A Patient’s Guide to Cataract Surgery Part 3: Post-Op

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With cataract extraction being such a quick and usually easy surgery, it is easy to forget that you just underwent a major procedure that requires close follow-up to ensure proper healing.  Your post-operative care generally begins one day after surgery, when you return to your ophthalmologist (surgeon) or co-managing optometrist and have the patch removed from your surgical eye for the first time. Here are some guidelines of what to expect:

Your vision: On Day One, your eye is just beginning its’ healing process, so don’t expect perfect vision from the start.  What most patients DO notice is that colors are much more distinct and crisp.  The clouding of the cataract causes whites to look more yellowed or brown, and once it is removed it appears “like the world has been dipped in bleach” to quote a happy patient.  As your eye continues to heals your visual acuity will improve, usually over the course of the next month.
Snellen Charts (above) check visual acuity.  Don't expect 20/20 vision on day one, but that doesn't mean you won't get there.

è Your comfort: Often times the eye is a little “scratchy” or irritated after surgery, simply due to the amount of inflammation that the surgery has caused.  Be reassured that mild irritation is normal, and with the use of your prescribed medications, these symptoms will improve.

è Complication Risks: At your post-op appointments, your doctor will be checking for several possible complications, as well as documenting your healing progress.  They will check:
                -your vision with and without correction
                -intraocular pressure
                -for leakage from the incision site (it should be sealed tightly without the need for stitches  depending on the method of incision used)
                - internal inflammation in the anterior chamber (this is called “cells” and “flare”)
                -proper position of the intraocular lens implant
                -rule out swelling of the macula (which would cause reduced vision; typically happens 1 to 3 months after surgery)
This is a Seidel test where flourescein dye is used to ensure there is no leakage of internal fluid (aqueous humor) from the wound.  In the picture above, there is obvious leakage and this patient would possibly need suturing.
è Your Medications:
                1) ANTIBIOTIC (TAN CAP): typically 4 times daily for 2 weeks
                                --examples = Zymaxid, Vigamox
                2) STEROID (PINK CAP): typically 4 times daily for 1-2 weeks, then taper slowly
                                --example: Pred Forte
                                NOTE: shaking this drop is important, especially with the generic 
                3) NSAID (GREY CAP):  depending on brand, 1 to 4 times daily for 2 weeks
                                --example: Bromday (once daily dosage!)
 Depending on your particular healing process, the dosage and length of use of these drops will be altered.

è Your Post-Op Visit Schedule: Typically you are seen at 1 day, 1 week, 1 month, 3 months
                --You maybe dilated (usually at the one month visit) to check for macular edema
                --Post-operative glasses can be prescribed at the 1 month or 3 month visit

è Things to Remember (a list of Don’ts)
      -DON’T lift anything heavier than 20 lbs for 2 weeks post-surgery (risk of wound rupture)
      -DO continue to wear the shield at night for 2 weeks
      -DON’T rub your eyes excessively (again, risk of wound opening)
                  --the shield at night will help prevent you from rubbing in your sleep
      -DON’T bend past the waist for 2 weeks (increases pressure on eye)

The follow-up period can be daunting to some, and there are a lot of eye drops to instill at the beginning of your recovery process.  Don’t be discouraged, because with proper healing your post-surgical vision may be better than you imagined possible without glasses!

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