What patients and their families must know: Cataract medication Cataract is a clouding of the lens, which cannot be eliminated by controlled diet or medication at present. Both domestic and imported eye drops for cataract treatment, based on our clinical observation: none of them have definite efficacy, such as Carlin U, Cataract Stop and Barrier Ming. As for other health care drugs, such as eye gold and eye gold, we advise you to choose carefully. The effect of cataract surgery is to remove the cloudy lens and replace it with a transparent IOL. The choice of IOL mentions post-operative results, and we must account for which IOL you should choose and which is more suitable.
The ordinary lens can make you see TV clearly, walk, and shop after surgery without any problem; but you can’t see your cell phone, read newspaper, or even eat a little bit clearly. This is because the traditional ordinary lens, which only guarantees to see far away, cannot solve the problem of presbyopia, and you need to wear presbyopic lens at 3 months after surgery. However, with the advancement of science, multifocal IOLs can help us solve the problem of presbyopia. If you have good financial condition, you can consider choosing multifocal lens, so that you can see clearly both near and far after surgery, and you can happily go to the park, read books and newspapers, and play mahjong at will, which gives you the feeling of rejuvenation. Of course, if your financial situation is average, don’t be depressed, you can choose a normal lens and get a pair of presbyopic glasses after surgery, which is also economical. Of course, for young patients, patients with trauma or concurrent cataracts, etc., it is better to implant a multifocal lens because such patients did not have presbyopia before the injury and can see clearly both near and far; after surgery, if the implantation is a monofocal IOL, even if you are lucky and the fundus is not broken, you can see clearly in the distance, but still cannot see near, and the patient will be extremely uncomfortable. There are also some patients, who may need to drive, it is recommended to install aspheric lens, the vision of driving at night will be better than normal lens.
In conclusion, the advancement of technology has given you more choices. The multifocal lens can help you see far and near, which makes life very convenient; however, you cannot choose multifocal lens if your astigmatism is greater than 1.5D, you can only choose a lens that corrects astigmatism; if, you need to drive and other activities, you can choose aspheric lens, which will make your night driving vision better than normal lens. If you have diabetes or iridocyclitis, or have had surgery for vitrectomy, or even silicone oil, a heparin lens will be better than the others; if you are traumatized and have no posterior capsular support, then an iris-clamped lens is an option. If you work and live in an environment where there is more daylight or brighter lights, yellow crystals are more suitable for you. Yellow crystals can absorb blue light and ultraviolet light and protect the retina, which is a reasonable choice.
With the progress of technology, in order to adapt to the needs of various patients, IOLs are available in various models and functional designs. The one we help you choose may not be the most expensive one, but it must be the most suitable one for you.
Pre-operative medication for cataract surgery If the patient has high blood pressure or diabetes, please use regular antihypertensive and hypoglycemic medications without stopping them before surgery. Usually, in the morning before surgery, the medication for high blood pressure can be doubled, for example, if you take 1 tablet of Kepone every day, you can change it to 1.5 tablets before surgery. Because the patient will be particularly nervous on the day of surgery, blood pressure will be higher than usual, the appropriate increase in the amount of medication, conducive to the safe conduct of surgery. For patients suffering from hypertension and diabetes, blood pressure should be controlled below 150/90mmHg and fasting blood sugar should be below 8.3mmol/L. After admission, eye medication should be ordered carefully, for example, the multiple use of antibiotic eye drops will reduce the risk of postoperative endophthalmitis.
Pre-cataract surgery training Pre-operative training is emphasized to train the patient’s ability to cooperate. Because the surgery is only surface anesthesia, the patient’s eye can be turned; however, the patient’s random turning increases the risk of surgery. We compare the surgery to a carpenter stapling nails on a bench, and the patient is the one holding the bench. If you shake the bench while I am stapling the nails, I must be unusually nervous about stapling out of position or breaking the bench. Therefore, we hope that the patient can keep his eyes still during the operation, and the best direction for both eyes to gaze is directly above, in the direction of the canopy. To use an analogy: the patient’s gaze is like a flagpole, straight up; and keep the eyes as still as possible during surgery. This is very important and is a guarantee of a safe and smooth surgery. We hope that the patient’s family will remember and help train the patient to improve intraoperative cooperation, especially for the elderly with poor hearing, and make sure to explain this clearly to the patient before surgery, otherwise the patient will be nervous during surgery and it will be more difficult to communicate. Preoperative fixation training is performed 2-3 times a day for 2-3 minutes each time. In addition, intraoperative sterile towels can lead to breath-holding sensation in some patients, and patients are instructed to cover their mouths and noses with towels before surgery to feel the surgical process in advance for 2-3 minutes each time. To improve the patient’s psychological preparation and adaptability to the surgery.
