Doctor My Eyes…Sailing Through Cataract Surgery

      Within 30 or so minutes of completing my first cataract operation last week, my wife Judy and I were enjoying a nice lunch—albeit sans alcohol, per post-op instructions.
      All went perfectly, said my doc, and I now am eager to get the second one done and out of the way in May (my in-demand surgeon’s next available time.) 

      It is, by far the most common surgery performed in the U.S. and most of the world—three million procedures done in the U.S. each year, out of 20 million worldwide. It is particularly common for our age group—because in the U.S., nearly 1 in 5 people age 65 to 74 have cataracts that affect their vision. By the time they’re 80 or above, more than 50 percent of Americans either have cataracts or had surgery to remove them. 

      As you might guess, with cataract operations being far and away the most common surgical procedure, the success rate for them must be through the roof, and it is: between 95-97 percent. And the results are wonderful. 

      My procedure lasted about 15 minutes, to remove the cloudy lens in my right eye and replace it with a new clear artificial one made of a polymer. I was awake through it all—it was a hell of a light show (a little like watching fireworks—bright reds, yellows and white) and I did not feel a thing.  

      Vision was blurry in the operated eye for the rest of the day, but that’s normal. What was immediate and remarkable, as everyone had told me, was the change in my color perception. 
      It was like those Claritin ads, that show a yellowish screen peeled back to show a brilliantly sunny field of green. 

      And since I had only one eye done, I could see the change in color values simply by alternately opening and closing my eyes. What I had thought was normal vision in my left eye now seemed by comparison to have a dull yellowish cast. And equally important: as a photographer I could see that my left eye also was seeing everything a good half-stop (or more) darker. 

      Taken together, that’s a big freaking deal. 

      I decided to have my cataracts removed when night driving became not just annoying, but dangerous. Oncoming car headlights had transformed into wide iridescent haloes that obscured the vehicles they fronted.  

      [Those iridescent haloes called to my mind Vincent van Gogh’s masterpiece “The Starry Night” and part of me assumed he too may have suffered from untreated cataracts. But actually that is unlikely. The tortured Dutch painter was only 37 when he committed suicide—far too young to have a condition (actually called senile, or age-related, cataracts) that largely affects those over 60. If van Gogh’s vision actually had been affected, it was likely due to medications he was taking for his mental illness, or too-heavy consumption of absinthe.]

Screw this, I said. At age 78 I signed up for surgery. 

      My surgeon, Dr. Kenneth Schwartz of Washington Eye Physicians and Surgeons, told me the technology that accounts for cataract surgery’s success and huge popularity is about 30 years old and owes much to microscopy and robotics. 

      “I work under a microscope,” he told me during my post-op checkup, “so that your eyeball actually looks this big (he spread his hands as if holding a small beach ball.) 

      Peering through a microscope, a surgeon works two separate hand controls—and two with his or her feet—to achieve pinpoint control and accuracy. 

      The old clouded lens is pulverized via ultrasound and suctioned out through a tiny incision in the eyeball. Once that is done, the more flexible polymer lens, rolled up into a tiny cylinder, is slipped through the same small incision, after which it unrolls and falls into place. 

      Easy, right? You try it. 

      “I’ve done 10,000 of these,” Dr. Schwartz said. 

      FYI, with the procedure done, I had to wear the eye guard pictured here for the first 24 hours—as well as while I slept during the next several days. I wanted to look like a pirate, but the eye guards did not come in black.  

      My wide-awake experience with my cataract also called to mind other local anesthetic surgeries I’d undergone—decades apart and vastly different.  

      More than 40 years ago I was awake—and also totally numb—while a surgeon in DC literally chiseled, then scraped with a scalpel, the cartilage in my left nostril to reshape my deviated septum: the result of my being an inept soccer goalie who took a kicked ball flat on the nose while at summer camp many years earlier. I remember the gentle pounding of the stainless steel chisel and the scraping of the scalpel almost as much as I remember the aghast looks of my stepsons Dan and Bill when I described being awake through all of this. 

      Many years later I had a front row seat (more or less) at my own colonoscopy. 

      I was curious—not just as a patient but as a photographer—to see what the gastroenterologist saw when he—how shalI I put this?—inserted himself into my colon. No problem, he said; if I was game so was he.  (And in truth I was under the influence of some first-rate happy juice.) 

      As with my cataract experience, it was a spectacular show, taking place in real time inside my own body. The fiber-optic probe lit up my colon like Times Square at New Year’s. In my narcotic-assisted state, I remember looking down a long, bright pink tube—not smooth, but a series of undulating folds, like the folds of Lawrence of Arabia’s tent in the desert—only in bright pink. 

      Mesmerizing. (And all that pink meant there were no nodules or other growths to worry about. It was a perfectly healthy colon, Grazie a Deo.)   

      But that was then. I leave to two dear friends these final thoughts on having cataract surgery: 

      Rachel Rubeor from Lubec, Maine: “I’ve had both (eyes) done. First impression: I have more wrinkles than I thought … second impression: this house is dirtier than I thought. Too much vision.” 

      John Edgell, from Washington, DC: “I had mine done last summer … I can finally hit a curve ball in the batting cage.” 

      [Wanna guess the next most common procedures, after cataracts, in this country? 

      After cataracts, at three million, are C-section births at roughly 1.3 million. After that come joint replacements (mostly knees) at about a million procedures a year in the U.S. 

      I never would have guessed number four: circumcisions—about a million little dick-snips a year in this country, rivaling knee and hip replacements.]