Photo by Madhav Rajesh on Unsplash

Health; Retirement in The Villages, FL

Alleviating the Fear of Cataract Surgery through Knowledge

Dr. Zeini’s fascinating 2-hour presentation far surpassed any office visit, video, or handouts. What we learned. Everyone knew what remained ahead.

Cataracts are an older person’s disease. You are 90% likely to have them if you reach age 65, even sooner, depending on where you live in the world.

My wife was just diagnosed as having cataracts at the level requiring surgery. Fortunately, it does not need to be done tomorrow but should be done within a few months.

The prospect of losing your eyesight is scary. I had cataract surgery a few years ago. I went into surgery “fat, dumb and happy,” with a layman’s understanding of what was happening, while depending on the medical experts, my surgeon, and my wife.

When I got out and opened the eye with the new lens, my first question was:

“When can I get the other one done?”

My eyesight was that much clearer.

Her situation is a lot different, due to her eyes and other medical conditions. She had numerous questions for Dr. Zeini, but he refused to answer them until after his presentation, which he gives every other Friday to patients having surgery.

Dr. Zeini’s 2-hour presentation — Summary

Everything you could want to know about cataracts. It was almost the same level, technically, as a presentation at a medical convention or one for medical students. It was perfect for us. Parts, especially the video of a surgery in real-time, may have been too detailed for someone squeamish, though.

How cataracts are formed. First, cataracts are not a disease in the normal sense. Doctors can not cure them with antibiotics and cannot prevent them with a vaccine. It is a change in structure of the lens of the eye, most frequently caused by sunlight and heat over many years. The presentation did not cover cataracts caused by other rare conditions.

Age-related cataracts can be delayed by preventative measures over your lifetime and being born in the right place (Wikipedia).

What they are. Most people think of the lens in your eye as being like a magnifying glass lens. It’s not. It is a shaped bag containing a clear gelatin, something like egg whites. Somehow, it works. Sunlight slowly cooks them, so they change color just like cooking egg whites. At stage 5, they become as solid as a rock.

History of cataracts. Before modern medicine, there wasn’t much physicians could do. At stage 5, the physician physically hit the cataract to knock it out of place and back into the eyeball, with a 50% success rate. Patients were thrilled when it worked, even though the cataract floated around and sometimes obscured vision. The alternative was complete blindness.

Before stage 5, the patient could be helped with extremely thick glasses, which we used to call Coke-bottle glasses. My wife is into genealogy. She pulled up a picture from 1945 of an ancestor wearing those glasses.

Most people didn’t get them 4 generations back because people did not live that long due to infections, diseases and accidents. In addition, many failed to reach adulthood due to the high death rate in children under age 6. After seeing those statistics, I have an even higher appreciation of modern medicine.

Today’s techniques. New procedures are much safer and quicker, IF you do them before stage 4. The video showing the entire surgery in real-time, about 5 minutes or less, was fascinating.

The doctor does not have time to look up from the microscope to a computer screen. I can’t imagine working with tools that small in a field where I could see individual blood cells.

Stage 5 is better than before, but still a higher surgical risk. The incision is much larger than the tenth of an inch needed for prior stages because the doctor must remove the cataract in one piece, since it is like a flat rock. In prior stages, it is still soft and can be sucked out through an extremely small tube.

The new lens. The bag holding the gel, now a cataract, is left in place. The physician inserts the new lens, folded, into the bag where the lens slowly unfolds.

Once the physician confirms the lens is seated correctly, the patient is sent to recovery and can go home. There, the patient must protect the eye with a clear shield and follow the post-op drug regimen for up to 3 months.

The patient’s choice includes several lens options, from single-distance to progressives. The decision may be limited by the patient’s other medical conditions, the patient’s experience with similar lenses in contacts or glasses, or finances. Some lenses and procedures cost more than others.

Most fascinating fact:

The Doctor gave the presentation himself
Not the nurse, assistant or clerk

The technology

Dr. Zeini described the technology and equipment in detail, including the cost and support services. He does optimize costs for the patient, like when to use one piece of equipment, needed only under rare special conditions known in advance.

He mentioned that the technology he’s using was used in Europe for over five years before it was approved by the FDA, although the procedure and equipment were developed and built in the US.

I understand the reasons behind the FDA’s caution in releasing anything prematurely after the Thalidomide disaster caused so many birth defects and infant deaths. It’s an awful position to be in. The question is always:

Save lives now -or- Risk lives later

The FDA procedures seem to fall on the side of caution and reduce the later risk.

Conclusions

At first, we thought some of the required procedures were excessive and only to make more money. We now realize the doctor leans to the side of caution instead of risk. We prefer to spend a little more money and not really need something than take a risk and have complications.

You don’t want complications with your eyesight

Statements in this article are my interpretation of Dr. Zeini’s presentation and not medical advice. Contact your doctor with any follow-up questions and to make medical decisions.

Dr. Zeini practices in The Villages, FL at EYES.

William “Bill” Myers, Analyzes all, Programmer, retired. If you learn anything new, find enjoyment, have a new thought, then I’m successful. Photo: 1st article

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