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Cataract and lens replacement day of surgery and postoperative instructions. 1-9-2018



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hello so today is your big day and we're

excited for you we're going to help you

improve your vision with cataract and

lens replacement surgery and it really

should be a pleasant experience for you

the surgery itself usually is painless

you'll see some lights you'll feel some

pressure maybe some fluid flowing over

the eye but it really should be quite

painless and comfortable it takes 10 to

20 minutes and then you're done once you

sit up from surgery you'll be able to

see but your vision won't quite be

normal a lot of people will immediately

notice that their vision looks kind of

pink or foggy or rose-colored normal

symptoms that they'll notice are

sometimes their eye will be slightly red

you might see a little bit of red blood

on the white of your eye that's very

common and should be of no concern

usually your vision will improve over

the period of about 12 hours that follow

surgery the numbing medicine usually

wears off after about a half an hour and

your eye might feel just a little

scratchy a little sticky but it's

usually not too bad your vision improves

gradually you might notice some very

common symptoms such as shimmering

lights kind of a flickering sensation a

shadow that you notice kind of out to

the side you might be a little bit

light-sensitive your eyes might feel a

little dry and Scratchy and your vision

might be a little bit blurry during the

first day usually within about 12 to 24

hours your eye will have had enough time

to heal such that you can tell your

vision is significantly better

additional common symptoms are tearing

or watering of your eyes your vision

will be initially cloudy especially for

the first six to eight hours after

surgery the tearing will make your

eyelid skin a bit swollen and that's

normal usually this one goes away after

a day or two do not expect to see

perfectly or great during the first 12

hours after surgery usually takes 12 to

24 hours before you start to notice

significant

improvement in your vision the day after

surgery when we see you for your

follow-up visit your vision will be

quite good noticeably better than it was

before your cataract surgery the day

after surgery most people see about 80

to 90% of their full improvement the

remaining 10 to 20% of the visual

improvement occurs by one month after

surgery let's talk about aftercare

instructions you'll be going home with

this clear eye shield which is shaped

like a teardrop this is the top of the

teardrop and this is the bottom of the

teardrop the eye shield is placed on

your eye such that the top of the

teardrop is placed between your eyebrows

the bottom of the teardrop is placed on

your cheek it's come it's placed almost

diagonally enclosed in your eye kit is

this roll of paper tape it's usually not

very irritating to your skin

all you need are two pieces of the paper

tape an inch or two in length and you

need one piece at the top of the

teardrop and one piece at the bottom of

the teardrop and then you place the

shield as we describe where the top of

the teardrop is between your eyebrow and

the bottom of the teardrop is on your

cheek

so it's diagonally taped one strip of

tape that's about an inch or two long at

the top of the teardrop and one piece of

tape that's about an inch or two long at

the bottom of the teardrop and it's

diagonal okay that's how you place the

show we ask that you wear your shield

all day on the day of your surgery

now to put in your eye drops that you'll

need to put in you can remove the shield

put in the eye drop and then place the

shield back on your eye just on the day

of surgery on the day after surgery you

don't need to wear it so when you come

to our office you don't have to come to

our office with your shield on you just

need to wear it whenever you're going to

lay down to go to bed or take a nap you

only need the shield at nighttime while

you're awake you don't need it at all

it's simply too

prevent you from damaging or rubbing

your eye inadvertently while you're

asleep and you're not aware of what

you're doing but whenever you think

you're going to take a nap or go to bed

at night or fall asleep inadvertently go

ahead and put it on for the first week

after surgery it's most important the

first night after surgery but it's

ideally warm for one week after your

cataract surgery let's talk about do's

and do nots after your surgery you can

use your eye you can look around you can

bend over you can pick things up you

could do most errands you can wash your

face you can wash your hair and shower

the day of surgery a shower and wash

your face of course there's going to be

water flowing around your eye let it

flow just close your eyes softly if you

need to wash your eyelids just you can

use soap and water but just be gentle

nothing real hard or strong or pinpoint

just gentle blotting gentle gentle

nothing real hard and firm to solve okay

we will see you the day after surgery

evaluate your eyes and then make a

recommendation on if it's safe for you

to drive after surgery there are some do

nots or some restrictions there's two do

nots for everybody so number one do not

rub your eye real hard with your finger

or your knuckle or your fist number two

do not squeeze real hard so if your eye

sting or they go irritable don't squeeze

real hard the incisions that we make in

your eye

self sealed but by rubbing really hard

or squeezing real hard especially in the

first few days you could put unnecessary

torque and strain on the incisions and

