Laser Surgery

March 21st, 2008 at 23:59 · Filed Under Blogging, Days in My Life, Education, Medical · 2 Comments 

I had a laser surgery for my right eye this afternoon. It is an outpatient procedure. It took me about 5 minutes or less but I had to wait from 10AM till 1:30PM. That was a long wait.

I had my cataract surgery on June 19, 2007. Read here. I also posted a video of a cataract surgery here. The surgery removed my natural lens which had been clouded by the penta-fluoro carbon (C3F8) gas in the retina repair surgery. A new artificial lens was inserted to replace my natural lens. The only consolation reward I could think of was that my short-sightedness was reduced by half, as my doctor told me.

Posterior capsular opacification on retroilluminationDuring the phacoemulsification procedure, the lens is removed but not the posterior lens capsule. It has to be left there to hold the new artificial lens. Not all lens cells can be completely removed. Some are left behind. Sometimes, the lens cells grow across the new lens. It is more likely to grow back if you are younger. Sometimes this happens in a few months after the cataract surgery, sometimes years. This is not a re-growth of cataract. It is the thickening of the back of the lens capsule. It is called the posterior lens capsular opacification. The picture shows the posterior capsular opacification on retroillumination.

Frequency-doubled Nd:YAG (neodymium-doped yttrium aluminium garnet; Nd:Y3Al5O12) laser with a wave length of 532nm is used to make a “hole” in part of the capsule to allow light to pass through the lens directly. This procedure is called YAG laser capsulotomy. The doctor aims the laser exactly onto the posterior lens capsule and fires very short pulses of laser to blast off the part of the capsule and make a small circle shaped area. This leaves some of the capsule intact to hold the lens. The very small part of the lens capsule which is cut away falls harmlessly inside the eye.

The laser capsulotomy is very quick and not painful at all. I only heard some clicking noise as the laser was working. My vision on my right eye became clear again immediately after the procedure. The only discomfort I had was when my doctor attached a contact lens onto my eye.

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Video of phacoemulsification cataract surgery

March 17th, 2008 at 0:59 · Filed Under Education, Medical · 2 Comments 

Last June, I had phaco to remove cataract on my right eye due to retina repair. Read more here. While surfing for some information, I found this video showing how this modern cataract surgery was done. It is very educational. I feel eerie while watching the video but it is rather educational. After watching the video, I appreciate my eyes more. And the video satisfies my curious appetite too.

Cheers! Sooner or later everyone has to go through this surgery. It is part of the natural aging process. Mine is caused by the retina repair surgery.

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Recovery

June 27th, 2007 at 23:50 · Filed Under At Home, At Work, Days in My Life, Medical · 4 Comments 

I went to Kuala Lumpur today for my post-surgery examination. I had my temporary new eye glass for my right eye on Monday.

I can see clearly now but my right eye has defects due to the retinal detachment. I see straight lines not straight at all. The perfect straight line that my right eye sees appears to be crooked. I asked my doctor if there was any chances for it to heal completely, his answer was, “Perhaps, but the chances are very tiny.”

I guess I will have to bear with this disability for the rest of my life. One thing that soothes me is that, my short-sightedness on my right eye has been reduced half. It was -6.5 with astigmatism of 25 (I am not sure the quantifying unit for astigmatism) on both eyes. Now, my right eye is -3.5 with astigmatism of 100.

I have to wait for another 5 weeks for the right eye to settle down before the optometrist can quantify my right eye correctly.

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Phacoemulsification Cataract Surgery

June 19th, 2007 at 22:47 · Filed Under Days in My Life, Medical · 4 Comments 

After more than six months of recovery from retinal detachment, finally I was scheduled for cataract removal surgery on June 12. Some unforeseen circumstances happened in the clinic and my surgery had to be postponed to June 19.

Today, I woke up early getting prepared to take the bus to Kuala Lumpur. When everyone were ready, LA took us in the car and sent me to the bus terminal at Sentral.

When I arrived at the clinic around 0900, many people were waiting at the clinic. I registered myself. My surgery was scheduled at 1400 so I had some time to check out some hotels around that area. There were some travelers’ lodges. The interior environment was not bad at all but I preferred attached bathroom and quieter environment after my surgery. I look around the area and found one hotel. Some hotels were fully occupied. Settled down in the hotel, I went for lunch and then went to Low Yat Plaza to check out some computer stuff. Nothing interesting and still had plenty of time. Bought a drink and sat down in Coffee Beans to read some newspaper while waiting.

