Aging brings loss of vision due to loss of transparency in the crystalline lens of the eye and the condition is known as Cataract. No medicine can cure it, so surgery to remove the opaque lens and replace it with an artificial lens is the only remedy.
With the advent of microscopes and phaco machines, cataract surgery has become a miracle bringing great visual results.
But surgery has its own challenges. Here, we as surgeons are afraid of infection leading to endophthalmitis and the second is intraoperative drownings of the crystalline lens in the vitreous chamber. Either of the two complications can lead to visual damage and phthisis - softening of the eyeball to the shrunken small eye. So though results are the best most of the time, it cannot be so each and every time and complications can occur.
Though this may sound to be a simple question, the answer is a bit complicated. I will start from the expectations. one by one from the maximum to the minimum.
- I should have the best possible visual outcome at the earliest without any pain, redness, or swelling.
- I will tolerate some pain and redness, but I should gain vision to some extent if not the best.
- Cosmetic: By chance, if something goes wrong during surgery for reasons beyond the control of the surgeon despite the best care, my eyeball should remain in shape and I should not have a deep shrunken eye.
- Painful blind eye: At least, I should not have an eye causing constant trouble like pain, watering, and irritation. I may tolerate small eyes (phthisis).
- Life-threatening complications: As time passes, I will accept ocular complications as my bad luck, but I should not die in the operation theatre due to a reaction to any injected drug or cardiac arrest. At least I should go home alive.
These are the thoughts I had myself while my cataract surgery was going on.
We, the eye surgeons operating thousands of patients during our lifetime and having complications at least a few times are not happy passing through such events. Being sensitive, we may become stressed and sometimes lose sleep for many nights.
Maybe we see this thought cycle of a patient and learn about the other side of the story - the patient.
Dr Bhaharchandra M. Desai
M.S (Oph)
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