YAG Capsulotomy (or Fun with Floaters)

I am frequently asked, "Are your eyes done yet?"  by people who know I've had eye surgery to improve my vision that also know I'm taking a route that's not the standard LASIK path.  So what's the update?  Am I seeing craters on Mars with the unaided eye yet?  It's not been a straightforward path to my bionic eyes, and I'm not there yet.

I started out fairly eye-ignorant, so here are some details of all the fun ocular things I've learned about or have experienced so far.

To start, I wasn't a good candidate for LASIK for vision correction due to the prescription I have.  However, I was a good candidate for lens replacement.  It's an entirely different, more dramatic, but longer lasting option. So that's the route I went.

The thing you need to know up front is I had what people commonly call, "cataract surgery" only not.  And this is confusing.  It's confusing in the terminology.  If the lens in your eye is not cloudy, it is a "clear lens."  If it has become cloudy, it has transformed into a cataract.  You don't have "a cataract on your lens,"  your lens has clouded and is now referred to as "a cataract."

If you have a cataract and have the cataract replaced, you have replaced your natural, clouded lens, with an artificial one and you have had "cataract surgery."  However, if you have a clear lens, that isn't cloudy at all, and you have the exact same artificial lens implanted, you have had a "Clear Lens Exchange."  It is the same surgery.  There are two different names for the your lens (clear lens or cataract), and there are two names for the surgery (cataract and clear lens exchange.)  But it's ultimately the same thing.  Hence the confusion.

If you decide to have an artificial lens implanted, you have choices.  There are multiple manufacturers and they produce lenses that accomplish different things.  Some are better for close-up vision, some for far sight and some are accommodating lenses that work at all distances.  I went with the most dynamic lens so I wouldn't need glasses for any distance.

At the completion of everything, I will have lenses that won't ever get cataracts, they won't harden and require reading glasses as I get older (known as presbyopia), and they will stay at the same, correct, prescription over time.  Attractive sounding, isn't it?

It's more dramatic though.  There are lots of videos demonstrating what happens in a clear lens exchange. Below is a link to a short video that goes through the process.  But beware, this isn't fun to watch.  It's instruments in your eye that are destroying the natural lens and sucking it out with a straw-like tool followed by an aggressive-looking shoving of an artificial lens into the now-empty capsule. Clear lens exchange with Crystalens artificial lens  You were warned.

Once the lens exchange surgery is complete, the lens needs time to settle into place.  My first eye did well, but was off of the target prescription.  That's not ideal, but is relatively easy to correct with LASIK.  We waited to do the second lens implant to see how the first eye would end up.  Based on those results, the prescription for the lens in the second was adjusted and when it was implanted, the result was right on.

But that's not all.  I have an astigmatism in both eyes.  During the lens exchange surgery, the surgeon also did Astigmatic Keratotomy (or AK) on both eyes.  Astigmatic Keratotomy are incisions made on the surface of your eye that address a football-like lopsidedness of the eye known as an astigmatism.

So there's more to be done.  The first eye needs LASIK to adjust the slight farsightedness from the variation in the implant.  The second eye needs a touch more AK to complete the astigmatism correction.  These need to be completed once both lenses have been well situated the vision has stabilized from both implants.

But wait, there's more.  I had a YAG Capsulotomy yesterday.  The only way I can explain this procedure is to make an M&M analogy.  (Say that three times, "M&M analogy," it's fun, isn't it?)

Imagine the lens in your eye as an M&M.  In the clear lens exchange procedure the chocolate filling is broken up and sucked out through a hole in the perimeter of the candy shell.  Next, an artificial, chocolate-tasting lozenge with handles is inserted in the hole.  This artificial lozenge is somewhat smaller than the original, natural, chocolate filling.  But now the shell of your M&M doesn't have the supporting interior chocolate holding it up and over time it crinkles over time.  Imagine that outer shell as a thin, saran wrap-type material that's crinkly.  And imagine trying to see through it.

That's what the YAG Capsulotomy procedure does.  It gets rid of the crinkle.  Here's a video of the procedure, and the ouch-factor on this one is quite low in comparison to the last one: YAG Capsulotomy.  To continue the M&M analogy, this procedure just blows holes in the front and back sides of the M&M so you can see straight through it.  The result is you have a clearer, unobstructed view.

This procedure is fast.  I went in to the doctor's office yesterday expecting to be there for hours because, it's surgery.  And we all know, surgery is drawn out, it's slow, and you pay extra to wait longer usually, right?  Nope, shortest appointment I've had there yet.  They dilated my eyes, sat me down for ten minutes for the dilation to complete, the doctor walked in to a small machine and did some zaps (just like in the video) and sent me straight home. 

Side effects?  Floaters.  The blown away capsule bits are having a party floating around in my eyes today.  And you can't blink them away because they're in the interior of the eye.  They won't ever be  absorbed, but they'll settle out pretty quickly to the bottom of the capsule only to resurface under head trauma.  And we're not signing up for any head trauma, thank you very much.

So in summary, where are we with the long list of eye stuff that's getting done as I move towards my 200 megapixel vision goal?  Lens replacement?  Complete.  AK?  Two-thirds complete.  Crinkled lens capsule?  Crippled.  LASIK and AK adjustments?  To come in the next month.  Vision finalization?  To be completed with those word search puzzles once all procedures are done.

But I'm close.  I'm already seeing very well.  I'm pleased with how far we've gotten and I'm getting pretty excited about well I may be able to see things when everything is complete.  Rings of Saturn...I plan on seeing you from the backyard soon, so get ready.

The Big Boy Update: Out of the bed and into the classroom.  He can climb out of his crib today.  He's been close for a while, but he knows now that he can do it.  This is going to be fun for him and annoying for us soon I'm guessing.  On the school front, he's adjusted well and we're going for the full school day tomorrow.  His teacher kept him an extra forty-five minutes today because she said he wasn't ready to go yet. 

The Tiny Girl Chronicles:  Bird Study.  She's participated in a hearing study twice now as a volunteer.  I sit her on my lap, have headphones on me playing music so I can't hear what she's hearing, react, and invalidate her responses, and she listens to sounds while watching a monitor.  The study helps understand what sounds a child knows innately are warning or danger sounds and at what age they lose the ability to naturally discern a warning bird sound from a normal bird sound.  Apparently we know these things when we're young but somehow lose them as we grow older.

Fitness Update:  I ran with my cousin today and we had some fun with hills.  Or rather, not so much fun.  Hills are just not fun.  But hills make us better runners.  So we ran what we could and took walk breaks from time to time.  We did over four miles and we had a great time talking.  Running with someone is so nice.  It's a great way to get caught up and get exercise at the same time.