cm and they didn't have a 20/25 line, but since I read the 20/30 line and some off the 20/20 line I suspect its 20/25 at 40cm.
I'm one of the small minority who see halos at night, but they are so mild/translucent that I've never considered them a problem, partly because my night vision otherwise is improved. I have less glare disability, i.e. headlights are noticeably less distracting and don't wash out the rest of what I see as much as they used to so the minor halos are a small price to pay for having better functioning night vision. I've been out less at night last two years than typical due to working a lot at home so perhaps its taken longer for my brain to learn to tune ou the halos, but I've recently stopped seeing them around some lights at home where I consistently always saw them, though they are still there, but milder, around other lights.
I find them to be like early pesbyopia when you just start noticing your near vision is a bit reduced, so for instance the fine print on a medicine bottle might be easier to read if its held out a bit further, and readers are useful for very near tasks like threading a needle.
Unfortunately a very tiny % of people do consider the night vision issues a problem with any premium lens, though the % is lower with the Symfony than with other lenses. So there is a very slim risk you'll want to do a lens exchange people should prepare for with any premium lens, but the high odds the results would be great for the rest of my life made it worth the risk for me, and many others.
vjl softwaredev
Posted
barbara2311 Guest
Posted
I had cataract surgery to my right eye 3 weeks ago
I was also very nervous,but it was completely painless, they put drops in to numb it first then some anaesthetic and my eye was completely numb didn't feel a thing.....it only took about 10 minutes......honestly there's nothing to worry about.
I am now waiting to have my left eye done....hooe this helps x
iellen32 Guest
Posted
Before seeing him I went to an optometrist who referrred me to a surgeon to do the surgery now-
I hear many experiences they have and the pos surgery sometimes brings unexpected surprises.
So I will disregard the surgery option
for now.
Your anxiety about this surgery is perfectly understandable.
Do it if highly recommended by your Ophtalmologist.
Wish you a wise professional advice and my very best.
iellen
I have Temporal Arteritis /GCA
softwaredev iellen32
Posted
Cataract surgery is the most common surgery done, as I noted above almost everyone has good results. Obviously if cataracts aren't degrading your vision enough to cause problems then there is no need to get the surgery yet, however cataracts only get worse over time and eventually everyone needs cataract surgery (if they live long enough) or they'll go blind. The rate that cataracts get worse varies drastically between people though, with some taking many years or a decade or two to get bad enough for surgery to be needed, with other uncommon cases (as with one of my eyes) getting bad enough within a few months (though my other eye remained 20/20 for 2.5 years so I postponed surgery).
So its useful to learn to get past the fear of surgery since it'll likely be done eventually, and to consider getting it when you notice it degrading your vision. Many people wish they'd had surgery sooner since their vision improves noticeably, but everyone needs to decide when to risk it. Most insurers and government healthcare cover surgery when your vision degrades below what is required for a driver's license, which is commonly 20/40 best corrected vision, i.e. vision with glasses or contacts.
Guest
Posted
Many thanks to all of your, I do appreciate you taking the time to post giving me information and reasurrance.
Must clear up something that I posted. I did the post yeterday (Monday) and for some strange reason I thought it was Tuesday, I am seeing the consultant tomorrow (Wednesday). I just blame my age here
I posted in a hurry yesterday so I will tell you a little more about me now.
I use to wear a contact lens in my right eye ,must of be for about nine years, I only had one in my right eye (the one that needs surgery now), it was a multifocal one and I didn't have the need to have one in my left eye at all, managed perfectly with just the one.
I had a routine contact lens check up end of Feb last year and nothing was found, eyes healthy. Had my two yearly eye exam end of April last year when I was told that I had a scratch on my right eye cornea and that there where cataracts, both low grade. Told not to wear contact lens for 4 weeks for eye to heal. I have very dry eyes and I realised that taking out the contact lens had caused the scratch so I decided to be sensible and not wear a lens anymore. I was suppose to have another eye check up end of this month but I knew something wasn't right so I went beginging of last month and the bombshell of needing surgery was dropped. Was then referred to the NHS for surgery.
I did some research on the internet and decided to go the private route to see if I could have a multifocal lens instead of the mono one that the NHS use. Specsavers referred me to a private consulatant, must say that they have been very good, not charging me for eye exams.