Precautions before cataract surgery Cataract preoperative care There will be preoperative preparation on the morning of surgery. In order to prepare you for surgery smoothly, please make sure you arrive at the hospital ward around 7:00 a.m. The nurse will rinse your conjunctival sac and cover the operated eye with sterile gauze. The purpose of this is to keep the eye clean and to reduce the incidence of intraoperative infection. Local anesthesia patients should not overeat one meal before surgery to avoid intraoperative and postoperative vomiting discomfort. Please empty your bowels and urine before surgery and wear a good patient gown. Women with long hair should braid their hair into two left and right braids. Do not bring glasses, ornaments (such as earrings, rings, etc.) into the operating room. Remove any movable dentures. Patients should wear their gowns.
The nurse will order anesthetic eye drops and eye drops to dilate the pupil for about 20-40 minutes. Depending on the dilated pupil, patients will be placed in the operating room in order, and each surgery will take about 20 minutes.
Once in the operating room, the patient will lie down on the operating table without taking off his or her shoes and will be covered with a thin blanket. The patient will be asked to look at the ceiling with both eyes. Cooperate with the surgery. After the surgery, one eye is covered with gauze. Wheelchair pushing to the ward. The patient’s family can wait for the patient’s return in the ward. After cataract surgery, the patient can rest flat on his back for 2-4 hours and then choose his own position or get out of bed. However, you should not shake your head violently, do not let dirty water enter the operated eye, and pay attention to not falling down when walking and not colliding with the eye. Daily activities such as drinking and eating can be carried out as usual. If there are other precautions to be taken for special conditions, the doctor in charge will give detailed instructions.
After surgery, there may be slight discomfort such as foreign body sensation in the eye, such as tingling, foreign body sensation, itching, which is normal. If discomfort such as loss of vision, obvious headache, eye pain, nausea and vomiting occurs, please inform the medical staff immediately for prompt treatment. Medication on the day after cataract surgery The operated eye will be covered with gauze after the surgery is completed, and no other treatment is usually required and no eye drops will be given. Additional medication may be given in special cases, such as diabetes, glaucoma, cyclopia, high intraocular pressure, corneal edema, or in the presence of other diseases. For ordinary cataracts, intravenous fluids are not usually given. However, in patients with monoculars, diabetics, patients with ocular trauma, or other complex cases, fluids will be given. Medications after removal of the dressing from the operated eye after cataract surgery Patients have 4-5 types of postoperative eye drops.
Usually, for 2 weeks postoperatively, 1 drop of Dimethoate ophthalmic solution 3 times a day and 1 drop of tropicamide ophthalmic solution every night at bedtime. The above eye drops can be discontinued after 2 weeks. Switch to pralofene ophthalmic solution, 1 drop 3 times daily; levofloxacin ophthalmic solution, 1 drop 3 times daily. Praprofen eye solution and levofloxacin eye solution are naturally discontinued when they are used up and do not need to be purchased again. If the patient is diabetic, the hormone use should be increased, for example, D&B eye solution 1 drop 4-6 times a day; for patients with ocular trauma, there may be more than 2 antibiotics used together, which will be explained by the specific doctor in charge. Instructions for removing the dressing from the operated eye after cataract surgery Patients can open the gauze on the first day after surgery and do not need to continue covering it. As the cloudy lens is removed and replaced with a clear artificial lens, the patient usually feels unusually bright and even feels like the light is blinding. This feeling is the same as when we wake up in the morning and feel that the light is too bright. There is no need to be nervous, you can wear sunglasses appropriately and reduce outdoor activities, and the abnormal feeling will disappear after a week or so of adaptation. Post-cataract surgery discharge missionary diet No special requirements, general diet is sufficient. If you have diabetes or hypertension, you should eat diabetic diet or low salt and low fat diet.
Note that you cannot routinely wash your face with water after surgery, we think the tap water, the water in the basin is bacterial. Please wipe your face with a wet towel after closing your eyes, and then put on eye drops, which is safe. Stick to towel wipe face until 2 weeks after surgery. Avoid strenuous activities, pay attention to the combination of work and rest, do not use your eyes excessively, do not go to crowded places to avoid injury to the operated eye; do not travel to prevent dust from entering your eyes.
1 week after the post-operative follow-up, make sure to visit the hospital outpatient clinic for review in order to adjust the medication and determine the next review time with the doctor. If you find sudden loss of vision, obvious eye pain and tearing, nausea and vomiting, please go to the hospital immediately.