Cataract surgery is an important surgery for restoring eyesight. In order to ensure the quality of surgery, patients should cooperate with doctors to make thorough preoperative examination and preparation before cataract surgery, please read the following contents carefully.
I. Diagnosis of cataract
Patients with asymptomatic vision loss should go to the hospital in time. If diagnosed with cataract, surgery is usually required after a series of examinations in order to decide whether it is suitable for surgery. After the initial examination, it can be generally determined whether the patient’s cataract requires surgical treatment. There is also a general idea of the expected outcome of the surgery. However, due to individual differences, each person’s eye condition is different. Patients are advised to carefully consult with the receiving surgeon about the difficulty of your surgery and the prognosis of your post-operative vision so that they can have a good idea of what to expect to avoid misunderstandings and disputes.
Outpatient examination items at the initial consultation.
Visual acuity, slit lamp, fundus, intraocular pressure, refractive error, understanding of patient’s medical history, etc. Patients should truthfully reflect their medical history, changes in visual acuity, systemic diseases that have an impact on surgery, such as cerebral infarction, cerebral hemorrhage, coronary heart disease, hypertension, diabetes, etc. Surgery is strictly prohibited when the condition is serious.
Preparation before cataract surgery
Before cataract surgery, patients should also have a comprehensive and detailed examination of the whole body and eyes.
1. Systemic examination: electrocardiogram, blood pressure, blood and urine routine, blood sugar and liver function tests, and blood clotting time.
2.Ocular examination: visual acuity, slit lamp, fundus, intraocular pressure, ocular A/B ultrasound, IOL degree calculation, tear duct flushing and other related examinations.
(I) Pre-cataract surgery medication
1. Three days before surgery, use antibiotics (tobramycin, quinolones, punamphetamine) eye drops to spot both eyes.
2. Patients with hypertension are advised to control their blood pressure within a safe range with medication, and to suspend surgery if their blood pressure is higher than 160/95 mmHg.
3. Patients with diabetes mellitus should have their blood glucose controlled below 8 mol/L.
4. In patients with acute and chronic dacryocystitis, the dacryocyst must be removed or the lacrimal duct reopened first.
(B) Know the eye and systemic medical history
The following conditions may cause difficulties in surgery or affect the recovery of vision after surgery, and the doctor should be informed truthfully so that he or she can make adequate pre-surgical preparations and strive to restore good vision as much as possible.
History of glaucoma or surgery; history of uveitis, whether the pupil can be dilated; history of eye contusion, whether there is crystal dislocation; high myopia; history of corneal disease or surgery (including history of refractive surgery); history of vitreoretinal surgery; diabetic retinopathy; and history of other fundus diseases; these medical histories are related to the final decision of whether the patient can operate, the difficulty of surgery and the recovery of vision after surgery.
Cataract surgery
Patients should wear comfortable clothes on the day of surgery and refrain from drinking alcohol or taking medications that may cause drowsiness. Cosmetics (including hairspray, perfume, and jewelry) are not allowed on the day of surgery. The patient’s time in the ophthalmology department is approximately 2 to 3 hours (including time for blood pressure testing, pupil dilatation, eye washing, and other preoperative preparations). The entire procedure takes only 10 to 20 minutes, but the preoperative preparation and waiting time is sometimes long, so please do not rush.
IV. Post-operative cataract review
Review time: After surgery, be sure to use medication according to the medical opinion. If there is any abnormal condition in the eyes such as sudden decrease of vision, eye redness and eye pain, please visit the ophthalmology department at any time.
Patients should come for review on the 2nd day, 1 week, 2 weeks, 1 month, 3 months, 4 months, 6 months, 1 year, etc. after surgery. Patients should be reexamined promptly if there is any abnormality in their eyes.
Review items: visual acuity, intraocular pressure, slit lamp, eye refraction, adjustment of medication, and fundus examination with dilated pupil if necessary.
V. Care of cataract surgery after discharge
Cataract is one of the main eye diseases that cause blindness in the elderly and requires surgical treatment, so after the surgery is completed and you go home to recuperate, you must do a good job of home care.
1. On the day after the surgery, the operated eye should be covered, with the purpose of reducing the rotation of the eye and giving the eye sufficient rest. After surgery, except for eating and going to the toilet, you should generally stay in bed to recuperate and pay special attention to not bumping the operated eye to avoid bleeding in the anterior chamber, elevated intraocular pressure and other complications.
2. On the second day after surgery, the gauze can be removed and antibiotics plus hormonal eye drops (such as D&B) can be applied to the eye, and the patient can take care of himself, but bed rest is still the main focus. Some patients feel pain and tearing in the operated eye, which are normal. If the eye pain is obvious, combined with headache, nausea and other symptoms, promptly go to the hospital for medical consultation.
3. The gastrointestinal motility of the elderly slows down, which can easily cause constipation, therefore, it is necessary to eat easily digestible food and fresh vegetables and fruits after surgery. Pre- and post-operative laxative medications, such as corkage, can be used to prevent excessive force during defecation, which may cause bleeding and wound dehiscence in the eye.
4. If there are corneal sutures, the sutures are usually removed 2 weeks after surgery or according to the situation. After the sutures are removed, local antibiotic drops should be given to dot the eyes 3 times a day. Erythromycin or gentamycin eye ointment etc. can be applied at night before going to bed to prevent infection. When you are old, you should pay attention to hygiene and wash your hands well when dabbing, and it is better to let your family members help to dab your eyes.
5. In addition, patients should keep a cheerful mood, treat various stimuli in daily life correctly, ensure sleep, prevent colds and coughs, and take cough suppressants when coughing badly so as not to affect the normal healing of the wound.
6. Three months after surgery, patients with poor refractive adjustment can improve their vision by wearing glasses.