You can take your usual medications the morning of surgery.
You need to discontinue anticoagulants or aspirin for five days prior to your cataract surgery.
During Surgery:
You will be brought to the pre-op room where the nurses will prepare you for eye surgery, and administer eyedrops to dilate your pupil.
When you arrive at the operating room, the anesthesiologist will place an intravenous line in your arm and may administer medication to help you relax. He will be monitoring your blood pressure, heart rhythm, oxygen level, and vital signs throughout surgery.
Topical anesthetic (eyedrops, no injections) will then be given to numb the eye.
The area around your eye will then be thoroughly cleaned and a sterile plastic drape will be placed around your head and face, leaving only the eye to be operated on exposed.
You will be aware of a bright light shining in your eye during the procedure.
I will give you simple instructions about where to look during the operation; this will ensure that your eye is in the best possible position for the procedure.
You do not have to worry about blinking at the wrong time—a special instrument will take care of your eyelids, and since the eye will be numb it will not feel the need to blink. Your opposite eye may be taped closed, and will not need to blink.
Eyedrops are instilled repeatedly during the surgery to keep the cornea moist. Although the front of the eye is already very numb, you will still be aware of the sensation of the drops hitting the eye each time; that does not mean that the “freezing” is not working. The eyelids can still feel the drops. Some patients have the feeling that their eye is”under water.”
You will be aware that I am working on your eye right through the operation. On occasion there will be slight pressure or minor discomfort for a very short time. Don’t be worried about this discomfort; we find that as long as patients have foreknowledge of minor discomfort during surgery and know that this is normal, they can easily take it in stride. However, if anything is bothering you, please tell us. I can administer additional anesthetic eyedrops and the anesthesiologist can give intravenous sedation as well.
You will hear gentle buzzing, clicking, tones, and beeping sounds of the ultrasound machine when the cataract is being broken up and vacuumed out.
The very best thing you can do during the operation is to pretend you are lying in bed at home. Trust us to do the very best work possible and you will find that it is so. Remind yourself, when you become aware of something slightly unpleasant, that it is meant to be that way and that the discomfort will soon pass. Do not allow yourself to”tighten up.”
The cataract removal and lens implant will take approximately 15-20 minutes. Usually the preparations take much longer than the procedure.
What to Expect After Surgery:
Topical anesthesia enables you to resume use of your eye immediately after surgery. Your vision will not be quite right at first because your pupil is still dilated, but you should be able to get around quite well and your pupil will be back to normal by the next day. If you required injection anesthesia your eyelids will be taped closed for a couple of hours. Double and/or tilted vision may be experienced as the anesthetic wears off. A droopy eyelid from the injection will return to normal in 1-3 days, and good vision should be reached within a few days.
It is normal for the white part of the eye to appear red or bloodshot. Do not worry; this will usually clear in a few days but can persist for a few weeks.
You should have no pain. The eye may feel scratchy or irritated at first and two Tylenol may be taken every 4 to 6 hours as needed. If you have actual pain or increasing discomfort, call us. It is common after surgery to feel a foreign body sensation (like an eyelash in the eye) for up to a week following surgery. As the eye heals this sensation will go away.
Notice how well you are seeing each day. Your vision should gradually improve but may fluctuate. Temporary floating spots and brief flashes in the vision are common immediately following surgery and these will disappear. Notify us immediately if your vision gets abruptly worse, if a shower of new floaters develops, or if a dark curtain or cloud appears and persists for more than 20 minutes
Medication Instructions:
Please bring your bottles of eyedrops to each office appointment so there won’t be any confusion about which drops you’re using, etc.
Antibiotic (Vigamox, Zymaxid, or Ciloxan): This medicated eyedrop is an antibiotic and is only used for one week after surgery. Use one drop every 2 hours on the day of surgery, then starting the day after surgery use one drop four times a day for two weeks, then discontinue.
Corticosteroid (Pred Forte, Prednisolone, or Durazol): This eyedrop reduces inflammation and promotes healing. It is used for several weeks. Use one drop every 2 hours on the day of surgery, then starting the day after surgery use four times a day for one week, then three times a day for the second week and finally two times a day until the bottle is completely finished.
NSAID (Non-steroidal anti-inflammatory such as Xibrom, Acuvail or Nevanac): This eye drop also promotes healing. Use twice a day for as long as directed.
How to Apply Drops:
Wash hands well.
Tilt your head back and look up at the ceiling.
Place your clean finger on your cheek, just under the eye, and pull down until a “V” pocket is formed between your eyeball and your lower lid. Do not put pressure directly on the eyeball.
Shake the bottle and hold it upside-down over the eye. Press the bottom of the bottle and one drop at a time will come out. Try not to let the dropper touch your eye.
Close your eye gently and use a clean tissue to absorb the excess run off medication.
Always let five minutes pass between drops when you are using more than one type. This will allow the first drop to absorb so that it is not washed out by the second drop.
Care of Your Eyes:
In the morning, gently wash your eyelids and the skin around your eyes with a clean wash cloth moistened with warm tap water.
During the day you may wear your glasses or sunglasses. Remember that the lens in your old spectacles corresponding to your operated eye is now incorrect, but will not in any way damage your eye. Some patients prefer to have their lens “popped out” until a new lens is prescribed three weeks after surgery.
Normal activities can be resumed the day after surgery. There are no restrictions on physical activities, except for swimming and going in a hot tub or whirlpool for one week. You may drive, walk up and down stairs, run or jog, exercise, shower and shampoo, watch TV, read, sew, or play the piano (if you know how). You may return to work anytime if you do not work in dusty or dirty air. If your job requires extreme physical exertion or you work in a dusty environment, please discuss with me. Keep your operated eye clean. Always use clean tissues (no handkerchiefs!) Do not reuse tissue and never wipe the unoperated eye and then the operated eye with the same tissue.
Visits to the Office:
Your first post-op visit at the office will generally be scheduled the next day and your second visit will be about one week later. The final visit is another two to three weeks after that. Usually by that time the eye is ready to have the spectacle prescription changed.
We encourage you to call the office if you have any questions before or after surgery. You will find that we are all committed to providing you with the most modern, safe and effective surgical care.