they could inadvertently leaked a little

bit of course we would not want that to

happen usually by one week after surgery

the eye has regained enough strength

that you no longer have to wear your eye

shield at night and you

apply more and more pressure to the eye

without adverse consequences for women

who use makeup or mascara we asked for

one week no makeup on the eyelid no

mascara on the eyelashes you can wear

makeup everywhere else except on your

lid and lashes on day eight after

surgery you can wear makeup however you

please on your lid and lashes the reason

for avoidance of the makeup is there is

a fine powder in the makeup and the

powder floats in your tear film and we

can see it through the microscope wooden

and we do not want any of that makeup

powder inadvertently migrating its way

into your eye after surgery also women

who remove their makeup they tend to put

quite a bit of pressure on their eyelid

to remove the makeup so we'd like you to

avoid that for the first week

facial moisturizing creams moisturizer

skin cream in general you can use it you

can use it on your face you can use it

on your eyelid the day of the day after

surgery but just be super gentle again

soft very gentle nothing real firm I'd

probably avoid sunscreen around your

eyelid for the first week as well

because it's it can sting and get in and

irritate your eye and we just want

anything that could be irritating to the

eye you just leave it alone for one week

another common symptom after surgeries

you might feel like there's sand or hair

in your eye that's very normal

that's the little incisions healing

after surgery the incisions we make are

tiny they're about two to three

millimeters in length they seal on their

own without stitches in the vast

majority of cases you'll be provided an

eye kit that contains in addition to

your eye shield and a roll of tape and

post-operative instructions you will be

given sunglasses that you could wear if

the sunlight bothers you you don't have

to wear them all the time you don't have

to wear them at all

the sunlight won't do any harm to your

eye but some people are light sensitive

so they'll mark

while wearing these sun shades they're

helpful if when you go out especially

after surgery your your your pupil is

dilated so you're going to be

particularly sensitive to light you can

put these sun shades on they are

designed to fit over your glasses

because they have this space built-in so

you can wear your glasses or you can

wear an eye shield and place the sun

shades over the glasses that you

normally wear or your eye shield that

you're wearing immediately after surgery

use them if you want but they're not

required they might help people who are

prone to squinting their eyes due to the

sunlight it'll block some of the

sunlight so you won't feel the need to

squeeze or squint the there is the

tendency for your eyes to feel dry

stinging Burnie feel like there's an

eyelash or hair in your eye after

surgery that's very common character to

in and of itself induces dry eyes that

are temporary in nature but tend to get

better in your eye kit we've provided

you a sample of a type of artificial

teardrop there are many different brands

these are three excellent brands that we

may give you a sample of or which you

can purchase on your own at every

grocery store every pharmacy these are

over-the-counter artificial teardrops

you can use them as often as you want

they're great for makes me where I feel

better

clearing your vision up if your eyes dry

you put these drops in as often as you

want it is not possible to overdose on

artificial teardrops use them as often

as you want if you think they're helping

or if they make your I'm more

comfortable a big bottle of these

artificial teardrops at the grocery

store a large bottle will typically cost

about $10 the most important eye drop

that we would like for you to use before

and after surgery is this bottle it's

called PG B

and it stands for the three ingredients

in this bottle prednisolone

Gadda flock CSUN and Brahm Fanuc

prednisolone is a steroid designed to

prevent inflammation and swelling after

surgery G is an antibiotic that is to

prevent infection after surgery and

broth enact is what we call a

non-steroidal anti-inflammatory drug it

is designed to reduce pain inflammation

and keep your eye very comfortable after

surgery in this bottle which has a

purple cap there are three point five

milliliters of medication there's 20

drops per milliliter therefore in this

bottle there are 70 eye drops we ask you

to use the drops three times a day

starting one day before surgery continue

three drops per day for one week after

surgery so that's 24 drops and then we

ask you to use one drop a day for weeks

two three and four let's go for

instructions on how to use the pgb

eyedrop first of all as you can see on

the bottle it says shake well so you

shake it well let's say I'm having

surgery or I just recently had surgery

on my right eye here you remove the cap

of course and the best way to still

eyedrops is to tip your head back

and then pull down on your lower eyelid

to create a little pocket using a

magnifying mirror can be very very

helpful and then you just place one drop

into that little pocket and if you blink

a little bit it'll distribute itself

using multiple using multiple drops

inadvertently let's say I put in two or

three drops sequentially bam bam bam

into the eye all at once will it do any

harm no not at all it's very safe but

the eye can only absorb one drop at a

time so if you put in multiple drops the

second and third drop if they're placed

sequentially within a few seconds

