[Part I can be found here.
Part II can be found here.]
“It’s very possible we won’t be able to remove your cataract,” the renowned cataract surgeon at Mass Eye and Ear repeated, and went on for many minutes in that same vein. This was no standard disclaimer of the type that all surgeons mention, in which unforeseen and unusual bad outcomes can happen but are highly unlikely. This was his emphasis, and he kept repeating how difficult my case was.
I felt very alone in that room. Was I hearing him right? I wished I had someone in there with me, or was at least recording what he was saying, because it was so shocking I was starting to wonder if I was perceiving it correctly. I asked him whether he could tell me my chances of success – give me some sort of percentage of likely success.
“No, I cannot possibly do that,” he answered.
This was unique in my experience. I’d had other tricky surgery consults for my back and arm injuries, and doctors had always answered that question. So I asked him again, saying that maybe he could just give me a rough idea.
He refused again. He could not and would not do it.
He barely spoke about the usual things like what kind of lens I might get implanted. It sounded to me as though he had given up before he even began. This was especially awful because I was under the distinct impression that he was someone who supposedly saw tough cases and plenty of them. If he couldn’t fix it, who could?
I felt lost and almost terrified. I had not expected this.
I asked him another question: could the synechiae (adhesions) have occurred because of my iridotomy? “Absolutely, ” he answered.
That at least seemed like the right answer to me, although it contradicted what the previous doctor had told me.
This Mass Eye surgeon added that if the cataract surgery failed, than I would need more eye surgery or perhaps several more eye surgeries of a more complex nature. But don’t worry, he would refer me to other surgeons for that, and Mass Eye had plenty of good eye surgeons.
Here we were, talking about the repair surgery for a surgery that hadn’t even happened yet.
I didn’t know what else to do, so I made an appointment for cataract surgery with him in about two months. At the very end he tried to reassure me by saying that at Mass Eye they usually were successful. After hearing for about twenty minutes how unsuccessful he expected my surgery to be, I didn’t feel the least bit confident.
I wanted to give myself a little time to think. But as time passed, the fear I had of that surgery never abated. In fact, the fear became worse as the surgery date – the first week of March – approached. I couldn’t picture letting this surgeon perform the surgery, but although I did searches for doctors specializing in complex cataract surgery, I couldn’t figure out where to go to find someone to trust. Mass Eye and Ear was supposed to set the standard for eye surgery in New England, and if they didn’t think they could fix it I felt lost and depressed and didn’t know where to turn.
I spoke to my brother and he mentioned he had an eye surgeon friend who might be willing to talk to me and give advice. She was very nice, but told me that most eye doctors didn’t see much of this condition, and that my local eye doctor who’d said he saw one or two a year was fairly typical. She’d try to find out who might be more experienced, and asked me if I was willing to travel to other parts of New England. I said I certainly was, and that I’d be more than willing to travel to New York. I probably should have said I’d be willing to travel anywhere, but I figured that New England and New York – the places she knew best – ought to have enough eye surgeons for her to be able to find one for me. But she didn’t seem to be able to find what I was looking for.
About a week before the scheduled surgery I called the Mass Eye doctor and we talked again. I had to make sure I had heard him right and that I wasn’t letting my imagination and fear run wild. He reiterated the entire message and even explained further. He said again that my case was unusual and especially difficult. My left eye hadn’t dilated at all in his office, and now instead of adhesions in about a quarter of my iris’ circumference – which had been the case six months earlier – now my lens and iris were stuck together for 180 degrees of the lens’ circumference. There also was some sort of extra membrane there.
I asked him whether I was the most difficult synechiae case he’d ever seen. He said “I won’t answer that.” Was that an answer of a sort?
And why on earth had the adhesions, which had involved about a quarter of the circumference of my eye for the previous seven years or so, suddenly doubled in size and scope in six months? I didn’t even bother to ask him that one; I was pretty sure there was no answer to be had.
At the end of the conversation, I told him that to be honest I was thinking of canceling the surgery. He said that I’d better cancel soon if I was going to cancel at all, so that they could schedule someone else for that time. I said I’d let him know within the next twenty-four hours.
You can imagine what those twenty-four hours were like. For the rest of the day and that night I felt sick to my stomach. I couldn’t see myself having the surgery with him – I really didn’t want him to go near me – but my vision in that eye was so poor and only slightly correctable with eyeglasses, and I felt I had to do something about it. But I had no idea where to go.
The tension mounted and I felt more and more ill. Talk about gut feelings! Around 1 AM, I did a search on my computer – the same one I’d done before I’d ever seen this doctor – for “synechiae and cataract surgery,” and this article popped up. I’d read it before, but that was before my appointment, when I’d still thought that Mass Eye and Ear would solve my problems and I wasn’t really looking for another doctor.
Now I read it again. The title was, “Synechiae can be managed during cataract surgery.” After having heard so much about how mine probably couldn’t be managed, I felt an immediate sense of relief on just reading that title. It was so calm and so positive. Can be managed.
And then it occurred to me to find the location of the doctor who’d written it. After all, he apparently had enough of an interest in the problem of synechiae and cataracts to have written on the topic. I discovered that his office was in Los Angeles, and that fact instantly gave me a good feeling as well. My ex-husband’s family lived there and I know LA very well. In fact, I’d had my arm surgery in LA when no one on the east coast had been willing to take a chance on me. My son had had his shoulder surgery there, and my husband his knee surgery.
The doctor’s name was Uday Devgan, and his website had hundreds of stories from satisfied patients and from other eye doctors. I realize these things can be bogus, but they were so detailed and so heartfelt that I felt buoyed up. Here’s just one example:
At 67 years of age, I had cataract surgery in Rancho Mirage, California. The surgeon botched one of my eyes, resulting in the loss of practically all eyesight in that eye. I consulted SEVEN ophthalmologists to learn the answers to three simple questions: 1) what was the problem, 2) how did it develop, and 3) what could I do about it.
NONE of these doctors could answer any of these questions, and I didn’t want to sue anyone. I just wanted to fix my eyesight. Most of the responses were shoulder shrugs, and a few were downright insulting, for example, one supposedly famous doctor said, “It’s academic at this point.”…
Finally, the last of the seven docs said, “I’m a pretty good surgeon, but I’m not good enough for your problem. If I had your problem, there is only one doctor I’d go to in Southern California. His name is Uday Devgan. Don’t let anyone else touch your eye.”
We beat a path to Dr. Devgan’s door. Low and behold, not only did he have the most and more up to date equipment than any surgeon we had visited, but within five minutes, he had answered ALL my questions. My cataract surgeon had made too large of an incision in my eye that was too close to the center, causing extreme astigmatism.
Dr. Devgan did three important things for me. First, he explained the entire problem and how he could resolve it. Second, his manner and the expertise that shined through gave me hope. And finally, after a year of healing from my botched cataract surgery, Dr. Devgan performed a PRK laser operation on my harmed eye that reshaped it and gave me 20/20 vision two months later in that eye.
I decided then and there at about 3:00 AM, that I would call Dr. Devgan’s office the next morning.
[To be continued….]



