In January, I wrote about having eye surgery during the first week of the new year to free myself from glasses and contact lenses. The procedure was called refractive lens exchange, or custom lens replacement (CLR, pronounced like the word “clear”).
In CLR, an ophthalmologist removes the natural lens behind the eye and replaces it with a synthetic interocular lens (IOL). The synthetic lens can never develop cataracts and is free of the age-related hardening and opacity a natural lens eventually experiences. CLR restores the eye’s original refractive ability. Therefore, depending on the kind of IOLs inserted – the patient no longer needs vision correction as a result.
Although CLR corrected my astigmatism as promised, it took a second procedure, LASIK, in mid-February to fine-tune the results and try to bring my close-up vision into focus.
LASIK did demonstrably improve my reading and close-up vision within a few days. I noticed as I was driving the following weekend my dashboard looked sharper than pre-LASIK.
Unfortunately though, after several weeks, I still haven’t been able to read or focus in the near term without my cheaters. Everything within a few feet of me has remained a maddening couple of clicks off. A handful of people had asked me to share how all of this turned out. But while it ambiguously dragged on I have delayed posting an update. (Don’t worry though – it’s going to work out. Read on.)
I’ve gone back to my eye surgeon for several follow-up appointments and more tests to try and determine the source of the problem. Initially we thought it was just the healing phase, as my brain “rewired” and learned to work with the new eyes.
Then we thought it might have been posterior capsular opacification (PCO), an opaque film that can grow over the membrane holding the IOL in place. PCO can cause cloudiness and blurred vision similar to a cataract. My eye surgeon dilated my eye to check for PCO, but didn’t see evidence of it.
So I practiced a lot of patience and hanging in there this past three months since CLR, dealing with the dizziness of taking my cheaters off and putting them back on many, many times per day. And trying not to panic that even while my cheaters were on, things didn’t look perfect. I battled headaches and disappointment, trying to keep the faith that I was simply in a transition period.
One major comfort was my eye surgeon’s approach – he’d always pledged to not charge me any extra money until I was happy with my eyesight. At several thousand dollars per eye for CLR, not covered by my vision insurance, this guarantee was important in my initial consideration of whether or not to start this journey away from glasses and contacts. And sure enough, I didn’t pay more for the LASIK or anything else post-CLR.
Finally, this week in my latest appointment, we came to the conclusion that I would need to replace the left eye IOL. Again, for no extra charge.
My eye surgeon told me that not all patients qualify for the multifocal IOLs I received. It seems I am one of the few qualifying patients that doesn’t “tolerate” the lens in the non-dominant eye, and needs to switch to something called blended vision. As hard as my brain has tried to connect the dots the past few months, objectively, there is just some blur that needs correction and I cannot “think” my way out of it. The lens is probably great for someone, but not me.
I will have the lens removed next week in a procedure called “explantation,” on the left side only. The right side is doing great.
Explantation sounds awfully creepy to me, in a science-fiction way. But it’s really just the same exchange I had before, except this time instead of replacing my natural lens for an IOL, I will replace an IOL that isn’t working for me with an IOL that – according to the updated tests – should function for me much better.
After a brief period of healing, the adjustment should allow me to have better visual acuity up-close, and maintain my distance vision too. The right eye IOL will remain in-place.
As I mentioned before, I was pretty scared to have eye surgery the first time. I was dismayed to find out later that I needed some refining corrections from LASIK surgery. (And man, did that sting afterwards!)
Now to realize I have to have my literal eyeball operated on again for about a half an hour… I’m just trying to take it in stride. This is a very long game I’m playing, and I certainly will be thrilled to say goodbye forever to cheaters! Wearing my carefully selected, high-quality glasses was distasteful enough to me; being chained to drugstore cheaters has really sucked and was not what I signed up for. It would be fun to totally break free, and even play with non-prescription colored contacts again from time to time if I want to (and if I can keep my extreme dry eye under control).
FWIW, my understanding from both the doctor and the practice’s reviews is that my experience is unusual. The vast majority of patients seem to have CLR and within a few days, see perfectly and never even need LASIK afterwards, let alone the somewhat drastic step of swapping out lenses. Yes, it can happen, clearly, because it’s happening to me. But it’s being handled well and I’ve been treated as a patient throughout rather than a nuisance, so I have no complaints other than just wishing I’d been luckier. Much due diligence was done beforehand and I really don’t see any way this could have been mitigated from their side.
With just under 11 weeks remaining now in my fourth tour, getting my eyesight under control before I launch into a year of long-term, intensive training is so important. I’m really looking forward to perfect vision again – upon waking, while swimming, in the shower, and at the gym. It’s going to be great. I’m feeling positive about it.
In my final update about CLR later this month, I’ll talk (non-graphically) about what to expect during the surgery for anyone who is considering doing something similar. Knowing how not horror-movie-esque it is would have helped me going into it.
Collecting Postcards 