I wrote the following last summer after the second of my eyes was operated on.
I had hoped to get it published by a newspaper, but was misled by the originally positive response of the Toronto Star, and just recently told they would not be using it.
The National Post then turned it down.
So I decided to blog it, and hope this gets linked to and seen by those interested.
I have changed a word or two from my first version, to bring it up to the present:

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I am ecstatic about my new silicone implants.

When my doctor recommended them, I did not consider all of the side effects of the surgery, but my life has changed quite profoundly. My confidence is much greater than before. I find it easier to look people directly in the eyes.

I think any man or woman who has this procedure recommended by his or her doctor should not hesitate to get implants.

Say what?

Let me explain.

I’m descended from the nearsighted tribe branch of Darwin’s tree.
We’re talking negative double digits.
You know who you are. Add a dash of astigmatism, and progression for reading. Grind finely till done.

January, 2006, I visited my eye doctor, ophthalmologist Dr. Albert Cheskes, on my bi-annual visit for a prescription, for yet stronger, and yet higher quality high refraction lenses for my eyeglasses. It was time to get my eyes re-tested, and I’d even get to pay for the eye test, as the Ontario government no longer feels this to be a medical right.

However, rather than being handed a new prescription, I was matter-of-factly informed that I needed new lenses alright, but they’d be the more recently designed acrylic foldable intraocular lens (IOL), and they would replace the originals that came with this body at birth.

My apologies for calling them silicone above, but I find it reads better.
There are in fact intraocular lenses made of silicone.

My eyes had cataracts, and my option for better vision was the surgical route. To get rid of the cataract, you get rid of the lens that was in your eye at birth.
Cataracts obscure and cloud the vision. They scatter light, creating halos. They interfere with good vision.

Len’s lenses were to be replaced.

Well, that’s good. I wouldn’t have to choose new frames.

And guess what? OHIP covers this visit, because cataracts are on its list of covered medical services.
Both surgeries would also be covered by OHIP.

A date was set for the first eye surgery, with a wait of a couple of months. This was no emergency.
Time passed all too quickly.

I’m a fifty-something person. A bit of nervousness about commencing with the replacement of body parts accompanied the news. I'll be turning into a cyborg. I may as well accept my fate.

Before a couple of weeks have gone by I am pointed to a New York Times article

http://www.nytimes.com/2006/02/07/health/07case.html?ex=1145937600&en=41a5e3b5d6c6c2ec&ei=

and I’m feeling a little better, once I read of the author’s experience.

Dr. Leary might be there to hold my hand. That would temper it.

A few weeks prior to surgery I get my eyes measured by the latest computerized laser-using ophthalmologic device that measure all kinds of parameters about each of my eyes. The curvatures, and distances and thicknesses and every measurement possible about my eyes are done, to enable Dr. Cheskes to make the best choice in lens implants.
I have paid a premium of $280 to get the measurement done by the non-invasive laser machine. It does not even care if I blink. OHIP covers measurement by a more primitive device that actually touches the eyes. I buy myself this luxury service.
I sit for a few minutes till the laser has done its readings.
My eyes are even given ultrasounds that reveal images of the back of the eye.
This information all goes back to Dr. Cheskes.

The day arrives. No liquids, no food, and drops in the one eye, the second of two to be instilled on the way out the door.
I have instilled into my eye an extremely effective drop at dilating it. This must be near the maximum dilation an eye can dilate. My doctor is delighted an hour later to see such a good pupil. (Sorry, that’s his joke.)

Nurse, still more drops in the eye please.

Dr. Tam, I’m pleased to meet you.

I’ve yet to meet an anaesthesiologist I don’t like.

He relaxes me with a needle in the back of my hand, and a dose of something.
(Note to Director, fade out here.)
Various things are placed in and over my eye and taped in place. There is a slight pressure on my eye from all that covers it.

Soon I am escorted to the next waiting chair, as my spot is shortly taken by the next patient in line, and as I wait my turn for fifteen or twenty minutes of surgery, in the adjacent operating room. At this point I, as promised by Dr. Cheskes, I am not having a bad time. I am quite relaxed indeed. Dr. Tam has begun well.