I have found out that the surgeon that I have been referred to also is at my local hospital,so I could see him via the NHS route. He is a vey good surgeon, have googled him and he is very experienced at cataract surgery has done over five thousand ops.
The private secretary of the consultant phoned to make the appointment and during the conversation she told me that I may not be suitable for multifocal lens because of my lazy eye (told her I don't want to go to the expense of having a mutli one in that eye). She did say that the consultant will advise me on what is the best for me. I told her in the conversation that I could see him on the NHS, but she told me that even if I am under is care at the hospital I will be part of his team and he may not be the surgeon that does the op, it may be one of his senior registrars, because they need to get some practice......well I didn't like the sound of that. With it being my good eye I need someone with experience just incase something happens during surgery.
I also suffer from rheumatoid arthritis and I have spoken to my specalist nurse at the hospital and I have to come off one of my drugs three weeks before I have the op and then after the op I have to get in contact for advice on when to start taking the drug again. I'm afraid that in 2012 my RA got very bad and I was put on one of the newer biological drugs that I inject once a week, this really dampens my immune system down so I have to stop taking it in order to heal after surgery. This drug gave me my life back, from hardly being able to walk, sitting on the sofa all day in terrible pain within 12 weeks of taking it I was in remmision and still am so I'm sure you will understand that I am very nervous about stopping this drug, I have read on various forums that when people have stopped taking it for ops, all their symptons come back and when they start taking it again it just doesn't work the same.
If I did go down the NHS route if a mono one is my only option I have the added worry that the op could be cancelled at the last minute and then re scheduled for a a couple of weeks later it will delay me starting the drug again. So with that in my mind and the thought someone getting some practice in doing my op I have decided that I am going to go private come what may.
I will update when I have seen the consultant and let you know what happens.
Can't get spell checker to work so sorry if there is spelling mistakes.
Thanks for reading.
Little Pea x
softwaredev Guest
Posted
Are you sure you need to stop taking the drug for RA for even as minor a procedure as cataract surgery, where you will be given antibiotics anyway, have you confirmed that with the surgeon to be sure? Can you say what the drug is? (partly curious for a friend with RA).
If you did well with a multifocal contact lens in your right eye then you should be able to get a premium lens, multifocal or Symfony, in that eye, there are people that use them in only one eye and a monofocal in the other.
Cataract surgery is very safe and standardized now so the odds are it would go well with any surgeon, however if you can afford to get a more experienced surgeon it makes sense just in case. Most people just use whatever eye surgeon they are referred to, however since I traveled to get my surgery (the Symfony wasn't yet approved in the US when I got it, so I went to Europe for it), I also made sure to find an experienced surgeon. I figured since most complications are rare that even though the odds were I wouldn't have a problem, that if I did an experienced surgeon would be more likely to have had experience with it. Studies do show that practice makes perfect, and even though the results are good with most surgeons, that those who have a high volume of cataract surgeries (I forget if this study was for those with > 1000 or > 1500/ year) do have slightly better results on average. (the surgeon I used had done 40,000+ surgeries).
Guest softwaredev
Posted
I don't mind telling you the name of the drug, it is called Entanercept or sometimes reffered to as Enbrel. it is a very expensive drug and here in the UK we have to go through hoops to get it. You have to of failed on at least two of the other first choice drugs that they give you and then have what is called a Disease Activity Score of over 5.1, they then leave you for a month and do the test again, during that time the don't normally give you any extra meds to help with the pain. Once you have reached the criteria twice you then have to have lots of blood test done and a chest xray and are talked through the side effects and sign to say that you understand everything. Some people then have to wait for funding to be approved by their hospital trust, a very long winded ordeal. It was during August 2012 that I had my first assesment and I didn't start the drug until end of November 2012. During this time I just got worse and worse till I got to the point I was more frightened about the drug not working than and side effects. I also inject methotrexate which is a chemo drug once a week. All this for what a lot of people just think is a bit of arthritis!
I do have to come of the enbrel, not the mtx though before the op. I will only listen to my specailist nurse at the hospital about this and not the eye consultant, they are not familiar with this drug and would not really know. There are only certain antibiotics that I can take as well whilst on mtx, so depending on what I am given I may have to stop taking that one after the op.
