Intacs Operation Diary - **Updated**

[Karl R]

Hi all.

Thought I would post my experience of the Intacs op for others.

Thur 8 Feb:

Having starved from 6 am I arrived at St Paul's Day Ward, RLUH at 11:45 and was booked in at 12:00. I saw the anesthetist at 12:30 and Mr Kaye at around 13:30. Mr Kaye explained the procedure again and also explained the risks, namely infection, possible need for removal of the Intacs, no refractive correction obtained and possible rupture. Consent form signed.

Taken into theater at 16:00 and don't remember anything after 16:15 until 17:45 when I came around in recovery to be told that I was being admitted overnight. Had hoped to have been able to have gone home the same day, but apparently I had a reaction to the anesthetic which had given cause for concern. Briefly saw Mr Kaye who informed me that as far as the insertion of the Intacs went, the operation had gone well and that he would see me again first thing in the morning.

The right eye wasn't painful, just uncomfortable with a gritty feeling, this was managed with ibuprofen and paracetamol overnight. Managed to get some sleep but the most uncomfortable thing, apart from the bed, was the eyeshield.

Friday 9 Feb:

Woke from a doze at 6:00 feeling very groggy after the anesthetic. Nurse came around at 6:30 to change the eye shield. After having the eyeshield removed and the eye bathed I was able to look out of the eye for the first time post op and immediately noticed a difference, I could see the bay number on the door 5 foot away without my glasses, albeit slightly blurred. Not been able to see a 4 inch character unaided out of my right eye for many years. The results of the op were looking good.

Saw Mr Kaye at 8:00, and did the sight chart unaided. Managed to get 4 lines plus 2 letters, again slightly blurred due to the fact my eye was watering a lot but they were fairly easy to make out.

Both myself and Mr Kaye were pleased with this result as it had been expected that I would have been lucky to get 2 lines unaided.

Mr Kaye told me to expect slight discomfort from the eye for a couple of days as although a clear protective lens had been placed over the site there was a large abrasion near the stitches. Discharged with antibiotic eye drops every four hours and anti inflammatory drops four times a day.

22:00 that night I was in agony with my eye. It delt like someone was cutting into it with a knife. Took some strong painkillers and fell asleep for a few hours.

Sat 10 Feb:

Woke at 2:00 again in agony with my right eye, this time it felt like someone had not only cut my eye but was repeatedly punching me in the eye, painkillers gave no relief.

By 09:00 I'd had enough and phoned St Paul's primary care for advice. Based on the symptoms I gave them and that by now the eye had closed fully, they advised me to go to my local A&E dept at Southport. Saw the on call ophthalmologist who had a good look at the eye and found it to be very inflamed as well as the eyelid being inflamed, although the eye was very red and bloodshot he could see no sign of infection but wanted to speak to St. Paul's for advice. After a while he came back and said that he's managed to speak to Mr Kaye and that he wanted to look at the eye again as he couldn't see the protective lens. Seems like I'd managed to somehow lose the lens the day before and the stitches and the abrasion had been scratching on the inside of the eyelid which in turn had become inflamed and had then been rubbing on the eye. A new lens was fitted. Sent home with some more anti inflammatory tablets and advised to get some sleep.

By the time I got home the eye had started to settle down with the new lens on place and was only slightly uncomfortable. Went to go and get some rest as feeling tired from the little sleep I'd had and within 5 mins of closing my eyes was in agony again, this time with a severe burning sensation. None of the painkillers I had offered any relief and had a sleepless night.

Sun 11 Feb:

By the morning, after having had no sleep since 02:00 the previous day I was knackered. Whilst open my eye was merely uncomfortable, but closed I was getting the severe burning sensation and pain still along with a yellowish thick and sticky discharge, and white smoke like haze in my vision.

Went back to my local A&E, again on the advice of St Paul's Primary Care. They have now found that I have managed to get an infection, an inflamed eyelid, an inflamed eyeball and also an inflamed cornea, all of which they have said would give rise to the symptoms that I am experiencing at the moment. The A&E have prescribed antibiotic cream and a muscle relaxant to be administered along with the drops that I am currently taking.

That everything up to date. Due to go back to outpatients in Friday and will post another update following that appointment.

Do I regret having the operation done? In all honesty, despite the pain, lack of sleep and the infection, the answer would have to be no I have no regrets.

