• Preparing for Cataract Surgery
  • What Happens During Cataract Surgery
  • Care after Cataract Surgery
  • What Happens During Lasik Surgery
  • Preparing for Corneal Transplant
  • What Happens During Corneal Transplant
  • Care after Corneal Transplant
  • Before Any Eye Surgery
  • After Any Eye Surgery
| Preparing for Cataract Surgery |

At Leela Eye Institute we ensure that the eye surgery is performed with minimal stress on patient. At the Institute our counselor will help you to understand the pre-operative procedures and obtain an estimate of the expenditure involved. Prior to your surgery, you will need to undergo some routine medical and blood tests. An A-scan eye test will help the doctor to determine the power of the new lens to be implanted in your eye.

It is good to wash your face thoroughly with soap and water, before coming for surgery. You will be advised to use some eye drops. Please follow the instructions carefully as these drops help dilate your eye. If your eye is not properly dilated, surgery may be delayed. You may also be advised not to eat or drink anything for a few hours prior to surgery.

If you have any concerns or questions, ask the eye doctor when you come for an examination.

Though the success rate for cataract surgery is almost 98%, sometimes there may be complications. Most of these complications are minor and can be rectified. Your doctor will advise you about any specific issues related to your case. Don't hesitate to ask questions and clarify your doubts. 

 

The Cataract Operation:

In the operating room the area around your eye will be cleaned thoroughly. Sterile drapes will be placed around your head and face, with only the eye exposed. Usually a local anaesthetic in the form of numbing eye drops is used. In some cases anaesthesia in the form of an injection is administered next to the eye. Sometimes doctors may have to perform the surgery under general anaesthesia. An oxygen tube will be placed near you nose so that you do not feel suffocated. The doctor is the best judge to decide about the suitable anaesthesia in your case.

At Leela Eye Institute at Kalyan, the surgical safety of Cataract operation is enhanced by using Everest Legacy Phacoemulsification Machine from USA. This top end machine is available at only 5 centres in Mumbai and we are the only center to have it on the central and Central Suburb of Mumbai.

The actual surgery lasts about 20- 30 minutes. You will be relaxed and awake but feel no pain. Generally, there is very little bleeding.

 

After cataract operation a bandage or a shield will be placed over your eye. You will be advised to rest till you are ready to leave.

You should wear protective glasses or an eye shield in the day and an eye shield at night to avoid accidental eye injury. The doctor will advise you when you can discontinue them. You can bathe carefully from below your neck but do not wet the operated eye for 15 days. You may gently clean the eyelids with a piece of cotton boiled in water or a sterilized tissue.

Some important tips:

·       Do not rub the operated eye.

·       Do not use any eye cosmetics until the doctor allows it.

·       Do not wash your hair until the doctor says you can.

·       Shave carefully, soap or water should not enter the eye.

·       Avoid any vigorous activity.

·       Do not lift heavy things.

·       Do not bend so that your head is lower than your waist.

·       Avoid driving till your vision improves.

·       Avoid sleeping on the operated side.

·       No sexual intercourse until permitted by the doctor.

·       Avoid alcoholic beverages.

·       Watch television for short periods only.

·       Please follow the advice of the patient counselor about medication and follow-up visits.

Be alert for problems

If you have persistent discomfort or pain, and if the pain is severe, inform the Institute or your operating eye surgeon immediately.

Watch out for these symptoms also, and if they last more than 24 hours, contact us immediately. Do not delay.

• any sudden change in vision or blurring of vision

• increase in sensitivity to light or seeing flashes of light

• increase in redness or swelling of the eyelid

• nausea or vomiting

• a white or cloudy cornea or pupil 

Secondary Cataract

Blurred vision, months or years after cataract surgery, leads to the mistaken assumption that the cataract has grown again. This is not a cataract but the clouding of the thin capsular bag membrane that helps keep the lens implant in place.

To restore clear vision, cataract surgeons use a laser to open a visual path through the cloudy membrane. This is a simple procedure and is done on an outpatient basis. No stitches or surgery are needed. Your vision should improve soon after the laser treatment. 

What do I Expect on The Day Of Treatment?

This is an outpatient procedure. The laser treatment usually takes less than a minute. The entire procedure usually takes 5-10 minutes per eye. First you will lie on a motorised bed to which the laser is attached. Anesthetic drops will be placed in the eye. The head is positioned under the laser and the eyelids are gently and comfortably kept open during the treatment with the help of a soft clip.

You will be asked to look at a blinking light during the entire procedure. Once the procedure is completed, a soft corneal protective shield is sometimes placed on the eye. A post-procedure eye examination is performed and eye drops are prescribed. We will inform you about the follow-up schedule.

 

Does This Procedure Hurt?

No. There is no pain during the procedure. There may be mild discomfort for a few hours after the procedure.

Preparing for a transplant

If you are advised to undergo a corneal transplant, your ophthalmologist will tell you what is required. The transplant will be scheduled according to the condition of your eye and the availability of a donor cornea. Occasionally, a shortage of donated corneas may delay surgery. If both your eyes need new corneas, the second transplant will not be performed until the first eye has stabilized, which may take up to a year.

If you are taking any other medication, ask your ophthalmologist whether you should continue it. You will probably be asked not to eat or drink anything for several hours before the surgery.

After surgery; you may be permitted to return home the same day, or you may be required to stay in the hospital for a day or more. 

