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Sunday, Mar 03, 2024 - 12:30 SGT
Posted By: Gilbert

Second Sight


The chimp inspects his prize
[N.B. Kecak dance arena at left in far background]
[N.N.B. Not too proud at having blurted out "He won!" at the coup]


The past fortnight has seen a trip to Bali for the Asia-Pacific Academy of Ophthalmology Congress, with a free afternoon devoted to the Uluwatu Temple for their ritual dance, for which the star was arguably the monkey god Hanuman; and fittingly too, given how his underlings have turned the temple complex into a happy hunting ground for (sun)glasses. These scamps are able to ambush from three dimensions - with more than a few tourists falling prey to muggings from eaves or tree branches - although the loss is often not permanent. As it turns out, the monkeys tend to be more than willing to return their loot, in exchange for a suitable offering of food. This honour system economy does seem quite stable, in their defence.

It was fortuitous, then, that I had no spectacles to risk, having taken the plunge on Implantable Collamer Lens (ICL) surgery. This admittedly came a little late in life, but after having been informed that my corneas were too thin for regular LASIK (and related procedures such as [Trans]PRK, SMILE, LASEK etc.) about a decade ago, I had shelved the thought of correcting my vision surgically. The desire would strike me again, however, and a little research brought up the option of ICL, which unlike LASIK and its ilk is an additive treatment that inserts an additional lens (think contact lens, which I never got used to), instead of sculpting (and thus removing) cornea material.

Having become less willing to procrastinate with age, I quickly scanned through local forums for recommended providers, which tended to turn up the same few names - reasonable, since ICL depends more on individual surgical skill than the laser-based procedures, which have been largely automated. Well, I had cause to trust the local ophthalmic fraternity perhaps more than most, and thus requested any available surgeon, which got me a consultation arranged by the next day. The good doctor indeed mentioned my colleague and supervisor at first meeting, so small world I suppose.

A battery of tests revealed that my anterior chamber depth was just about sufficient, and I would have laser peripheral iridotomy (LPI) performed on both eyes about a week later, with two machines used to puncture tiny holes in both irises to forestall potential pupillary block (and glaucoma). Despite some trepidation, there would be only very minor soreness and no burning odor as warned by some, which was a good start. Most of the discomfort came from getting lens pushed onto the eye.


How it is done


The surgery itself would take place four days later, and the morning began with liberal application of dilating eyedrops. I discovered that I was not even the first patient upon arrival, and the clinic staff would briskly dab my right arm with iodine (probably to test for allergic reaction) after I had donned the standard gown and cap. Upon getting on the surgical bed, my left sock got rolled down with an accompanying light pinch near the ankle - if that was the sedative, it was efficient. It then proceeded much as I had read from past accounts online - sheet over face with only a hole for the eye cut open (right one first), eyes held open with tape and then speculum, after which the incisions were made with periodic application of iodine.

Some accounts have the patient instantly getting crystal-clear vision once the lens is placed, which was unfortunately not the case here, although the overhead lights did come into focus somewhat. This was then repeated for the left eye, with the entire business taking maybe ten to twenty minutes. It was a testament to modern anesthesia that next to nothing was felt throughout, though there would be some minor soreness in the right - and later the left - eye for a day or so. Vision would be technically 6/6 the day after, if slightly hazy compared to glasses, but I'll give it a few months before deciding whether additional lasik touch-ups might be called for. The excellent visual quality on stepping out from hot showers does lend confidence that it might just be a dry eye issue, though.

That's one item off the checklist, and the dentition is next, after finally dispensing of my wisdom teeth last August. I'm suspecting that my habit of consistently sleeping on the same side might have contributed to the slight misalignment here, but this should be fixed in about nine months if the Invisalign ClinCheck projection is anything to go by.



Wonder if it'll affect the side profile?



Not that obvious from the outside




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