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  • My cataract updates

    Hello all,
    I returned home a day back after meeting the cataract doctor on monday.
    I will post all the proceedings here so that it can be useful for others who has to go for cataract under high myopic + sjs + sjogrend + mgd + high photophobic eyes.

    i had sjs in 1990 at age of 8 years.

    Had preliminary check up with cornea specialist.who had seen me and had vision test also.Stats of vision are as follows.

    Right eye:Finger counting vision upto 10-12feets.
    Left eye:could read first line on vision test globe, without any power.With power of -10 spherical and -2 cylindrial added to it, i could read 4 lines.So thats my best corrected vision at present.

    I had not worn any powered specs in my life.No doctor were able to see me properly due to non stabilized surface and excessive dryness.The coernea specialist was surprised at this and asked me to wear these numbers if i dont get cataract done shortly.

    After these the cornea specialist saw me who had seen me before also in 1997 and 2011
    He told my surface related issues have been improved over the years.And said such improvements are generally not seen in SJS patients.So i was doing good on that.(i would say thanks to cyclosporine).
    He had me on schimer test and for left ye it was 12.So not bad.
    He said my lids dont produce oils of the required quality.And said my lids are scratched.He said not to have any surgical procedure for lid smoothneing. as the more we have surgical procedues, the more weaker eye will get.He gave a lube to be applied on lids.its a Chlorocol contented eye ointment.

    He said he is okay with surgery but decision to operate will be taken by cataract specialist himself.(Dr.Abhay Vasavda(http://www.raghudeepeyeclinic.com/or...eadership.html)

    Then i visited the cataract specialist.He saw me and was ready to operate me.My cataract is Posterior Sub Capsular cataract.We asked him to oparate himself and not by his co ordinators.He said he will only operate and none else can operate such difficult cataracts.which is right and i agree to.

    he scheduled my surgery on 6th march tuesday.I will be in for pre operative check ups on Monday.The things related to IOL selection would be done then only.

    As myopic cataract needs to be watched closely for a higher chance of Retinal Detachment(RD), he advised me to take second opinion for retina.which will be done on monday evening.

    Im on genteal eye drops, genteal eye ointment and cyclosprine 0.1% at present.Cataract doctor called up cornea doc to recheck if cyclosporine is okay in regards to infections.and cornea doc said he is okay with cyclosporine and no need to stop it.(this is an interesting debate whether cyclosprine increases chance for infection or not, i had a small discussion on this with our user Littlemermaid).I m going to continue with cyclosporine till 4th march.Then will stop it.

    I will keep posting updates whenever i get chance in this thread.
    Really need to be a ROCK to take the pain!

  • #2
    http://video.osnsupersite.com/video/...3A%20exclusive

    This would help people.I liked the video...its informative.
    Really need to be a ROCK to take the pain!

    Comment


    • #3
      Hi
      Went to the local doctor for general check ups and retina advise.
      The doc told me not to have any other retina checkups unless the one which is scheduled 1 day prior to the surgery.
      One imp thing i came to know as doc said retina cannot be checked as precisely in cataract patients as it can be in a clear IOL patients.The cloudiness of iol bars the vision behind the eye(where the retina is).

      He told me very strictly to cancel the surgery even on last moment if i come to know Dr.Abhay Vasavada is not going to operate.Asked me to get operated only if Dr.Abhay Vasavada operates, not any other in his team.(even though Dr.Abhay has confirmed me that he will only operate we can never know if they change last minute due to unavailability etc)
      Really need to be a ROCK to take the pain!

      Comment


      • #4
        Hiren ~ We are thinking of you. Love and best wishes for great results.

        (Video is severe dry eye and cataract surgery, 'How to manage compromised corneas in 2011' - Dr Deepinder Dhaliwal, Director of Cornea & External Disease Service, Univ of Pittsburgh Medical Centre. Registering for OSNSupersite to access info is easy.)

        Is Dr Vasavada in the clinic in the post-op weeks or have you made good friends with the team?
        Paediatric ocular rosacea ~ primum non nocere

        Comment


        • #5
          hi there.
          yes he should be seeing me post operative period.

          i did not get a good chance to have a detailed talk to him.i just made him aware that i am an informed patient by asking him things about which technic he Will use in surgery. he confirmed he Will be doing phaco.he also informed me that new technology is invented just before three months where they use laser technology in operations.
          i asked him to make sure all pre operative tests as m highly myopic.then only he advised to take second opinion about retina from another retina specialist,out of his clinic.(this is the benefit of patient having information )
          i Will be having a few more queries when i meet him pre operative.
          Really need to be a ROCK to take the pain!

          Comment


          • #6
            I think laser for cataract is available in India but not with him yet, is that right? Just wondering if he thinks it might help if capsule is fragile, I imagine the equipment's very expensive. Wish you both the very best xx
            Last edited by littlemermaid; 03-Mar-2012, 10:53.
            Paediatric ocular rosacea ~ primum non nocere

            Comment


            • #7
              oh yes he didn't offer me laser surgery so i presumed thy don't have the facility yet.
              m getting more confused whether i should wait for more time before surgery as to wait some more new inventions coming up.likes of laser,lacritin that enhances glands to produce more tears etc. also the doctor informed that they are going to have BSL Facility by October this year in their clinic.
              it all confuses me more. i Will try to check his confidence when i meet him tomorrow.surgery is scheduled on Tuesday if all goes well within pre operative periods. if i feel his confidence is lacking then i may opt out temporarily and wait. my cataract does not need urgent treatment at present.

              lets see how things go
              Really need to be a ROCK to take the pain!

