Cataract Surgery - Grendahl Eye Associates ~ LASIK, PRK, laser vision correction, eye care, hyperopia - farsightedness, myopia - nearsightedness, astigmatism and excimer laser information.

CATARACT SURGERY

BEFORE CATARACT SURGERY

WHAT IS THE PROCEDURE FOR ARRANGING SURGERY?

When we decide that you are ready to have surgery we will then schedule a date for the operation as close as possible to the time you would like it. Most cataract surgeries are now scheduled on an out-patient basis with excellent results. If in-patient surgery is required due to medical problems this will need to be preauthorized by the insurance company.

Our office will schedule your operation with day surgery; however, you will need to complete pre-admission forms with day surgery a few days prior to surgery. We will give you complete written instructions when you set your surgery date.

You will be scheduled to see your doctor 4-5 days before surgery, at which time some additional medical information will be obtained and all lab data will be reviewed. An axial length measurement (measure the length of the eye), a curvature measurement (keratometer measurement), endothelial cell counts, and a very new measurement called corneal topography (EyeSys and Orbscan) will be scheduled. The EyeSys and Orbscan are especially useful for people who have pre-existing corneal astigmatism. We use the corneal topography information in your surgical planning to correct your astigmatism and to know where to place the tiny scleral pocket or clear corneal cataract incision for your cataract surgery. Endothelial cell counts are done on selected cases to determine the health of your cornea much like an EKG is done to assess the health of your heart prior to surgery. These tests are all done in our office.

Arrangements will be made for you to have some preliminary routine tests, which may include a chest x-ray, an electrocardiogram, and blood and urine tests. These need to be done a few days to a week prior to surgery so that the results will be on your chart the day of surgery. They can be done at your family doctor's office or your preferred lab within eleven days prior to surgery.

At the present time we do surgery at the free standing out-patient surgery facility. For those patients who will be coming from some distance outside the Anchorage area, every effort will be made to arrange a convenient time frame so as to avoid unnecessary trips back and forth or long delays between your initial examination and your surgery.

When you make your final preoperative visit to the office you should bring with you a list of all medications that you take regularly, including the name of the medication, its strength or dosage, and how often you take it.

You will find bright light uncomfortable in the first few weeks after surgery. You may use any of the many types and styles of sunglasses. Special dark wrap-around sunglasses will be provided if you need them for those extra bright days. A metal protective shield and gauze are placed on the eye immediately after surgery. A video tape will be provided for you to learn about how to take care of your eye after surgery along with a post-operative eye-care book.

THE DAY OF SURGERY

Four days prior to surgery we want you to start Ocuflox and Acular eye drops. Place one drop in the eye to be operated on every three hours.

The night before surgery, you will need to fast from midnight on. You may not have breakfast, coffee, tea, toast, milk, or anything by mouth the morning of your surgery. However, take all of your usual medications with a minimal sip of water. You will also be asked to take two Neptazane tablets and one drop of Acular prior to leaving for your surgery.

Arrive at Day Surgery at the time as instructed by the office. The surgery will take place 3-4 hours after you arrive. We need all that time to get you prepared for the surgery. Stay close to a telephone the day of surgery because if we run early at surgery we will call and ask if you can come in earlier. Please leave the telephone number where you may be reached with our front desk office staff. Once you arrive at the surgical facility, expect to do a lot of waiting until the surgery actually occurs. We need this time to do the extensive paper work required by the Federal Government and patient preparation. We need time to start an I.V., put in the local block, record a history, take your blood pressure, heart rate, and attach all the instruments and monitors that are used to assure your safety during the surgery. If a minor equipment problem occurs in a case prior to yours, this puts subsequent surgeries behind. You may want to bring along reading material or something else to occupy your waiting time. Plan to be at Day surgery a total of approximately 4-6 hours.

At Day Surgery the nurses will give you some medication to lower the pressure in the eye, as well as eye drops, which help prepare the eye for surgery. An I.V. will be started. A nasal oxygen cannula will be placed around your nose.

In the operating room several nurses will be available to make you comfortable and look after you during your operation. As a means for verification, you will be asked several times what eye we will be operating on. A colored sticky dot will be placed on your forehead, over the eye being operated on.

We prefer to use local anesthesia for this surgery as it makes it possible for you to be awake and active very soon after leaving the operating room. General anesthesia can be used if you prefer, or if there is some special reason to do so.

You will be pleasantly surprised to find the operation itself is not nearly so bad an experience as you may have anticipated. It generally lasts less than an hour and there will be no discomfort except for some mild stinging of the eye just at the beginning of surgery. Occasionally you can feel the doctor grasp the superior rectus muscle. Please let us know so that we may add more anesthetic. Usually people cannot see at the time of surgery because of the peribulbar or retrobulbar nerve block. Some people describe seeing a kaleidoscope of color while others see nothing, and still others see everything but in a blurry fashion.

AFTER THE SURGERY

After surgery, you will go to the recovery room until you have recovered from the anesthetic. You will have a patch and shield over your eye. You may remove it when you get home to begin using the eye drops immediately. Many people have double or slanted vision until the anesthetic wears off. Replace the gauze and metal shield until the lid begins to function. In between drops, you will use your glasses or shield to protect the eye. Tape the provided metal shield on at night to prevent eye rubbing in your sleep. If you nap during the day use the metal shield. You will find that if you tape the metal shield on at its edges you can look out of the central holes and will have good useful vision through them. If you react to tape, sew a piece of elastic band to the holes in the edges of the metal shield and place it around the back of your head to hold the shield in place. It is common to have double vision or tilted vision and the inability to open your eye or sometimes one half of your mouth until the long-term anesthetic wears off (6-8 hours).

You will return to the office the day after surgery so we can check your intraocular pressure, implant, and front of the eye and review the care of your eye with you. It is important that the eye be checked as instructed during the first eight to ten weeks after surgery.

The eye requires a period of about one to ten days for healing to progress to the point where the best vision will be achieved. In the first few days after surgery vision may not be particularly good and may even be worse than prior to surgery for a short time. This is normal and should not be cause for concern. The vision should get progressively better with time. You should expect some redness in the eye and perhaps a mild irritation, which will disappear as a little time passes. Occasionally bright red blood can accumulate under the conjunctiva and over the white part of the eye but will clear within 1-2 weeks. This usually occurs in the upper part of the white of the eye, but can occur in the lower part as well.

It will nearly always be necessary to change whatever glasses you wear, at least for the operated eye, after two to eight weeks. During this time, you may continue to use any glasses you have been wearing as they will not harm your newly operated eye. There will also be no harm in using your eyes to read or watch television during the healing period. You may purchase a pair of plus 2.25, 2.50, or 2.75 reading glasses at Grendahl Eye Associates. Glasses cost approximately twenty dollars and may be used for reading if your previous reading glasses do not work. You may use your previous glasses if they work for you. We have reading glasses in our office for your convenience.