Instructions for Cataract Surgery

Medications

  1. Antiobiotic to prevent infection in your eye.
  2. Non-steroidal anti-inflammatory drug (NSAID) to reduce inflammation and pain in your eye after surgery. It also reduces the likelihood of swelling in your retina, a known complication of cataract surgery.
  3. Steroid to reduce inflammation in your eye. The eyedrop is a suspension and is milky white in colour.
  4. Painkiller to relieve mild pain after surgery when necessary. If pain is severe or persists despite using painkiller, contact your doctor immediately.

Two days BEFORE surgery (including day of surgery), to start antibiotic and NSAID eye drops.

AFTER surgery, to continue antibiotic for about 1-2 weeks and NSAID and steroid eye drops for about 4-6 weeks.

  • Shake all eyedrop bottles prior to use.
  • You only need one drop from each bottle each time although a second or third drop at a single time is not harmful.
  • It does not matter which bottle of eye drops you use first.
  • It is important that you wait at least 5 minutes between each eyedrop so that the medication has a chance to be absorbed by your eye. Otherwise, the second eyedrop will wash away the first eyedrop and reduce the efficacy of the first eyedrop.
  • Occasionally, the eyedrops (especially Acular) may cause a mild burning sensation immediately after application.

Continue to use your eyedrops unless you have been instructed otherwise.

Before Surgery:

  • Wash your hair before your surgery for hygiene reasons since you should avoid washing your hair for at least a few days to a week after the operation to reduce the likelihood of contaminating your operated eye.
  • Do not use any make-up on your eye or face on the day of surgery. Remove all face make-up including all types of oils, lotions, sunscreen, facial moisturiser, liquid foundation, power, eyeliner, mascara, eyebrow pencil and eye shadow.
  • Remove all your jewellery and leave them at home.
  • Do not take any food or drink beginning 6 hours before the surgery. However, you should continue taking your usual medication (EXCEPT diabetes medication) with small sips of clear water.
  • If you have diabetes, DO NOT take your diabetes medication during the fasting period. If you use insulin, DO NOT take your insulin when you are fasting. Instead, bring your insulin to surgery for administration after surgery.
  • If you are using a blood-thinning medication (eg, aspirin, warfarin, Plavix), notify your doctor and he will let you know if you should continue with your medication. Most patients can continue with the medications.
  • If you are a male patient taking Flomax (tamsulosin) for urinary frequency, notify your doctor. Your doctor may have to take special measures to compensate for the eye effects of Flomax. While patients taking Flomax generally do quite well with surgery as long as your doctor is aware of it beforehand, they remain at slightly higher risk of problems compared to the average patient. You may be asked to stop Flomax. If stopping Flomax causes intolerable side effects, resume the medication and inform your doctor.
  • If you have any doubt about your medication, please consult your doctor.

During Surgery

  • Plan on spending approximately 4 hours at the hospital if your surgery is being done as a day surgery. (Some insurance company, eg AIA, may require you to stay for at least 6 hours during a day surgery)
  • Before your surgery, a nurse will instill an anaesthetic eyedrop and other dilating eyedrops to enlarge the pupil in your eye to be operated. Your blood pressure and general health will also be assessed.
  • Your surgery usually takes about 20-30 minutes.
  • When you leave the operating room, you will be wearing a plastic eye shield over your operated eye. To instill your eyedrops, expose your operated eye by removing the tape on your forehead and flipping the eye shield onto your cheek.

After Surgery

  • After your surgery, you will be offered something to eat and drink.
  • A nurse will review the post-operative instructions with you. This is a good opportunity to get any questions that you might have answered.
  • You may go home about 1 hour after your operation.
  • Have someone accompany you home. Do not drive home after surgery.

Care after surgery

  • Use your eyedrops as prescribed even if your eye feels well.
  • Do not bump or rub your operated eye for 1 month following the surgery.
  • Avoid letting water get into your operated eye for 1 month, especially when washing your face or hair.
  • Avoid washing your hair for at least several days to a week or have your hair washed in a hair salon. After the first week, close your eyes tightly or use a swimming goggle when washing your hair to prevent water from getting into your operated eye.
  • If soap gets into your eye, use an artificial tear or one of the eyedrops prescribed to wash out the soap. DO NOT use tap water to rinse your eye.
  • To protect your operated eye from injury, wear the plastic eye shield when you are sleeping for the first 1 to 2 weeks after surgery. Use 2 strips of Micropore tape to secure the plastic eye shield over your operated eye. DO NOT use any cotton wool or gauze over your operated eye.
  • Avoid sleeping on the side of the operated eye for about 1 week.
  • Do not use any eye makeup on your operated eye for 1 month.
  • You may read, use the computer or watch television with your operated eye starting on the day of surgery if your eye feels comfortable.
  • You may wear sunglasses to provide comfort from bright light, especially when outdoors.
  • Do not miss your scheduled appointments with your doctor.
  • Bring all your eyedrops with you on your post-operative visits.
  • Minor discomfort, foreign body sensation, tearing and irritation may occur following surgery. If you have mild pain, take a painkiller (eg, Panadeine) for pain relief.
  • Contact your doctor immediately if you experience one or more of the following “RSVP” symptoms:
    • R – Redness
    • S – Swelling
    • V – Vision decrease
    • P – Pain

These symptoms may mean that you are developing an infection. This is a rare but potentially blinding complication of cataract surgery.