Cataract surgery is a sight restoration surgery. In order to ensure the quality of surgery and to be responsible for patients, patients should cooperate with doctors to make thorough preoperative examination and preparation before cataract surgery.
After being diagnosed with cataract, the patient usually needs to undergo a series of examinations in order to decide whether he/she is suitable for surgery. After the initial examination, it can be roughly determined whether the patient’s cataract needs surgical treatment or not. There is also a general idea of the expected outcome of the surgery. However, due to individual differences, each patient’s situation is different, and patients are invited to consider whether to undergo the next follow-up examination.
Initial examination items: visual acuity, slit lamp, fundus, intraocular pressure, refraction, and understanding of the patient’s medical history. Patients should truthfully reflect their medical history, changes in visual acuity, systemic diseases that affect surgery, such as cerebral infarction, cerebral hemorrhage, coronary heart disease, hypertension, diabetes and other diseases.
The patient should undergo a comprehensive and detailed examination of the whole body and eyes before surgery.
1. Systemic examination: electrocardiogram, blood pressure, blood and urine routine, blood sugar and liver function tests; 2. Eye examination: visual acuity, slit lamp, fundus, intraocular pressure, ocular A/B ultrasound, IOL prescription calculation, tear duct flushing and other related examinations; (a) Preoperative medication Three days before surgery, use antibiotic (tobramycin, chloramphenicol, quinolones) eye drops to spot both eyes.
Patients with hypertension are advised to control their blood pressure within a safe range with medication, and to suspend surgery for blood pressure higher than 180/100mmHg.
Patients with diabetes mellitus should have their blood glucose controlled to less than 8 mol/L.
In patients with acute and chronic dacryocystitis, the dacryocyst must be removed or the lacrimal duct recanalized first.
(ii) Know the medical history The following conditions can cause difficulties in surgery or cause poor recovery of vision after surgery and should be explained to the doctor in detail
Whether there is a history of glaucoma or surgery; whether there is a history of uveitis and whether the pupil can be dilated; whether there is a history of ocular contusion and whether there is crystal dislocation; whether there is high myopia; whether there is a history of corneal disease or surgery (including a history of refractive surgery); whether there is a history of vitreoretinal surgery; whether there is diabetic retinopathy; whether there is a history of other fundus diseases; these tests and medical history are directly related to the final decision of whether the patient These examinations and medical history are directly related to the final decision of whether the patient can be operated or not.
Patients should wear comfortable clothing on the day of surgery and should not drink alcohol or take 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 measurement, pupil dilatation, eye washing, and other preoperative preparations).
IV. Regular postoperative review Review time: Postoperative medication should be administered according to medical advice. 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 reviewed promptly if there is any abnormality in their eyes.
Items for review: visual acuity (one week after surgery), slit lamp, eye refraction, adjustment of medication, and fundus examination with dilated pupil if necessary.
Cataract is one of the main eye diseases that cause blindness in the elderly and requires surgery.
On the day after surgery, the operated eye should be covered, with the aim of reducing the rotation of the eye and giving the eye sufficient rest. After surgery, except for eating and going to the bathroom, you should generally stay in bed to recuperate, and pay special attention to not bumping the operated eye, so as not to cause bleeding in the anterior chamber, elevated intraocular pressure and other complications.
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. 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.
The gastrointestinal motility of the elderly slows down, which can easily cause constipation, so it is necessary to eat easily digestible food and fresh vegetables and fruits after surgery. Pre- and post-operative laxative medications, such as corkage, are available to prevent excessive force during defecation, which may cause local wound bleeding and wound dehiscence in the eye.
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. At older age, it is important to pay attention to hygiene when dabbing, wash your hands well, and it is best to let family members help dab the eyes.
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.
After 3 months of surgery, patients with poor refractive adjustment can improve their vision by wearing glasses.