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Surgery Patients

What do I do before surgery?
 
Check with the surgery scheduler for anticipated surgery time and arrival time and plan to have a driver for transportation. During retinal surgery systemic anesthesia is used. While usually very light, it is still important to not have anything to eat or drink for 8 hours prior to the procedure. Having an empty stomach reduces the risk of complications during anesthesia.
 
Do I take my medications?
 
Instructions will vary by anesthesiologist but it is generally recommended to take your blood pressure medication with a small sip of water the morning of surgery. Blood thinners such as aspirin, Plavix, Coumadin, and Xarelto should be discussed with your surgeon and prescribing doctor. Depending on why they are needed they may need to be stopped 1 week prior to surgery or an alternative medication used around the time of the procedure. It’s important to discuss all medications prior to surgery. For diabetes medication, do not take oral diabetes medication the day of surgery. For insulin, take ½ the normal dose of long-acting insulin the night before the surgery and do not take short acting insulin in the morning. It is very important to monitor the blood glucose prior to the surgery to ensure the blood glucose does not go too low while not eating.
 
Will I be asleep?
 
Most surgery is performed with the patient awake, but with the eye numb and medication to help relax. Avoiding general anesthesia reduces the risk to your overall health and helps speed recovery following the procedure. It is important that you can lie flat on your back and remain still during the procedure. Patients with severe back pain, claustrophobia, or anxiety may require general anesthesia to perform the surgery safely. 
 
What do I do after surgery?
  • After the procedure, the eye is covered with a patch and you spend time in the recovery area until all anesthesia has cleared and then will be able to return home. 
  • Depending on the type of surgery, special positioning may be required for optimal retinal healing; you will receive instructions if any positioning is needed.
  • Keep the eye covered with the patch overnight and keep it dry. 1 day after surgery you will have an appointment at which time the patch will be removed. 
  • Pain and nausea medication will be prescribed and can be used to minimize any discomfort. If pain or nausea persist more than the medication can control, it is very important to call your physician. 
  • You will also be prescribed eye drops, keep these medications and they will be started after the patch is removed.
  • Rest and limit any physical activity
  • If a gas bubble is placed in the eye a green bracelet will be given. It is important to keep this bracelet on until the gas resolves. It is very important to avoid changes in altitude, air travel, and nitrous oxide anesthesia until the gas completely resolves.
 
What do I do the first week after surgery?
  • Most important is to maintain any necessary positioning after the surgery. Each procedure is different and the requirement will vary, but proper positioning is very important for retinal healing.
  • Use any eye medications as instructed. If multiple medications are needed at the same time, separate them by a few minutes to prevent them from washing each other away
  • Limit physical activity to things that are not strenuous or vigorous. Do not bend, strain, or pick up heavy objects
  • Keep water out of the eye for the first week after surgery
  • Wear the eye shield to protect the eye at night
  • During the day, normal glasses can be worn. Most people are sensitive to light and sunglasses can make bright environments more comfortable
  • Keep wearing the green bracelet that signifies gas in the eye and remember to avoid changes in altitude, plane travel, and nitrous oxide anesthesia
  • A second follow-up appointment is generally scheduled in a week but may vary depending on the situation
  • You can return to work when the eye is stabilized following the surgery. If no positioning is required then most people return to light-duty after the first postoperative appointment. If positioning is needed then it often prevents normal work and longer time off is important to be able to maintain the position.
  • You can start driving when the vision improves in the surgical eye. This often takes time, especially if a gas bubble is used that will decrease the peripheral vision. Always keep safety first, and if the vision is limited have a driver bring you to your appointments.
 
What about my vision?
 
The primary goal of retinal surgery is to restore retinal anatomy, after this is achieved, the retinal tissue has to regain its function. This process takes time, sometimes up to 6 months following surgery. The level of visual recovery is different for every person and will vary depending on the type of disease and any other underlying eye conditions. 
Dr Kruti Dajee Dr Jawad Qureshi Dr Johnathan Warminski