Ophthalmology. Cataract Surgery. Information

Transcription

1 Ophthalmology Cataract Surgery Information

2 Welcome to Spencer Ward We would hope your stay with us will meet your expectations. We have compiled this booklet to help answer any questions you may have regarding your operation. It will also remind you of any instructions which the doctor or the nursing staff may give. Please feel free to ask any further questions you may have. What is a cataract and lens implant? Behind the pupil of your eye is a clear lens, which focuses the light that enters your eye, allowing you to see clearly this lens can become cloudy, which then makes it difficult to see. This condition is known as a cataract. If the vision gets bad enough to cause problems, the cataract can be removed by means of an operation. The purpose of the operation is to replace the cloudy lens (cataract) with a plastic lens, known as the lens implant. This will not harm your eye. At pre-assessment, measurements were recorded of your eye. 2

3 The lens required for your operation is calculated using these measurements. They come in a range of strengths, just like glasses. The implant chosen is usually the one that will give best distance vision after the operation. You may need glasses after the operation to fine-tune the vision. It is unlikely that strong glasses will be needed. Reading glasses are nearly always needed, however, we do advise you to wait 6 8 weeks after the operation before going to your optician. If you require surgery to both eyes, we advise you wait until your second operation has been performed before going to the opticians. If you have suitable reading glasses, use them if you wish. If you do not have any reading glasses you may purchase "off the peg" reading glasses until your second operation. 3

4 This procedure may be carried out under either local or general anaesthetic. Local anaesthetic procedure Cataract operations are usually performed under local anaesthesia. With this method the patient remains awake. The local anaesthetic can be given by two different methods. 1. Local anaesthetic eye drops, followed by one/two small injections into the tissue around the eye. These injections will sting for a few seconds before numbing the eye. 2. Local anaesthetic eye drops, followed by local anaesthetic solution being flushed around the eye using a blunt cannula (a fine tube). If you have sedation a small needle may be inserted into the back of your hand through which drugs can be given, if needed. You will then be transferred to the operating theatre. The skin around your eye will be cleaned with antiseptic solution. A fine drape will be positioned over your face and chest with air flowing underneath to ensure your comfort. 4

5 You will be aware of a bright light initially; this will fade after a few seconds. The vision in your eye may still be present; this does not mean that you will feel the operation. The operation normally takes minutes, but may take up to 45 minutes. You will be required to lay flat and keep your head still. During the operation you may feel water running over your eye and you also may hear an intermittent buzzing noise. A member of the theatre staff will hold your hand during the operation if you wish. If you feel at any point uncomfortable or that you are going to cough or sneeze, please alert staff by squeezing the nurse s hand. This will allow the surgeon to halt the procedure. When the operation is completed a plastic shield is secured in place, covering your eye for protection. General Anaesthetic procedure (Please note that if you are having the operation carried out under local anaesthetic, this section does not apply to you) Occasionally a general anaesthetic is necessary. This means you will be asleep during the operation. 5

6 It may be necessary to perform a blood test, ECG and chest X-ray to ensure you are medically fit for this type of anaesthetic. The final decision, however, rests with the anaesthetist. It will be necessary to stop eating and drinking, as instructed by the nursing staff. Your normal clothing will need to be removed, as it is necessary to wear a special gown. This is to allow the anaesthetist to monitor your progress throughout the operation. A small needle will be inserted into the back of your hand through which drugs will be given to send you to sleep. When the operation is completed a plastic shield is secured in place, covering your eye for protection. You will be transferred to the recovery room, where your blood pressure and pulse will be monitored before transferring you back to the ward. Please arrange for a responsible adult (18 years of over) to collect you after the operation and remain with you for 24 hours following your anaesthetic. You will need to be taken home in a private car or taxi; please do not use public transport. 6

7 Risks and benefits of cataract surgery All operations have a degree of risk. However, more than 95% of patient s have improved eyesight following cataract surgery, providing the rest of the eye is working normally. There is a very small risk, which may affect your vision permanently. Whilst every precaution is taken at the time of surgery, it is not always possible to predict whether you will be affected. Risks Benefits Increase pressure in the eye after surgery Infection after surgery Haemorrhage in the eye Improved vision Better colour perception Before your admission Ensure your transport to and from hospital is arranged Please bath or shower the day before the admission 7

8 If you are having a general anaesthetic please bring with you a dressing gown and slippers Please inform the ward staff if you have experienced a cough, cold or any sticky discharge from your eyes. On the day of your operation Wear something comfortable on the day, that is front opening, so it will be easier for you to remove when you get home Eating and drinking follow the instructions given at pre-assessment Tablets and medicine take as usual, unless instructed otherwise at your pre-assessment. On admission Your nurse will check your details on admission and you will have a visit from the surgeon. You will be required to sign a consent form agreeing to have the operation. Eye drops will be put in 1-2 hours before the operation. This will enlarge the pupil and may sting a little. 8

9 They will be administered by either putting drops in every 15 minutes or by having a tiny piece of sponge, soaked in the drops. This will rest inside your bottom eyelid. This will stay there and be removed just before you go for your operation. A member of staff will escort you to the anaesthetic room. After your operation you will be offered refreshments. Your pulse and blood pressure will be recorded. Approximately 1 hour after surgery your eye shield will be removed by one of the nurses. A doctor or senior nurse will then examine your eye. Providing all is well, you will be allowed to go home. The nurse will give your some eye drops to put in at home, along with full instructions on how often to use them. You will also be given an instruction leaflet. A contact telephone number will be given to you should you have any problems or concerns following your discharge. It may be necessary for you to return the following morning. If this is the case the nurse will discuss it with you. 9

10 An appointment will be given to you to return for a check- up. After care Eye-drops please use the eye-drops as instructed. Rubbing the eye do not rub the eye when you get home. For 2 weeks gentle activities only when you get home. Driving do not drive until you have your check up appointment. The doctor in the eye clinic will advise you when to resume driving. Also check with your motor insurers, as your insurance cover may be affected for a short time. You should refrain from swimming and wearing eye makeup for 3 weeks after your surgery. 10

11 Following surgery, it is possible you may experience any of the following: Aching around the eye - take any usual pain relief medication. If the pain gets worse, contact the ward. Double vision this will gradually wear off in 2 hours. Watering eyes use clean tissues to gently wipe under the eye. If your eye becomes very sticky contact the ward. Headache take your usual painkillers. If it gets worse contact the ward. Blurred vision this will gradually clear. If your vision gets worse contact the ward. 11

12 Contact Information If you have any concerns or require any further information, please contact: Spencer Ward Monday to Thursday 8am - 6pm Friday 8am - 5pm Reference: Royal College of Ophthalmology guidelines for cataract surgery (February 2015) If you need this information in another format or language, please telephone Further information about the Trust is available on the following websites: KGH - NHS Choices - Ref: PI 290 December 2016 Next review: September 2018