Surgery

Surgery Day

The day of surgery I woke up more than a little nervous, but ready to go. I definitely wasn't quite ready for how long of a day it was really going to be. The first thing they did when I got there was test my pressure, which they noted was higher than it had been the week before. They didn't seem all that concerned about it however, and just gave me a new eye drop, which brought my total up to four. They told me it was nothing to be concerned about because the steroid drops I had been on since the iridotomy tended to have the effect of raising the pressure some.

After that they took me back to a room next to the OR where they took my vitals and put in my IV. Most places that do the ICL need to meet you at a hospital somewhere since they require an actual OR, but one of the nice things about the place I had it done was that they have an OR connected to their normal office. They put multiple sets of dilating drops into my eyes, and a couple numbing drops. From there they took off my glasses and led me into the OR. I remember sitting down onto the table, having a bit of a conversation with the anesthesiologist nurse, and then my memory cuts out. I wasn't completely asleep, but was essentially doing anything someone asked me to do, all though apparently not for very long as I would find out later. Of all the things I was told going into this procedure, I would say the thing that turned out to be the least true was how quickly my vision would be perfect. I should stress that this is not always the case, and I read many accounts of people waking up from surgery and being able to read the clock right away. I was definitely not able to do that.

I can sort of remember being helped into the car, and coming home to just lay down on the couch and pass out. Two hours later my mom woke me up to tell me it was time to go back, and I noticed right when I woke up that things were not really as they should be. I could see a little better than I had without my glasses on, but it wasn't a huge difference, and I had a pounding headache in my temples. I also felt like I had a grain of sand in my right eye every time I blinked. As we were driving back to the doctor's office, but mom explained to me how while under anesthesia I was told to look down, which I did, then I immediately looked back up, which caused the doctor to scratch my left cornea. After surgery they had then put a contact on the eye to act as a band-aid and help the eye to heal faster. That didn't really explain what was bugging my right eye though...

My first post-op check-up revealed two things going wrong with my eyes. First the right eye also had an abrasion on it, but this one was more like a burn across the cornea that was causing it to sag off my eye a little bit. Or at least that's how it's been described to me. Like I mentioned, it really just felt like blinking with a grain of sand in my eye. So to fix that, they just put a second contact into that eye, to also act as a band-aid. This isn't as big of a problem as it sounds, cornea abrasions can heal relatively quickly. The second problem they noticed was that the pressure in both my eyes was way too high and needed to be relieved, which is not quite as comfortable of a fix.

This has been known to happen in ICL procedures, but apparently not often, because we were first told by my doctor that he had had to relieve the pressure five times before, but he later revised it to only three. Before the collamer lens is implanted into the eye, they release a sort of organic gel into the incision, which acts as a buffer between the implant and the rest of the eye. While this protects it very well, and keeps many problems from happening, it can also create a few. Once the surgery is finished, they attempt to flush out as much of that gel as possible, but occasionally too much of it can stay in, and block the eye's natural "drainage" system. The gel will naturally dissolve within 24 hours, but until it does, if the eye is blocked, the only solution is to release some of the water/gel that is building up and causing the pressure. The way they do this is to press on the eye with a needle (from the side) and squirt the fluid out through one of the smaller incisions made in the eye from the surgery. They numbed my eye before doing this, so it wasn't nearly as painful as it sounds when I'm describing it. The relief is also immediate, the pounding headache and fuzzy vision go away, and you feel like a million bucks. I still couldn't see of course, but at this point I figured I'm a little behind on recovery due to the abrasions. As I was leaving, they mentioned that it was possible that my pressure would go back up, and I would need to call them and come in right away if that was the case.

Turns out they were right, I woke up around 3pm, in more pain than I had been the first time. The pressure can't as much be felt in your eyes as it can your temples, or eyebrows. I could tell that the pressure in my left was higher than my right because it was pounding so much more in that eye. I could also see a spot in my vision right in the center looked similar to the spot you see after rubbing your eyes really hard. It seemed like I was seeing a reflection of the back of eye, but I can't say for certain that's what it was. So we went back up the eye doctor and went through the same process as before. They had to put dye in my eyes to better monitor the pressure, next they took out the contacts, and pressed on them to relieve the pressure.

I went back home hopeful that I could make it through the night and be fine the next day, but sadly this wasn't the case. I had to go back a third time, we called the doctor from the emergency number we were given and met him up at his office at around 8pm. Since I was on a schedule of needing the pressure to be relieved about every four hours, it really seemed likely that I would need to do this again around midnight. No one involved really wanted to have to do that, so the last time he relieved the pressure it was actually a little painful because he was trying to get out as much of the pressure as possible so I could make it through the night.

After all of that, I was in fact able to make it through the night, and woke up with my eyes feeling fine. Not exactly fantastic, but they weren't giving me a migraine anymore. I had an appointment scheduled that morning, that was supposed to be my 24 hours check-up, but of course they had just seen me at 8 the night before. The abrasion in my left eye (the small scratch) had healed completely, and I read at about 20/50 in that eye, which they were able to get down to 20/25 by having me read the chart through a small hole in an otherwise covered black screen. I had never seen something like that before, but apparently looking through a much smaller hole enables you to test the vision without any of the light bouncing off the swelling in your eye. The right eye was still healing, so it only read at about 20/70. I was a little irritated that my vision was not nearly as recovered on the second day was everyone had told me it would be. That said, it wasn't exactly terrible considering I had my pressure spike three times the day before, and had abrasions on both eyes. This would be my biggest complaint with the whole process, I just don't feel like anyone was ever honest with me on the recovery time required. When I asked, they told me that after the post-op the next morning I would be completely fine going to work. Walking out of the appointment  I knew they was no way that I could drive, let alone work on a computer for the rest of the day. So I went home and just sat on a couch with my eyes closed for the remainder of the day.

I went back to work two days after the surgery, and oddly enough, my eyes have switched in strength from the vision test I took. I can see perfect out of my right eye, which barely read at 20/70 a day before, but my left eye seems to be on a slower recovery.

Writing this, five days after the surgery, my left eye is still fuzzier than the right, but seems to improve a little each day. I feel like it's just more swollen because the pressure was always higher in that eye, thus it had to be pressed on a little harder to relieve, but it's hard to say for sure.

If the left eye does not completely get to 20/20, I am able to get lasik performed on it at no additional charge, but I'm definitely hopeful that it doesn't come to that. So far I'm certainly not at the point of wishing I hadn't done the surgery, but I definitely wish my eyes were healing faster.

I have another check-up in a few days to mark a week since the surgery, and will write another post then.