I find myself in conversation with one of the nursing assistants. Because I see that post-operative patients are offered coffee, tea and the same cookie selection offered when donating blood, we’re soon discussing blood donations, and the paperwork involved, and the many questions to be answered…

I hear a woman say to me, “and have you ever paid for sex?”

I’m thinking that this two-tiered medicine thing isn’t bad at all, when I realize I am discussing questions on the blood donation questionnaire with someone in Dr. Cheskes’ office and I burst out laughing at the weirdness (the wiredness?) of it all. The nurse realizes the course of my train of thought, and laughs along with me.

A few minutes go by and I’m walked into the operating room and my next chair.
After some preparations, I am draped with a surgical sheet which covers all of me, except the opening that is revealed to the doctor around my eye. The sheet itself adheres to the area surrounding my eye.
I’m given an injection somewhere behind the ear, it seemed.
Next I am told to look upwards and back, and I really am unaware of whether my eye is open or closed. I know it is open. An injection was then made into some part of my eye, or behind it.
I’m later told that my optic nerve had been frozen.

My doctor does his stuff, which is a slit in the cornea to remove the clouded lens in my eye, with ultrasonic tool and machines that when reset to a new setting on his instructions, speak back the new setting to confirm it. I can hear everything going on on the other side of the sheet.
Once in a while water or something like it washes down my cheek as the eye is kept clean and lubricated.
Then it is over.
The sheet is removed, the eye covered and protected.
A lens made of acrylic plastic manufactured by a company now owned by the food giant Nestle, has been inserted behind my iris.
A follow-up visit the next morning sees the covering removed, and a pleased doctor.
I follow a rigorous drop in the eye schedule for the next few weeks. One set of drops 4 times a day, one three times a day, one twice. I figure out a system, and take good care of my eye.
The first couple of days with the new input device, my right eye, are much closer to Dr. Leary than had been the surgery itself. I am able to walk in Kensington Market, and on the busy streets of Toronto, without my prescription glasses on that I have worn for the past 50 years. A fabulous side effect of cataract surgery, in my case, is that I now have a prescription lens right in my eye. It is of fixed focus, as the lens one is born with is adjustable with muscles in the eye. What has been gained however outweighs by far what has been lost.
Protective sunglasses are very necessary in daylight, and at times indoors, as my brain adapts to my upgraded eye.

Dr. Cheskes is delighted with the result at my one month check-up.
I tell him I have a joke for him. But first I speak about an unusual side effect of the surgery that I am quite happy about. My penis appears to be larger.

Those who laughed already, move to the head of the class. Ophthalmologists and optometrists should all be laughing.
The near-sighted person who has vision corrected by prescription glasses sees a smaller than real view of the world through those glasses.
Look a myopic in the eye through their glasses and you see a smaller than real eye.
That is the same effect, observed in the opposite direction.
So with the correction for vision directly in the new lens, the world is back to its real size.
Things appear to be larger, because they have seemed smaller for so long.

We schedule the second surgery in a couple of months.

I am so much more relaxed for the second surgery prior to any sedation that I am asked if I am on blood pressure medication. I’m not.
Certain details seem different for the second surgery.
No pressure on the eye prior to surgery, and drops rather than needles for the anaesthetic.
But a new lens with optical correction is inserted in my left eye.

It is now almost a year since the first surgery. I no longer wear prescription eyeglasses.
I can read, use the computer, work with the tools that are part of my life, and am able to drive, and do anything I want in fact.
I had purchased glasses to correct my vision to nearer 20-20 if that should become necessary, for night driving, for example.
In the end I have required them once or twice only.
I am very happy not to have to wear glasses any more.
And I have almost completely stopped reaching to my eyes to push my (non-existant) glasses up my nose.
Some habits are hard to let go of.

I should add, that a few weeks ago I spoke to an acquaintance whose father had had cataract surgery done, not at the same clinic as I did, and by a different surgeon.
The result of his first surgery was corneal damage that left him with permanent blurred vision in the eye.
So this very common surgery does have a risk factor, as I had always been aware, and was certainly informed about.



Authored by Len Micay,
in Toronto, Canada