Ophthalmologic Surgery Health Article

Pre-surgery preparation

Patients having ophthalmologic surgery usually must stop taking aspirin, or aspirin-like products, 10 days before surgery unless directed otherwise by the surgeon. Patients taking blood thinners also must check with their physician to find out when they should stop taking the medication before surgery. A number of pain relievers may affect outcomes, making it important for patients to disclose all medication. The patient might have to ask about alternative medications if the surgeon requires that he or she stops taking the usual regime before the procedure. Some prescription medicines have been known to cause postsurgical scarring or flecks under the corneal flap after LASIK.

To reduce the chance of infection, the surgeon may request that the patient begin using antibiotic drops before surgery. Depending on the procedure, the patient may also be advised to discontinue contact lens wear and stop using creams, lotions, make-up, or perfume. Patients may also be asked to scrub their eyelashes for a period of time to remove any debris.

Patients are advised not to drink alcoholic beverages at least 24 hours before and after the ophthalmic procedure.

Patients must usually avoid eating or drinking anything after midnight on the day before the surgery; however, some patients may be allowed to have clear liquids in the morning. It is important for patients to ask their physician for a list of foods and medications permitted on the morning of surgery. Some patients may take morning medications (with physician approval) with the exclusion of diuretics, insulin, or diabetes pills. Patients are advised to dress comfortably for the surgery, and wear button-down shirts that will not have to pass over the head.

Presurgical tests sometimes are administered when the patient arrives for surgery. For refractive surgeries, this ensures the laser is set for the correct refractive error. Before cataract surgery, measurements help determine the refractive power of the intraocular lens (IOL). Other tests such as a chest x ray, blood work, or urinalysis may also be requested depending on the patient's overall health.

Most ophthalmic surgeries are done on an outpatient basis, and patients must arrange for someone to take them home after the procedure.

Before surgery, doctors will review the presurgical tests and instill any dilating eye drops, antibiotic drops, and a corticosteriod or nonsteroidal anti-inflammatory drops as needed. Anesthetic eye drops also will be administered. Many ophthalmologic surgeries are performed under a local anesthetic, and patients remain awake but in a relaxed state.

Aftercare

After surgery, the patient is monitored in a recovery area. For most outpatient procedures, the patient is advised to rest for at least 24 hours until he or she returns to the surgeon's office for follow-up care. Over-the-counter medications are usually advised for pain relief, but patients should check with their doctor to see what is recommended. Some pain relievers interfere with surgical outcomes. Patients may also use ice packs to help ease pain.

Some patients may experience slight drooping or bruising of the eye. This condition improves as the eye heals. Severe pain, nausea, or vomiting should be reported to the surgeon immediately.

After surgery, patients may be advised not to stoop, lift heavy objects, exercise vigorously, or swim. Patients may also be required to wear an eye shield while sleeping, and sunglasses or some type of protective lens during the day to avoid injury. Wearing make-up may be prohibited for weeks after surgery. The patient may be restricted from driving and air travel.

Patients usually have their first postoperative visit the day after the eye surgery. Subsequent exams are commonly scheduled at one, three, and six to eight weeks following surgery. This schedule depends on the patient's healing, and any complications he or she might experience.

Some patients will be required to instill eye drops for a number of weeks after surgery to prevent infection, pain, and to lessen inflammation. Eye drops also are used to lower intraocular pressure. In some cases, correct eye drop usage is critical to a successful surgery outcome.