Saturday, August 23, 2014

Cataract Surgery

Cataract surgery fast, painless and effective

3 days ago
TRIBUNE PHOTO/LARRY BECKNER
Nancy Mayernik, LPN, left, and Dr. David Boes, work to remove a cataracts from Polly Kolstad eye at the Orthopedic Center of Montana.

The signs were all there.
I was having difficulty viewing a computer screen, colors appeared dim and faded, and I faced unbearable glare while driving into the early morning sun — all resulting in frequent changes in my glasses prescription.
I had developed a cataract in my left eye, affecting the good vision I had enjoyed most of my life.
Cataracts develop when the lens behind the colored iris becomes obscured, brown or yellow. Light is scattered by the lens before it can focus on the retina, and as a result, vision becomes blurry and colors muted.
If untreated, cataracts eventually cause blindness. The good news is that corrective surgery is more advanced than ever before. The old clouded lens is replaced with an intraocular lens during the procedure, which is noninvasive, usually done without sedatives, relatively pain free and is performed in an outpatient facility.
I was scheduled to have the surgery done by Dr. David Boes, an ophthalmologist who has been practicing since 1994.
Boes operates in Great Falls and at eight facilities in towns throughout the area. He also takes time twice a year to travel with a team of technicians and nurses to Belize to do volunteer cataract surgery for a week.
Since his residency at the University of Washington in the early 1990s, Boes has seen dramatic changes in cataract surgery techniques. Originally, no intraocular lens implants were used, and patients had to rely on Coke bottle-thick hyperopic glasses.
Today, the lenses are manufactured in a variety of optical powers and are made from acrylic and silicone.
Taking the plunge
After a night of fasting, I reported to the surgery center on a recent Friday morning.
I checked in and was escorted to a presurgery area where I settled into a recliner. The nurse reclined my chair and carefully put drops in my left eye to prevent inflammation, bacterial infection and to numb the eye. She also placed an ink dot over that eye, identifying that it’s the one undergoing the procedure.
I was given booties, a hairnet and warm blankets and then waited with my eyes closed to be called for surgery.
Within 20 minutes, I was wheeled in my chair to the surgery room. My head was nudged into a stationary helmet, and a seat belt fastened across my arms and waist to keep me from moving throughout the surgery. I was totally covered with a white sheet and blanket with just a small opening for my eye.
Three bright lights were turned on and a large machine lowered from above.
Boes directed me to look up at the lights and put more numbing drops in my eye.
He had one foot on the controls of the aspirator — the machine that breaks up and vacuums the cataract particles — and the other foot on the microscope foot pedal.
Nurses and technicians assisted him.
“We take an entire team approach,” Boes said. “Every step matters.”
He made a tiny incision in the cornea and then inserted an instrument about the size of a pen tip.
A short time later, he told me we were one-third of the way done.
I was awake the whole time and had not felt a thing.
Soon I began to hear rhythmic piano-like sounds from the instrument Boes used to break the cataractous lens into little pieces with high-frequency sound waves. As the lens broke apart, the probe suctioned the pieces from the eye, and soon it was completely gone.
The sound continued for some time before Boes told me we were two-thirds of the way through.
I now know the doctor was inserting the new lens, which fits right into the groove where my original lens was. Two arms secure it in place.
Throughout the six- to 10-minute surgery, Boes continued to place numbing drops in my eye. I felt the wetness rolling down my face, but no pain.
Before I knew it, Boes had finished, and I was unhooded. My eye was taped shut and fitted with a patch that must remain there for two hours. I was wheeled back to the recovery room and offered beverages and a snack.
After I was given followup instructions and several eye drops to put in my eyes for up to one month, my daughter picked me up and drove me home.
Drastic improvement
After two hours, I took off the patch as directed. Amazingly, my vision already had improved greatly, although I saw halos over the lights in the bedroom. (Boes later explained that is because the eye is still dilated.)
I reported back to Boes that afternoon for a follow-up appointment. The exam showed that the surgery was successful, and he instructed me to wear a patch over the eye for four nights.
That evening I attended a concert. I was able to see the stage without glasses, but the red and blue spotlights had aureoles over them. I felt like I was at a circus with halos dancing above the lights.
The next morning, I could hardly wait to take the night patch off.
Seeing is believing.
The halos were gone, and I could almost read the newspaper without glasses.
Before another day passed, my eyesight continued to improve. Newsprint now was very much in focus, and at a later eye check, my left eye measured 20/20.
My sight has been improved beyond belief.

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