The post op complications are annoying and unfortunate but although it's early days yet the result of the operation is better than expected.

Hopefully my experience to date will not deter others from having this procedure done as I am sure that it was just the unfortunate luck of the draw that I managed to get complications post op

[jayuk]

Karl

Excellent! This is exactly whats needed....these kind of diaries and experiences written lke you have....I cant thank you enough....as it really highlights the process and whats involved....

J

[GarethB]

Thanks for the update.

At last we are getting posts from those of direct experience of the op.

Please keep us updated as you make progress.

Much valued information.

[Rohit]

This is brilliant, ive been thinking and disscussing the intacs process with the surgeons an the rest for a while but its great to get info first hand.

[Karl R]

Time for an update.

Mon 12 Feb

Still a lot of pain and no sleep. Getting p'd off with the lack of sleep so went to GP. GP sent me to St Paul's Primary Care.

After a 5 hour wait, it was decided to increase the frequency of the drops to hourly as the infection was still rampant and the swelling not showing signs of subsiding.

Tue 13 Feb

Much the same as the previous day.

Wed 14 Feb

Still no sleep overnight, but eye starting to be less painful and looking less swollen. Lens came out in the evening.

Thu 15 Feb

Finally managed to get sleep, a whole 6 hours. Woke up and eye was feeling much better with only slight discomfort and grittiness. Looking at the eye in the mirror showed that the swelling had gone down considerably overnight and the eye was much less red looking and you could actually see a fair amount of the white. Spwnt most of the day sleeping in between the eye drops.

Fri 15 Feb

Another good night's sleep. Eye feeling better than the previous day. Went to St Paul's for post op follow up.

Visual acuity unaided not as good as the previous week, could only manage 6/24. I had expected the vision to vary as I had noticed it would vary throughout the day so no disappointment there.

At the end of the refraction test I was shocked to be told that aided the vision was 6/6 plus 4! For the 1st time in over 15 years of wearing glasses I could read most of the bottom line of the sight chart. Went for Orbscan.

Saw Mr Kaye shortly afterwards. After a good look at the physical condition of the eye, he said that it was progressing well and that aided vision was much better than expected, especially given that there was not much difference in the pre op orbscan and the post op orbscan. This was explained that it was possible that there were irregularities present which they couldn't see pre op and that now I'd had the intacs the cornea had become more regular in surface shape.

No new glasses yet as they want my vision to stabilise. Need to continue with antibiotics for a further 2 weeks and the pred forte until eye swelling has gone completely. Follow up appointment in 5 - 6 weeks time when all the tests will be repeated and the stitches removed.

A week post op and the difference is noticeable. Objects are becoming much clearer and crisper, writing is becoming easier to read. Whether this will remain only time will tell, but at the moment the future is promising. Still have no regrets about having had the operation done.

[GarethB]

Karl,

Thanks for the update, hope you are feeling lodas better and sleeping better too.

[Karl R]

Thanks Gareth.

The eye has now settled down and is only occasionally slightly painful

[Andrew MacLean]

A week post op and the difference is noticeable. Objects are becoming much clearer and crisper, writing is becoming easier to read. Whether this will remain only time will tell, but at the moment the future is promising. Still have no regrets about having had the operation done.

Good man, Karl.

You have been through the mill a bit, but I hope you begin to emerge from the gloom (sorry about the mixed metaphor)!

Andrew

[Mark Baker]

Hi Karl

glad everything is going ok.

Having had a graft in my left eye in 1999 and intacs in my right eye last August i know which of the two operations I prefer!

Even after the graft I still had very poor vision in my left eye ( - 9.75) and the recovery was a nightmare, with the continual check ups every month and I remember being disappointed as I could not be fitted with a contact lens until about a year after the op.

The intac has settled in very well and the only problem I had was with light sensitivity as they used a femtosecond laser which I was told could cause problems. It got so bad at times, particularly when driving, as the sun was low in the sky and I had to stop a number of times.

Any way I am now wearing spectacles and the vision is fine.

I hope your recovery continues well

[dplees]

I am having Intacs fitted in 6 weeks time. I am a bit nervous about the healing time, does anyone know how long the light sensitivity lasts for? I have read that the patients treated with the femtosecond laser can resume all activities almost straight away.

I'm self employed and cant afford to be off work for too long.

Many thanks