At Any Time: Call the office IMMEDIATELY (415) 454-5565 if you have any problems!

Pre-Operative Instructions

Appointments:

  1. Pre-operative eye exam with surgeon
  2. Intraocular lens measurement and power calculation. Contact lens wear may cause an error in the results of the implant power measurement. Because of this, soft contact lenses must be removed one week prior to appointment. Hard contacts are generally removed for 2-4 weeks.  Timing can vary, special instructions will be given to you by your technician.
  3. Physical exam, lab work & EKG with your Primary Care doctor Schedule this appointment with your primary physician. Your physical exam and lab work needs to be completed within thirty days of surgery.

Transportation Arrangements

Arrange transportation to and from the surgery clinic for the day of surgery and the day after surgery. Please be flexible, it may be necessary to adjust your arrival times.

Two Weeks Before Surgery

DISCONTINUE: certain Glaucoma Drops: (FOR THOSE WITH GLAUCOMA) Pilocarpine, Isoptocarpine, Pilogel or Carbachol in the SURGERY eye only. Other types of glaucoma medication should be continued unless you are specifically instructed otherwise.

Continue: all other glaucoma drops should be continued.

Male patients taking FLOMAX® (tamsulosin) for urinary frequency MAY BE ASKED TO STOP PRE-OPERATIVELY. You MUST report using FLOMAX® to your surgeon. Special measures will be necessary to compensate for ocular effects of Flomax®. While patients taking Flomax® generally do quite well with surgery as long as the doctor is aware of it beforehand, they remain at higher risk of problems than the average individual. Click here for more information on Flomax. If you are asked to stop, and stopping causes intolerable side effects, resume the medication and give us a call to inform us.

COUMADIN (warfarin), Aspirin, and Plavix are usually CONTINUED, unless your INR test result is more than 3.0. The INR should be checked before surgery. Consult your primary care physician. THE EXCEPTION TO THIS WOULD BE PATIENTS UNDERGOING COMBINED Cataract ond Glaucoma surgery.

Three Days Before Surgery

Begin using your eye drops in your operative eye as follows;

  • Ofloxaxin (antibiotic) use one drop in your operative eye three times a day.
  • Ilevro (anti-inflammatory) one drop in your operative eye once a day at bedtime.

Remember: You only need one eye drop from each bottle (more is not harmful at a single time), in any order that you like. It doesn’t matter which bottle of eye drops you use first. It is important that you wait five minutes between each eye drop, so that the medicine has a chance to be absorbed before the next drop comes along.

Morning of Surgery

Use your eyedrops on the day of surgery as well, before and after.

EVERYONE:Wash your hair the night before so it can be avoided for the first two days after.

The Day of Surgery

At home before surgery

DIABETICS: If you are INSULIN-DEPENDENT your surgery will be scheduled early. DO NOT TAKE YOUR MORNING INSULIN; instead, bring your insulin to surgery for administration after surgery.

EVERYONE:

  • No solid food for 6 hours prior to your surgery.
  • No thick liquids after midnight (Milk, cream, orange juice, prune juice.)
  • Up to 2 hours before surgery, we encourage you to drink clear liquids (coffee, tea, apple juice, water, soft drinks or meat broth.) Sugar in your coffee and tea is okay, but no milk products.
  • You Must Take usual morning medications, except for Insulin and other diabetic medication, prior to arrival at the surgery center. (Heart, High Blood Pressure, Chronic Pain, Seizure, or Tremors) Take with a sip of water only.
  • Put your pre-op eye drops your surgery eye.
  • Completely and thoroughly remove all face makeup. (This includes all types of oils, lotions, sunscreen, facial moisturizer, liquid foundation, powder, eyeliner, mascara, eyebrow pencil, and eye shadow. Lipstick is okay!)
  • Please remove all of your jewelry and leave it at home. (Wedding bands and small earrings are okay.)
  • Wear comfortable clothing. Please wear shirts or blouses that button or zip up the front. Long sleeves are okay as long as the fabric is lightweight.

Checklist for the DAY OF SURGERY

  1. I instilled my surgery eye drops in surgery eye.
  2. I took usual morning blood pressure, heart, seizure, chronic pain or tremor medications with a sip of water. (If you are treated for these conditions)
  3. I have no cream, lotion or makeup on my face. (Lipstick is okay)
  4. I removed my jewelry and left it home.
  5. I have not eaten any food since midnight.
  6. I did not drink any clear liquids for four hours before my surgery.
  7. I am wearing a lightweight blouse or shirt with a zipper or buttons down the front.
  8. I have arranged transportation to and from surgery today, and also tomorrow for my post-op appointment.

Surgery day at Marin Ophthalmic Surgery Center

Our Surgery Center is located across the hall from our clinic in room 260. Upon arrival please check in with our receptionist located at the desk in the main hallway. The nurse will provide you with a cap to wear over your hair and a gown to be worn over your clothing. You will be assisted to a comfortable reclining chair where you will rest. An anesthetic eye drop will be administered followed by dilating gel. Your general health is monitored, and an anesthesiologist will start your IV and administer appropriate sedation. Sedation and topical or local anesthesia will be given to ensure your comfort before, during and after surgery. After your surgery you will be offered something to eat and drink. Your IV will be discontinued and the nurse will review your post-op instructions with you. This is a good opportunity to get any questions answered that you might have. You will need someone to drive you home after surgery. Plan on spending approximately two hours at the Surgery Center.