they're just all wasted they'll flow

down

cheak they won't actually stay on the

ice surface so all you need is just one

drop three times a day so think about it

is use it breakfast lunch and dinner

every day starting one day before

surgery use it for three times a day

breakfast lunch and dinner for the first

week after surgery and then once a day

for starting date eight until day 31 if

you need to use artificial teardrop

let's say you're using artificial tears

to moisten your eye because you have

some dryness to your eye how long should

you wait after putting in this drop how

long should you wait until you put in

this drop it's only about one minute so

you want to allow at least one minute

for the first medication to absorb into

the eye before you put in any subsequent

eye drop because you don't want the

second drop to wash the first drop out

about one minute is all you need between

two different medication eye drops okay

to recap pgb is the most important eye

drop you said three times a day starting

one day before surgery and for the first

week after surgery and then starting day

eight and four weeks to three and four

usually just once a day you'll use a

total of about fifty drops if you apply

it correctly there's 70 drops in the

bottle it should last you the full month

you should only need one bottle of

medication pgb per eye let's say it's

been one full month after your surgery

to your right eye and you stop the drop

and your eyes starts to feel a little

bit sore or red or light sensitive but

your vision is still pretty good but

your eye just doesn't feel right it's

okay between one and two months after

surgery for you to go ahead and put in

an extra drop once a day if your eye

still hurts try to stop it after the

first month but if your eye feels achy

sore painful uncomfortable it's safe to

use this once a day as needed between

month one and month two after surgery so

between the

and sixty days after surgery if your eye

starts to ache or feel sore put in one

drop and then don't take it the next day

see if your eye is comfortable enough to

stop it can stop it completely if you go

a couple of days and then your eye

starts to ache again go ahead and put in

another drop as needed to keep your eye

comfortable but most people I'd say 95%

of people only need this medication for

the first 30 days after surgery and then

they can stop it but if you have to take

it between day 30 and day 60 as needed

it's probably safe if you still need the

pgb drop after 2 months after surgery

because your eyes still painful or your

visions not clear or your eyes not

feeling normal

and seeing normally then we should then

then please call our office so we can

examine your eye and make sure

everything's okay if you have redness to

the I will check out the day after

surgery typically it'll just reabsorb on

its own without special treatment within

two weeks after surgery but 2 weeks

after surgery here I should be very

white and quiet there are some warning

symptoms that if you experience them we

would want you to call our office number

one excruciating pain number two nausea

or vomiting fever vision that initially

is getting better and then suddenly gets

worse vision that improves gradually

over the first few days and then

suddenly gets worse redness to your eye

that it is present initially and then

starts to improve and then the redness

suddenly gets worse we would want you to

call our office so we can evaluate your

eye it's normal to have some discharge

the day of surgery but usually the

chances of infection the first 24 hours

after surgery are exceedingly rare

because we've given your eyes so much

medicine and antibiotics it's not likely

the discharge is of any danger in the

first 24 hours after surgery but if you

experience discharge to your eye after

the first day then we want to evaluate

your eye to make sure

that everything is okay so when you get

home today you can resume your normal

diet

there's no dietary restrictions you can

resume all your normal medicines of

course we don't ask that you stop any of

you usual medicines before your surgery

the valium pill that most of our

patients receive to help them relax

during surgery will tend to make you

sleepy so go home get some rest

if you're resting of course remember to

use your eye shield usually the valium

wears off in about 12 to 18 hours if

your vision is clear and you feel safe

driving you can drive yourself in for

your follow-up visit however if your

vision is not clear or you do not feel

safe driving then we would ask that

somebody else drive you so you can come

in for your one day after surgery

evaluation will take great care of you

today during your surgery

our team is outstanding they should make

you feel comfortable and know that

cataract and lens replacement surgery is

our specialty we've done this thousands

and thousands of times it's very safe

it's highly successful you're going to

receive the best care possible so come

in relaxed come in happy everything's

going to be taken care of for you you

don't have to worry about anything we'll

make sure it goes well for you and that

you're gonna have your vision improved

and you'll know that within the first

day after surgery and you'll and you'll

you'll be able to tell for yourself how

much better your vision is usually

within 24 hours after surgery so we'll

make sure you feel comfortable and we'll

take great care of you and I'll see you

in the operating room and then I'll see

you tomorrow

on your first day after surgery

follow-up thanks for trusting us have a

wonderful day and we'll make sure your

surgery goes well thanks again