Ⅰ. Preoperative:
1. Ophthalmic examination: binocular vision, intraocular pressure, B-ultrasound, binocular cataract master, slit lamp examination, ophthalmoscope examination, lacrimal passage flushing, etc.
2. Routine examination: routine blood test, blood biochemistry (liver and kidney function, blood sugar, electrolytes), urine routine, preoperative coagulation, complete set of preoperative coagulation (hepatitis, syphilis, AIDS detection), electrocardiogram, chest radiograph, etc.
3. Past medical history: if you have previously diagnosed some underlying diseases such as diabetes, hypertension, etc., or there are special circumstances: such as long-term anticoagulant drugs after heart valve replacement, history of drug allergy, history of previous operations of surgical eyes(especially postoperative complications), etc, you should be reported to your doctor. And it is best to control blood sugar and blood pressure in the internal medicine before admission for cataract surgery.
4. Disinfection of surgical eyes: if you often shed tears and have a lot of eye excrement, you should explain to your doctor for lacrimal passage flushing to eliminate the situation of lacrimal duct obstruction dacryocystitis. After admission, you will be given a bottle of eye drops, most of which are 0.3%-0.5% (left) of ofloxacin eye drops. It can be applied to both eyes. Please make sure that you have applied it at least 8 times from the first time to the time of operation. (Note for eye drops: turn the bottle upside down, squeeze out a drop to flush the bottle mouth, and then drop 1-2 drops into the lower conjunctival sac (the groove in the lower eyelid). You can not touch your eyelashes, skin, etc.)
5. Preoperative preparation:
Practice head position: lie on your back, keep your head upright, and practice three movements to cooperate with the surgeon during the operation:
a. Open your eyes and look at the ceiling directly above
b. Open your eyes and look at your feet
c. Open your eyes and look at the top of your head
During the operation, due to an aseptic operation, disinfection of towel laying, there will be 3-4 layers of cotton cloth in front of your nose. Some elderly people will not adapt to it, finding it difficult to breathe. Therefore, they can fold the dry towel twice before the operation and gently put it on their nose and mouth to practice breathing, so as to eliminate the discomfort during the operation.
6. Decide which intraocular lens to use
7. Decide what refractive state to keep after the operation
8. Know the possible complications of the operation and sign the operation consent
9. Preoperative preparation of patients under general anesthesia: generally, local anesthesia is enough for this operation. However, general anesthesia is needed in some cases. You can't eat or drink after 10 o'clock the night before the operation.
Ⅱ. Intraoperative:
1. Before entering the operating room, change into open clothes and defecate. If operating patients have a long-term chronic cough, they should explain it to the surgeon, especially during the operation, so as to avoid accidental injury to normal tissues caused by the vibration of intraocular instruments and ophthalmic surgery instruments.
2. The operation time is about 20 minutes. Your surgical eyes will be dripped with topical anesthetics and mydriasis drugs before the operation. Basically, there is no pain. Patients should keep their eyes open (don't worry that you can't open your eyes for a long time. There are instruments to help you open your eyes during the operation). Look at the light directly above and keep still. If necessary, slowly move your eyes in accordance with the instructions of the surgeon.
3. After the operation, cover the surgical eyes with gauze and an eye mask for one night and rest quietly in the ward
Ⅲ. After operation:
1. There may be foreign body sensations 1-2 hours after the operation, and there may be flying mosquito disease after uncovering the gauze the next day. These are normal phenomena. (Note: floater disease is caused by the opacity of the vitreous body mentioned earlier. As the postoperative visual field becomes clear, the original vitreous opacity becomes clear at once. There is no good treatment for simple mild vitreous opacity, which can not be treated. If it continues to aggravate significantly, you need to see a doctor.)
2. Avoid bumping the surgical eyes. You can walk, read and watch TV in the ward, but don't be too tired.
3. Avoid dirty water entering surgical eyes. The face towel should be wrung dry, and do not rub surgical eyes one month after the operation. Shampoo and bath should be taken with special care 1-2 months after the operation to avoid the entry of dirty water.
4. Sunglasses are not required. However, due to the increase in crystal transparency and the increase of light entering the eyes, some patients who feel that the light is too strong can wear sunglasses.
5. No certain food is forbidden
6. The mixed eye drops of antibiotics and glucocorticoids should be used after the operation to prevent inflammation and infection. Take Tobradex (tobramycin + dexamethasone eye solution and eye ointment) as an example: the eye solution should be applied every two hours (about 6 times/day) in the first three days after the operation. Apply eye ointment before going to bed at night (squeeze 1cm to the conjunctival sac); The eye liquid is changed to 4 times per day in the next three days; 3 times per day in the following week; In the following week, it can be used twice a day. After that, it can be stopped; Eye ointment can be used for two weeks after an operation or it can be used according to the postoperative reexamination and the doctor's advice.
7. Check the visual acuity and binocular condition every day from postoperative to discharge. If the vision recovery is not ideal, and your refractive medium is transparent at this time, your doctor will make a further examination for you and take the next step of treatment for fundus lesions.
8. One week after discharge, the ophthalmic clinic shall recheck and follow up regularly. If you feel uncomfortable, you should see a doctor immediately.
9. Matching time of glasses: for those who need to be matched with presbyopia and myopia after the operation, generally speaking, the condition of the surgical eyes is relatively stable three months after the operation, and recoverable astigmatism basically disappears. At this time, the degree of matching can be relatively stable. However, the diopter of surgical eyes of some patients still can change half a year after the operation.
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