Postop Instructions

Day of Surgery:

Take it easy. Resume your pre-operative drops and start any additional medication given to you on discharge. Watch TV, if you like. You may read if it doesn’t cause any discomfort. Resume your normal diet. Do not strain to lift, don’t rub your eye. Take 1-2 Tylenol tablets every 4-6 hours if needed for mild discomfort. Call if that is insufficient. Blurry vision, tearing and a sandy feeling are common the first day after surgery. Close your eyes to rest them if this occurs.

For serious discomfort Call (415) 454-5565 at any time.

Permitted Activity Week by Week

The day after surgery

  1. Please have someone drive you, to your appointment.
  2. Please bring your eye drops with you to your appointment.
  3. Instructions will be given to you regarding your medications.

One-day Postoperative visit all patients must be seen the day after surgery by your surgeon or one of his associates. This must be incorporated into your schedule and transportation plans. Someone else should drive. The eye will be examined and instructions reviewed. Bring all medications, instruction sheets and supplies to every post-operative visit.

During the first week

Avoid getting soap in your eye. Avoid creams lotions and make-up around the operated eye. Wear eye glass protection, especially outdoors. Use moderation in your activities: Walking, running and golf are OK. Wash your hands carefully and avoid touching or rubbing your ere. Do not swim, lift weights or engage in contact sports, including tennis and racquetball.

During the second week

Don’t engage in activities risking direct impact to your eye. Still no weight lifting, aerobics are OK. Wash your hands carefully and avoid touching or rubbing your ere. Wearing eye make-up is okay. There may be some redness, itching, mild discomfort or bruising around the eye. These sensations will decrease and your vision will improve progressively.

2-Week Postoperative visit

We plan to give you a new prescription for glasses. You may wish to fill this prescription at our Optical Gallery. Ask your physician whether there are any continuing activity limitations. Our Optometrist will recheck your vision and if there are any problems refer you to your surgeon.

Call the office IMMEDIATELY  (415) 454-5565  if you have:

  • Pain unrelieved by Tylenol.
  • Persistent irritation.
  • Increased redness or discharge.
  • Worsening vision.
  • Spots or flashes in your vision.
  • Any sensations or worries that concern you.

Risk's of Cataract Surgery

Download Consent Form 20090301

INTRODUCTION

Please read this information carefully and completely. If you have any questions, ask your eye doctor. Your decision should be based on your own visual needs following a thorough consultation with your eye doctor. The purpose of the following information is to give you a general introduction to the potential problems and potential benefits of cataract surgery. Any decision regarding surgery should be made by you in consultation with your doctor.

POTENTIAL BENEFITS OF CATARACT SURGERY

Although the results of your surgery cannot be guaranteed, the expected benefit of cataract extraction is to improve vision to the extent allowed by removal of a cloudy lens. Cataract extraction is intended to remove a cloudy lens that is reducing your vision. Usually, an artificial lens is placed after removal of the cataract. The cataract procedure will not improve the condition of the cornea, retina or optic nerve and if these structures are responsible for decreased vision, the cataract extraction process will not improve those problems. The surgery is intended only to improve the optical clarity of the eye hopefully resulting in a useful improvement in vision. Specific results from this treatment cannot be guaranteed.

GLASSES AFTER SURGERY

You will need to wear glasses at least some of the time after the cataract extraction procedure for either distance or reading vision or both in order to get the best possible vision. You should carefully discuss with your doctor any questions you have about how your vision will be with and without glasses. You and your doctor make a plan together to best fit your needs. More information on refractive issues is available.

DISCOMFORT

Discomfort during surgery is unusual, and if it occurs additional pain relief medication is administered. After the surgery, irritation and minor aching is usually relieved by Tylenol or similar medication. If that is insufficient, call the doctor to discuss what should be done. Painful complications such as infection, high pressure, need for secondary surgeries or corneal abrasion occur infrequently.

COMMON RISKS

Any surgical procedure carries potential risks. Cataract extraction may be followed by complications. Risks of cataract extraction include, but are not limited to, infection, bleeding, retinal detachment, dislocation of the cataract or lens implant, corneal clouding or scarring, macular swelling (edema), worsening of diabetic retinopathy or macular degeneration, glaucoma (high pressure), inflammation, reduced or complete loss of vision or eye, corneal abrasion, astigmatism, need for laser after cataract extraction, need for additional surgical procedures, bruising from injection, irregular pupil, iris prolapse, drooping of eyelid, glare or reflections from lens implant, and need for glasses after surgery. Complications due to anesthetic injection or sedation are possible, due to drug reactions or other problems. These complications may involve other parts of your body, including the possibility of brain damage or even death. Rarely, the optic nerve may be damaged which can result in loss of sight. There is a possibility of hemorrhage or bleeding. In some cases, complications may occur weeks, months or even years later. Some complications could result in the need for more surgical procedures. One situation that is fairly common is for a “secondary cataract” to form, sometimes months but usually years after even perfectly performed surgery. This requires a laser treatment (also available at Marin Ophthalmic Surgery Center) to correct. Since it is not possible to list every potential complication that may occur as a result of any surgery, this list may be incomplete and there may be risks associated with laser surgery that are currently unknown. Contact your doctor with any problems noticed after the surgery, such as pain, light sensitivity, loss of vision, or unusual mattering or discharge from the operative eye. Many complications are manageable if caught early. You are responsible for reporting any symptoms and making arrangements to be evaluated.

ALTERNATIVE TREATMENTS

You may elect not to have cataract extraction, or to postpone it. In this situation, it is expected your condition will stay the same, or worsen over time. Presently, there is no other known therapy for reduced vision from a cloudy cataract other than surgical removal. You will confer with your doctor as to the lens implant style and power options for your needs.