Jan 09, 2010
After dealing very personally with over 10,000 cataract surgeries, I've seen just about all the things that patients can do right and wrong. Every surgeron, like myself, has an organized, written list of instructions for you to take home after surgery. But, of course, even the "best laid plans of mice and men often go awry." Here is my list of helpful post-operative tips after cataract surgery:
1. Get to know your drops and what they are for. Typically there is a steroid (anti-inflammatory), an antibiotic, and sometimes a non-steroidal anti-inflammatory. The more attention you pay to the names and dosages, the less likely you will be to make major mistakes.
2. Make surey your drops are "fresh" and not an old bottle you had in your drawer for who knows how long. Usually patients get brand new drops for the surgery, but particularly with cataract patients with glaucoma, they may not think to start a brand new bottle of glaucoma drops after surgery. The goal here is to lessen the chances of a bottle contaminated with bacteria.
3. Know your drug allergies WELL. You should know what drug affected you and how. Sometimes a person may not have a true drug allergy but perhaps had an upset stomach after taking erythromycin on an empty stomach. That is more of a side effect than an allergy. It is so important to know these things because incorrect allergy information can limit the choices of some pretty effective medicines.
4. Try not to use different drops too closely together. Keep drops of different medications at least 5 minutes apart to avoid washing out the first medication.
5. Never touch the tip of the bottle to your eye. First you could scratch your eye, but also you will contaminate the bottle and possibly introduce bacteria into the bottle, which could increase your risk of an infection. If I accidentally touch the tip of a drop bottle, I usually clean it with a alcohol wipe and let it air dry.
6. Consider taking a non-steroidal anti-inflammatory drop such as XIBROM, NEVANEC or ACUVAIL for one to two months post-operatively, even if you think you are doing great. This class of drops can help to stabilize retinal capillaries to reduce your risk of cystoid macular edema (CME) which can cause vision loss. CME doesn't get a lot of fanfare but it can be terribly frustrating in that a person with a perfect cataract surgery who sees 20/20 at one day or one week post-op, can have a painless and significant loss of vision at the 3 or 4 week post-op visit. There is little downside to these type of drops other than the cost and sometimes some stinging but that are like an insurance policy against CME. If you are a diabetic, I would definitely use these drops since the CME risk is much greater.
7. Finally, remember that the post-operative drops are not there to soothe or lubricate the eye and they can definitely cause some degree of irriation to the surface of the cornea. Have a good supply of high quality artificial tears with a disappearing preservative like genteal or refresh tears or thera-tears or preferably some preservative free artificial tear to use 3 or 4 times a day or whenever there is irriation. Remember to not use the tear drops right before or right after your medicated drops. Make sure to use new, fresh artificial tears as well.
That's all for now, more to come later. Take care.
Michael Kutryb, MD