Continuing my series of posts covering what to expect around the time of cataract surgery: today I will describe what I tell my patients to expect the day of surgery. Remember, this is what I tell my patients to expect - other surgeons will differ in what they tell their patients to expect depending on technique and preferences.
Day of Surgery:
1) When you arrive at the surgery center there will be some minimal additional paperwork to fill out.
2) You will change out of your clothing into a hospital gown (note: some surgery centers do not require this).
3) A mark will be made on your forehead indicating which eye is to have cataract surgery. This may be done in the "pre-op" area or in the operating room depending on which surgery center is used.
4) During the time you are in the surgery center you may be asked multiple times “what eye are you having surgery on?” This is not because the staff don’t know but because they check and double check that we are operating on the correct eye. This is for your protection.
5) Multiple drops will be placed in your eye multiple times. Although the drops you use at home must be spaced at least five minutes apart, the drops in the hospital will be given to you one right after the other. This is OK.
6) It may take 45 minutes to two hours for your eye to dilate enough to safely perform surgery. The doctor will check your pupil once you are in the operating room. Do not worry about the dilation - if needed there are techniques your doctor can use during surgery to sufficiently dilate your pupil.
7) An IV will be placed in your arm either in the pre-operative holding area or in the operating room. Once in the operating room the anesthesiologist will give you something through the IV to relax you. One of the effects of this medication is short-term amnesia. So, if you are having your second eye done, don’t be surprised if you don’t remember all of these things being done when you had your first cataract surgery. This is a very common feeling.
8 ) A blood pressure cuff will be placed on your other arm. This is necessary for monitoring this critical vital sign. Periodically this will inflate and give you a sense of pressure. Just relax and the pressure will go away.
9) Some doctors (myself included) feel that music works both to relax you and assist with the rhythm of surgery. If you have a particular type of music you would like to be played during the surgery, let your surgeon know. Note: not all surgeons accept requests, but I do (my iPod has over 9,000 songs so I can honor almost any request except country music - closest I have on my iPod is Johnny Cash, but I'll even listen to country music if you bring the CD).
10) During the actual surgery you will hear buzzing and bells. There may be a sense of pressure in the eye and you may feel fluid running down the side of your face. This is all normal.
11) You should not feel pain during the surgery (but you will feel pressure and sometimes a sense of "tugging"). If you do feel pain or discomfort, let your surgeon know and he will give you additional anesthetic.
12) You will be in the operating room for about 45 minutes to an hour. About half of this time is spent preparing for the actual surgery.
13) After surgery a shield will be placed over your surgery eye. you will then be transferred to a recovery area for and hour or so while the nurses check your vitals and confirm that you have recovered from the anesthetic.
14) The entire process from the time you arrive to the time you leave the hospital can take from three to five hours.
Afternoon and Evening of surgery:
You may have the sense that there is something in your eye like a grain of sand. This is normal and will be relieved by using the drops that you have been instructed to use. If needed, you may take Tylenol for relief. You should not have significant pain. If you do, call your surgeon's office as soon as possible.
Note: find out who will be taking call for your surgeon. Will it be the surgeon or another ophthalmologist or optometrist? Will you be able to get through 24 hours a day, seven days a week? Or, will you be forced to go to the emergency room after hours if there is a problem? Practices vary, but I take my own call except for every third weekend when my partner, Dr. Richard Kratz, takes call for me. Even then, he can get in touch with me as I carry my cell phone everywhere I go (I will even give my personal cell phone number to my patients who have had cataract surgery - though the fastest way to get in touch with me is actually through my answering service which picks up the phone whenever my office is closed - no answering machine or voicemail here).
Next post: what to expect after surgery...
© 2009 David Richardson, MD
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