              Comment


              • #8
                http://www.defence.pk/forums/indian-...hed-india.html

                it should be available soon at his clinic i guess. what we also have to know is how the laser affects dry eye patients? not sure about it. if anyone has any idea about it let me know
                Really need to be a ROCK to take the pain!

                Comment


                • #9
                  Wonderful innovations, and good to hear your cataract is not so urgent, you must be feeling much more relaxed about this. (Laser cataract surgery is advertised but often looks like spin-off from laser refraction business, doesn't it, as if they don't care about outcome, I hope the businesses would not take on a difficult case, so much better with hospital expertise.) I do feel with my daughter that the surgeon's expertise is the most reassuring along with resources available, although I suppose finer tools and technology make his job easier.

                  It is a great blessing that Raghudeep are expanding the service so successfully, yet they have the drive to serve the community so charitably (Binkhorst medal speech http://www.youtube.com/watch?v=ALVFv...eature=related)

                  So happy you have the resources for relaxed choices after the court case and the opportunity to work with Dr V with your best interests at heart. Good to hear they are innovating with BSL in 7m. Would they use bandage lens for you post-op or is it entirely steroid control? I was wondering if he thought the capsule is more fragile than normal? And curious where he recommends for tied IOL for the other eye? I notice he says there's a high incidence of glaucoma post-IOL in aphakic eye and wonder whether he can look after you post-op if you go for that elsewhere?

                  We dearly hope for the best treatment and wonderful outcome for you.
                  Last edited by littlemermaid; 04-Mar-2012, 09:18.
                  Paediatric ocular rosacea ~ primum non nocere

                  Comment


                  • #10
                    hi.
                    i m not sure about using bandage lenses or steroids after surgery for wound healing.i Will ask him tomorrow.

                    the other eye is to be operated after this one gets done with.they Will have to use fixation iol because the capsule is raptured in that eye by a cataract is surgery in 2000 when there was no expert surgeon around as well as lack of technology.

                    dr.sangwan and dr.vasavada both were keen on operating my better eye first then the other eye.
                    Really need to be a ROCK to take the pain!

                    Comment


                    • #11
                      hi all
                      had all the pre operative check up done yesterday.felt like my eye is being butchered again and again at every check up.

                      the case seems to be complicated not only from dry eye front.but many other complications are there.

                      i had retina checked at two different places.both said my retina is too thin .they say retina is thin from birth itself and its good that till now it did not have a hole or tear or detachment.
                      they both said thin retina is not a problem for cataract surgery.so both gave green signal for surgery.but told to be extra careful by checking retina often.
                      vision correction after cataract Will depend on how much the retina works.being thin it won't give me a normal eyes vision.so they did not have any idea how much correction of vision Will be done. sad.

                      after all the check ups they found my eye is.s too long.axis of eyes suggests i have myopia since birth.they found my myopic number to be -17!
                      the doctor said he has never seen such large myopia.so they sent me for check up again.the problem with taking corneal measurement was my eye was getting dry within a second of putting drop.they needed wet eyes to take measurement of it. they tried a lot and got success sometimes. but results were varying each time. but again they found myopia around same range they found before.

                      then had a counselling with doctors and he said he would not be able to put lenses as such large myopic power lenses is not available anywhen in the world.i was really disappointed.
                      then i had a talk with my local optho doctor.he talked to dr.vasavda and asked him to consider putting lenses of any power so as to protect weak retina.

                      then dr.v felt happy to have such informed patients.and he told he Will try to put lenses.the decision Will be taken after he opens my eye in operation theatre as he want to see whether capsule is strong enough or not.if he finds capsule is weak he Will refrain from putting a lenses and leave eye aphakik.as he said the cataract is matured and would need removal soon else it would melt and give vision loss which would be irreversible.

                      so i Will be undergoing cataract surgery in next four hours.i might not be able to be here immediately.lets see how things go . keeping fingers crossed .
                      Really need to be a ROCK to take the pain!

                      Comment


                      • #12
                        If you can please pray for Hiren. We are thinking of you <hug>
                        Last edited by littlemermaid; 06-Mar-2012, 01:46.
                        Paediatric ocular rosacea ~ primum non nocere

                        Comment


                        • #13
                          Hiren, Wish you a speedy recovery and you are in our prayers!

                          Comment


                          • #14
                            hi all,
                            just wanted to convey that im alright , fitted with an IOl successfully.
                            But they are using pupil dialation drops to promote healin so im unable to read on pc.
                            I will write details later.
                            Thank u all for praying n wishing.
                            Im happy with the surgery for now.
                            Really need to be a ROCK to take the pain!

                            Comment


                            • #15
                              Hiren,
                              I'm so glad this is over!!! Wishing you a speedy and complete recovery.
                              Claire

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