Postoperative care

Published on 08/03/2015 by admin

Filed under Opthalmology

Last modified 08/03/2015

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CHAPTER 18 Postoperative care

Modern cataract surgery has become a triumph of logistics over inconvenience. The postoperative period has become short but is nevertheless important. Distinct from the days of spending 6 weeks in bed with sand-bags supporting the head because there were no sutures used, many units do not review the patient at all and some only once in the post-surgical period. This has been facilitated by the development of secure wounds, drugs which prevent infection and inflammation, and rapid lines of communication if problems do occur. Several studies have shown no worsening of outcomes1,2.

Preparations for the postoperative period begin intraoperatively with wound stromal hydration as this has been shown to increase wound stability in the first hour postoperatively3.

The patient is transferred from the operating theater to a recovery area where it can be ensured that the patient is comfortable and has all the information necessary to look after the operated eye, medication to help this, and contact numbers in case of problems (perceived or real).

Some surgeons still like the eye to be covered with a pad and/or an eye shield in the first postoperative day, partly to protect the anesthetic eye from undetected trauma and partly to allow the eye to settle under a closed lid for a period of time.

Clearly, adequate information about what to expect and what to do and not to do in the postoperative period is important. This should be written as well as verbal so that reference can be made to it later.

A contact telephone number should be made available to the patient in case of problems and the person answering that number should have the experience and expertise to decide whether the patient needs to be assessed sooner than their routine preoperative appointment or not. If no such service is available, then clear instructions regarding access to local emergency services should be given to the patient or their carers.

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