Anasthesia:

Usually a local anesthesia is used for surgery, so you will be awake but feel no pain. Intravenous medications will help you relax. The nerves in your eye will be completely numbed so you will not be able to see or move your eye. Sometimes the doctor may use general anesthesia.

The Cornea transplant procedure:

For the transplant, the doctors use an operating microscope and very delicate instruments. Once the old cornea is removed, the new cornea is stitched into place. The sutures stitches are barely visible and are not painful, although you might feel some irritation or a scratching sensation for few days.

If necessary, other procedures may be performed at the time as your transplant. For example, a cataract may be removed and replaced with an intraocular lens (lOL) or an old. IOL may be replaced or removed. The vitreous gel may be removed from the eye and replaced with fluid. A damaged iris may be repaired. Your ophthalmologist will advise you about them.

 

Important tips on care after surgery:

·       Do not lift heavy things.

·       Do not bend so that your head is' lower than your waist.

·       Avoid sleeping on the operated side.

·       No sexual intercourse until permitted by the doctor.

·       Do not rub the operated eye.

·       Avoid any vigorous activity.

·       Avoid alcoholic beverages.

·       Watch television for short periods only.

 

You can bathe carefully from below your neck, and also shave, but do not let the operated eye become wet for at least 15 days.

You may gently clean the eyelids with a piece of cotton boiled in water or a sterilized tissue. Do not wet the eyeball.

You should wear an eye patch at night; the doctor will advise you when to discontinue using it during the day.

Always wear protective glasses or eye shield to avoid accidental injury.

 

Medication and follow-up

At the time of discharge our patient counselor will advise you about medication and follow-up visits. Please follow the instructions regarding medication. Please adhere to the follow-up appointment date.

If you have any concerns or questions, you can ask the doctor when you come for an examination. If you feel you cannot wait, call or email us, or send a fax, at our numbers.

 

Rejection of a transplant - the danger signals!

Rejection of a transplanted cornea can occur any time but it is more likely to happen in the first year after surgery. Unfortunately, rejection reduces the chance of success of repeat corneal transplantation. However, this can be prevented by timely diagnosis and appropriate management.

 

Danger signals:

·       Eye Redness

·       Sensitivity to light

·       Vision loss

·       Eye Pain

 

The acronym 'RSVP' can help you remember these symptoms. If you notice any of these symptoms in your operated eye, however minor they may seem .and regardless of time of day, contact us immediately. If this is not possible, visit the nearest ophthalmologist, preferably a cornea specialist.

Before your Eye Surgery:

Thank you for choosing Leela Eye Institute for your eye surgery. The information given below will explain you the events on the day of surgery.

Reminders for the day of surgery:       

·       Have a head bath with shampoo in the morning before you come for surgery.

·       Wash face thoroughly and do not apply tike or vermilion on forehead.

·       Take all your routine medication as prescribed by your physician for hypertension, diabetes or any other disease.

·       Have a light breakfast in the morning before you come for the surgery.

·       You are expected to report 1 hour prior to the surgery.

·       One relative is required to accompany you and wait for you during your stay in the hospital.

·       Bring your general medicine file as well as Leela Eye Institute file with you.

What to Expect in the Operation Theater:

The Operation Theater for eye surgery is very sophisticated and maintains a high level of sterility all the time. You will be asked to sleep on a motorized ophthalmic table in a comfortable position. The anaesthesia used for cataract surgery routinely is topical, which does not require any injection.

But the surgeon can change to local anaesthesia, if the topical anaesthesia is inappropriate for you. That decision is made by the surgeon. Topical anaesthetic drops are instilled in your eye and your face is draped with sterile material leaving the eye to be operated open. Cataract surgery takes approximately 15 – 20 minutes. After the surgery you will be given a dark goggle and will be shifted to recovery lounge.

What to Expect after Discharge:

Following surgery, you will be able to return home with very few restrictions. You will receive verbal and written home instructions from a nurse. Drops will be put in your eyes and given to you to put as per the schedule. A responsible adult should be present to understand instructions, escort you home and be with you overnight. You will be examined again in the morning following surgery.

Eye Care after Surgery       

Use medication as advised and for as long specified by the doctor. Correct use of medication can dramatically increase the success rate of treatment. Not taking medication or changing your regimen without consulting your doctor can lead to ineffective treatment and in some cases even visual loss.

It is important to tell your doctor of medications that you are or have been allergic to.

Carry with you your old medicines, there prescription and reports for consultation

Take all advised doses as per schedule as missed doses reduces the effectiveness of treatment.

Please carry your medication when traveling.

Check which eye the drops are ment for before you start putting drops. Check the label for right drop and check the expiry date on it. Check if it is sealed properly when purchasing it.

Wait for 10 -15 minutes when putting two or more drops consecutively.

Wash your hands before handling your drops. Do not touch the nozzle of eye dropper while handling it.

 

How To Instil Eye Drops:

Proper method of drops instillation are:

Tilt the head back, pull the lower lid down and look up when putting in the drops. Shut the eyes gently and press one finger against the lower lid where it meets the nose for at least 2 minutes to slow the absorption of eye drops in to blood stream.

If there are uncomfortable symptoms please let the doctor know about it.

Dr. Abhijit Wadekar
Dr. Abhijit Wadekar completed his
M.B.B.S at Lokmanya Tilak Muncipal Medical College,
Sion in Jan 1997. He was selected for
M.S. in opthalmology

Feel free to enquire