The drugs that I take dampen down my immune system because it is that thats attacking my body, but obviously because of the surgery I need to stop taking them in order for my immune system to start working again.
Little Pea x
softwaredev Guest
Posted
I can understand that you have reason to have more concerns than many people due to getting treatment for other medical issues (though that is likely fairly common when at least in the US the average age for cataract surgery tends to be mid-late 70s, I was very atypical getting it decades early). I would suggest consulting with the doctor treating your RA, or finding one familiar with combining cataract surgery and RA to address any concerns you have.
A quick search by someone unfamilar with RA or this drug does reveal differing views as to whether to discontinue that during cataract surgery, but I don't know if they are resolved and that is old or incomplete info, and I'm not curious enough to look further. Infections are very rare after cataract sugery though, but despite that I do see one paper mentioning a case with someone taking that drug, however it may be a coincidence if since the elderly age of typical cataract patients likely has a larger fraction of people with RA taking that. I'd suggest whatever doc is prescribing the meds would be the one likely most knowledgeable about the data and side effects to check with. I mention that partly since I see there used to be some concerns regarding risk of corneal issues with surgery in some types of RA though, suggesting continuing treatment might reduce the risks, but one article suggested that the data from studies didn't match the concerns (sometimes a concidence happens and doctors just worry there might be a connection that might not be the case). It would seem worth asking about it. I had wondered if the antibiotics would be enough to make up for the depressed immune system. You might also ask about whether to take them during any laser correction also if you wish that after surgery if the lens power is off.
Guest softwaredev
Posted
Thanks for your reply and for taking the time to do a little research into RA. You probably realise that it is a very complicated illness. I've seen the consulant and he thinks my cataracts are age related I'm 59 and also the use of steroids that I have had in the past for my RA.
softwaredev Guest
Posted
In my case I had no steroids or eye trauma or other obvious risk factors the doctors could think of to explain it, but had my problematic nuclear cataract appear at age 49, so although its rare, they can occur even at a younger age than typical. Even at your age even if a cataract is present, its not usually causing enough trouble to require surgery so it might be the steroids, or just bad luck getting it younger than usual as it appears to have been in my case.
It is a complicated illness unfortunately, partly in terms of the research about the impacts of the illness and side effects of treatments still being a work in progress, which is why I didn't think it productive to try to research further since it would likely take a long time (or require access to journals behind paywalls) given my lack of background knowledge about the topic. So it seems more productive to suggest checking in with experts, both on the RA side and a high volume cataract surgeon.
Overall though the impression I get is that the odds are you'll have great results, its just a question of whether or not to continue with your particular treaments. I'd suggest its likely a specialist nurse may have anecdotal experience and awareness of what she has heard, which shouldn't be underestimated I realize, but that it still makes sense to check with physicians who may have looked at any relevant studies. Or perhaps see if a search turns up any relevant experts to email to see if they'd answer a quick question.
Guest
Posted
Well, I've seen the surgeon and I am afraid that he's advised against multi focal lens due to my RA. In his words......I could take loads of money off you, give you what you want, but if years down the line your RA affects your eyes (yes RA can attack your eyes, in worst cases make you blind), it will complicate things, so lets make things simple and go for a mono one. Not the news I wanted to hear......many thanks to RA for that one.....the disease that keeps on giving!!!
I'm going to start a new discussion about this because I now need peoples experiences of the different sort of lens available, got to go back tomorrow for scans etc. Surgery booked for the 23rd of this month.
Many thanks to all of you who have taken the time to answer, much appreciated.
Paula x
softwaredev Guest
Posted
I woud suggest that some surgeons aren't as familiar with the relatively new Symfony, which isn't a multifocal even though it uses diffractive optics, and so many surgeons consider it in cases where they wouldn't recommend a multifocal. There is also the accommodating lens the Crystalens which overall I don't think is usually as good a bet, but since it is a single focus lens which may change focus a bit that some surgeons may be more comfortable with that as an option for those they wouldn't recommend for a multifocal. I don't think RA would interfere with that as an option, but I hadn't researched it.