Later On

A blog written for those whose interests more or less match mine.

Cataract surgery lead-up

with 6 comments

I went in today for measurements. I swear that those machines must operate on Bayesian principles. The priors are easy: either the ophthalmologist’s own judgment or the average of the most recent n patients with a similar complaint (n=10, say). Then the machine makes a lot of measurements quickly, and each observation can be used to adjust the probabilities of the actual situation—sort of like the search algorithms I’m reading about now in The Theory That Would Not Die (and I’m amazed at the number of serious accidents and losses the USAF had regarding nuclear and thermonuclear weapons, including dusting some fields in Spain with plutonium: a terrible record, which is why they went to such lengths to keep it all a secret from the American people—our government seems really reluctant to allow citizens to know what it’s doing, have you noticed?)

At any rate, I got the measurements made and I can pick up the various eyedrops I’ll need from my pharmacist. No further action until the day before the surgery (surgery is 16 Nov).

The technician was marveling at how opaque and large was the cataract in my right eye, and also marveled when I told her how I had been consistently advised to avoid having surgery and simply wait while the cataract grew until it became absolutely intolerable. What is the medical thinking in that recommendation, I wonder? The same person who made the recommendation, when I asked about the risks of the surgery, assured me that the surgery was simple and virtually always trouble-free: an outpatient procedure readily done.

So why wait? Why the consistent advice to let the cataract get worse? I don’t get it. I suspect that it might have been the adviser projecting their own fears about eye surgery, but it doesn’t seem to be based on anything logical.

Written by LeisureGuy

31 October 2011 at 1:12 pm

Posted in Medical

6 Responses

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  1. Your experience parallels mine exactly. I am having a second CHRISTALENS put in on the 14th. One of the best medical procedures I can imagine.

    Regarding the universal reluctance to operate until the cataract becomes ridiculously large and opaque: I think it is due to a reluctance go prescribe something that has a low probability of failure, but a horrible consequence if it does fail. The consent agreement is quite sobering.

    Also, there may be a health insurance protocol involved.

    My surgeon says they do install lenses for extremely farsighted conditions which otherwise require very thick and awkward eyeglass lenses – even in the absence of cataracts.

    Bob Slaughter

    31 October 2011 at 2:36 pm

  2. How is the Crystalens working for you? I was tempted.

    You’re right: I think it may be an insurance issue, and the insurance agreement may require the doctor to say, “It can wait” if that statement has any semblance of truth.

    LeisureGuy

    31 October 2011 at 2:46 pm

  3. A friend’s mother waited to have cataract surgeries (both eyes). When the time came to have surgery, both cataracts had hardened to the extent surgery could not be done.

    That was some years back (and the mother has since died), so perhaps now cataract surgery procedures have advanced to the point that they can deal with hardened cataracts like hers.

    SweetOK

    31 October 2011 at 2:55 pm

  4. I have heard of this recommendation to delay and i would assume it is because they want the area fully developed ? easier to get a hold of ? thicker and bigger and more readily accessible to squeeze or slip out ? i don’t really know just a guess really, Good luck with the surgery !

    Nick

    31 October 2011 at 3:50 pm

  5. My first CRISTALENS is working out just fine. Doctor says they are not quite as good as the hype (the accommodation range may be narrower than you might wish). I was quite nearsighted, and now I cannot read the NYT without reading glasses, but this has the potential to improve. Computer screen is OK, however. Haven’t had such good distance and intermediate vision in 60 years. The goal on the second eye is to lean toward near vision. If all works out I might be able to read without glasses.

    NICK: I believe the cataract is removed by breaking it into bits before removal.

    Bob Slaughter

    31 October 2011 at 5:14 pm

  6. BOB: Thanks, silly me,

    I just went and took a look at an animated no blade LASIK procedure http://www.youtube.com/watch?NR=1&v=l3zXrvrfuOg and it seems so simple, like you said break it all apart and vacuum up and poof ! all done !!

    Nick

    31 October 2011 at 5:47 pm


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