Letters to the Editor: Local hospital staff, surgery wonderful

Some time ago I read an article on
cataract surgery written by the Editor of The Compass, Mrs. Tammie Chisholm. It
was interesting to me because I was increasingly becoming a candidate for
cataract surgery, and suddenly a whole new world was opening up to me. 

Like many others, I was unaware of
the advances in this surgery that could, as if magically, eliminate glasses
that I had worn for most of my life.

I am writing this letter with a
view to adding to this information from a local perspective so that others
contemplating this procedure can more comprehensively decide on where they have
surgery. I chose local – given the many advantages- and I had wonderful service
along the way to my current better than 20/20 distance vision, right here at
the Cayman Islands Hospital. Specialist ophthalmologist Dr. Jyotin Pandit,
director of the Eye Clinic, performs some 20 such procedures each month, I am

Among the advantages of going local
was that I could not afford the US$10,000 that had been rumoured to be the cost
(US$5,000 per eye) for overseas procedures with the new high-tech lens. Perhaps
that figure was being overstated, but then there were the costs of travelling
back and forth, hotels and so on. 

As a CINICO (Cayman Islands
National Insurance Company) client, I went dutifully to the Eye Clinic at the
Cayman Islands Hospital for an assessment as to my readiness for cataract
surgery, originally with a view to pursuing it overseas. Surprise, surprise, I
was informed that the new high-tech lens could be arranged there – as well as
from private ophthalmologists.

From the start, Dr. Pandit advised
local anaesthesia, which I selected as I really did not want to risk general
anaesthesia if I could avoid it.

I was very happy with that
decision. While it sounds very daunting for a needle to be inserted into one’s
eye, I did not find it that unpleasant. The needle is inserted into the fleshy
bulb in the inner corner of the eye and the anaesthesia slowly released. Dr.
Pandit then worked it around by pressing on the eye and moving it from side to
side, until the anaesthesia took full effect.

Incidentally, there is a third
option, Dr. Pandit tells me – topical anaesthesia. I understand that patients
who opt for this can expect to feel aspects of the procedure, which could
possibly be a little daunting for some – depending, perhaps, on confidence in
the surgeon, and so on.

While the anaesthesia is taking
effect, the surgical nurse drapes the other eye, which helps to reduce patients’
procedural awareness. Also, surgical approaches to the eye are undertaken
peripherally, eliminating any natural reactions to a direct approach: I
experienced none. 

First breaking up and extracting
the existing cataract, the surgeon rinses the cavity and inserts the new lens.
There is no stitching and nothing further needs to be done, except for some
follow-up care involving patients’ applying drops for a period.

The whole operation takes about 15
minutes. For my first eye, I felt a little “zonked” afterwards, mainly
resulting from my own unwarranted apprehension. I was happy I had arranged
someone to pick me up and I really did feel that I needed to take the
prescribed rest. However, I felt much less anxiety going into the second
surgery, resulting in a far more relaxed state. When it was over, I actually
drove home (well, I do live just down the road from the hospital, but yes, the
eye was bandaged and it was likely not a good idea to drive, so suggest better
not to do that.) 

A comment about the pre-op care in
the Ambulatory Care Unit: I had first-class care, especially evident at the
second surgery. I felt absolutely pampered: Seated in a recliner in a quiet
room after the initial processing, I was watched over by attentive staff and
fortified with warmed blankets against the hospital cool — the works. The
staff of the unit absolutely exceeded my expectations. Kudos as well to the helpful
young ladies and gentlemen who ferry patients to and from the operating room.
Their kind attention and thoughtfulness are an important part of what makes the
Cayman Island Hospital such a fine health care facility in so many ways.

Another important aspect of
information for those considering cataract surgery is in regard to lens
selection, which provides for a number of broad options. The No. 1 option in my
view is lens that will dispense entirely with use of glasses. Unfortunately,
the shape of my eye did not make me a good candidate for this, I was told.
Another option is “mono-vision”. This means, strange though it may seem, using
one eye for distance and one for close vision: The eyes will complement each
other, and, voila, no more glasses.

Tempted though I was, I did not
select mono-vision. My choice was driven largely by my goal – as perfect as
possible vision for driving. Of course, given that reversals of any of these
procedures are difficult to access, likely expensive, and possibly risky,
expert advice and comprehensive information are critical.  

I chose the third option – lenses
that would allow me, as it turned out, perfect distance vision (now better than
20/20), though I must wear glasses for close vision. My original eye condition
was myopia – nearsightedness. It struck me as a little quirky that those who
had myopia end up with perfect, or near-so, distance vision, while those with
hypermetropia (farsightedness) end up with the opposite circumstance – they
will likely be able to read without glasses while they will need glasses for
distance viewing.

I must confess I miss curling up in
bed enjoying reading without cumbersome glasses, though I am adjusting to that,
but I really do relish driving free of the need for glasses. 

In a broader sphere, I recognise as
well Dr. Pandit’s initiative in equipping the eye clinic in line with its
modern services. Since his arrival in 2005, he has successfully championed the
service’s needs and the clinic and the operating room has acquired more than
US$250,000 worth of necessary state-of-the-art equipment, replacing obsolete
precursors. One of his innovations is a chair that duals as a surgical bed designed
so that the surgeon has full latitude of movement and access to the patient’s
eyes during the operation. And it is comfortable, to boot. It is important to
get the proper neck support during the surgery and the chair/bed allows for
that very agreeably.

Overall, I was happy with the
surgery. I was particularly pleased that I was able to access these
break-through lens right here at home, with little disruption to my life and at
no cost to me, having been fully covered by CINICO.

E. Patricia Ebanks

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