When it was time, I left for the clinic. I was second in the queue. The first patient was a businessman from Malacca. What a coincidence! We introduced ourselves and chatted for a while. Not waiting too long, our doctor arrived and the man was told to get ready. After some 15 to 20 minutes of waiting, it was my turn to get ready. The nurse led me up the stairs and prepared me. Shortly after that, the man was out from the surgery room. His right eye was bandaged. “Is it painful?”, I asked. He replied “No. Not at all.”

Then a nurse came and took me into the surgery room. “Lay there”, she commanded friendly. I laid down on the operating table and the other male nurse covered me with a blanket. Then the female nurse covered my face with a surgical cloth exposing my right eye. Skillfully, she put on an adhesive film onto the exposing part of my face.

I could hear the doctor sat down and asked me if I was fine. “Yeah, I’m fine.”, I replied. He then with a scissor in his skillful hand, cut a hole on the film exposing only my right eye. He then told me that he was going to administer local anesthetic. I could see him holding a syringe with very fine needle. He told me not to move. Both the nurses were holding my head on both sides. I began to tense. So tense that I became as stiff as a dead log.

“Ouch!”, I cried. It was painful. I felt like he was injecting into my eyeball. Eight shots! My God! “Ouch! Ouch! Ouch!…”, I cried. After the injection, somone put a thick gauze onto my right eye and massaged with some pressure. After a while I could feel numbness. I could feel the instrument working on my eyeball. Not really painful but I could feel like a stick was being manipulated in my eyeball. The feeling was somehow sensational and frightful. I was so tensed during the entire procedures and the doctor told me several times to relax.

The surgery is called Phacoemulsification Cataract Surgery. It is a combination of microincision procedure, phacoemulsification (ultrasonic cataract removal), and a foldable lens implant. This type of procedure is considered state-of-the-art for cataract surgery today.


The most commonly used cataract incision is about 3 millimeters in size – just about one-eighth of an inch! Because of the careful construction of this incision, and its small size, the incision is generally self-sealing. This translates to a “no-stitch” type operation.


The surgeon then creates an opening in the capsule, which is a micro-thin membrane surrounding the cataract. This procedure, called capsulorhexus, requires extraordinary precision since the capsule is only about four-thousandths of a millimeter thick! This membrane is actually thinner than a red blood cell and the surgeon must delicately remove the capsule while manipulating instruments within the anterior chamber – a space only 3 millimeters deep!


Phacoemulsification is the aspect of the procedure in which ultrasonic vibrations are used to break the cataract into smaller fragments. These fragments are then aspirated from the eye using the same instrumentation.


The surgeon may elect to create grooves in the cataract, and subsequently break the cataract into smaller pieces using the phacoemulsification tip and a second instrument passed through a smaller “side-port” incision.


The lateral view of the procedure shows the phacoemulsification tip being placed into the substance of the cataract by the eye surgeon. The “phaco” aspect of the procedure is used to remove the denser central nucleus of the cataract.


Once the denser central nucleus of the cataract has been removed, the softer peripheral cortex of the cataract is removed using an irrigation/aspiration handpiece. The posterior, or back side, of the lens capsule is left intact to help support the intraocular lens (IOL) implant.


The intraocular lens is often folded and passed through the tiny incision where it is opened (implanted) inside the “capsular bag”. In this illustration, the lens is being inserted via an “injector”. This is an instrument designed to help keep the incision size small while allowing implantation of a 6 millimeter lens through a 3 millimeter (or even smaller) incision!


The IOL is shown here implanted within the “capsular bag” where it is neatly centered. The springy “arms” of the IOL, known as haptics, hold the lens implant within the capsular bag. The IOL does not generally require sutures to remain in good position.


This lateral view of the IOL implant shows the lens within the “capsular bag,” which is the desired location. This position is the same as that of the natural lens (cataract) of the eye and, therefore, is generally tolerated best and provides the most optimal visual results. At this stage, the cataract operation with IOL implantation is complete.

The article was extracted from EyeMDLink.

The procedure took not more than 40 minutes and I was done. I was taken to the resting area in front of the surgery room for a rest and a cup of hot drink. Here’s the photo taken myself at the rest area.

After the 10 minutes of rest, I was escorted down the stairs. I took my medication and headed back to the hotel.

I had to go back to the clinic for examination remove the tiny stitches. Here’re some photos of my eyes taken at the clinic after the bandage was removed.

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