What to Expect After Surgery
- Your eye surgeon will call you the evening after the surgery to make sure all is well.
- Eye patch after surgery: Most patients do not require an eye patch after pediatric or eye muscle surgery.
- Stitches: Most stitches used in eye surgery are thinner than human hairs. They will dissolve on their own over 6 weeks. They may make your eye feel scratchy for the first few weeks. The antibiotic ointment and a cool compress will alleviate this symptom if it occurs. Your doctor will discuss with you if the stitches need to be removed after surgery.
- Diplopia or double vision: Some double vision is normal for the first few weeks after eye muscle surgery.
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Restrictions After Eye Surgery
- Showering: As with other surgeries we want the patient to keep the operated area clean until the surgical incisions heal, typically 10 days after surgery. This means no swimming and keeping the area dry during this time. Patients may shower with care to avoid dirty water entering the operated area.
- Eye Rubbing: Because even the youngest patients realize the area around the eyes is tender after surgery, eye rubbing is almost never a problem
- Driving: Most adult patients may drive on their own a few days after the surgery. The decision of when to drive again is often up to the patient.
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Length of Surgery
- Probe and irrigation of nasal lacrimal system: 10 minutes
- Lid mass removal: 10-30 minutes per lid.
- Strabismus, eye muscle surgery: 1-2 hours.
- Ptosis lid surgery: 1 hour.
- Pediatric cataract surgery: 1-2 hours.
- Expect an extra 20-30 minutes before and after the surgery to take into account the time it takes for the patient to fall asleep and wake up.
- All eye surgeries are outpatient procedures and the patient may go home typically 1-2 hours after surgery.
- Expect to spend half a working day at the hospital.
- Most patients may return to work or school 3-5 days after most procedures.
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- To avoid the discomfort to the patient during surgery and to prevent the movement of the eyes during surgery a general anesthetic is required.
- When we perform pediatric surgery we only use anesthesia doctors who specialized in pediatrics.
- In a healthy child the risk of a complication from today’s general anesthetics is extremely small. It has been compared to the risks of riding in a car in the US.
- To avoid the risk of the patient choking while under the effects of anesthesia, all patients must have an empty stomach the morning of surgery. This typically means no fluids 6 hours prior to surgery. Surgery will be cancelled or postponed if the patient consumes liquids or foods prior to the surgery.
- All patients must be cleared for surgery by their primary doctor prior to the day of surgery. If the patient develops a cold or other illness the surgery will be postponed to avoid any unnecessary risks.
- Parents in the OR: Depending on the patient’s age, one parent may be allowed to accompany the patient and stay with them while the patient falls asleep. Once the patient is asleep the parent will be escorted back to the waiting area. As hospital policy parents are not allowed to stay in the operating room during the surgery because they would create a distraction to the surgical team.
- For further anesthesia questions, you may contact the anesthesia department at the hospital where you will be operated.
- Needles: If the procedure will take longer than 10 minutes, IV (intra-venous) fluid may be necessary for the anesthesia doctor to administer anesthesia related medicines. In young children the IV is placed with a small needle after they are asleep to avoid discomfort while the patient is awake. The needle is then removed. The IV tubing is removed painlessly after the child awakes.
- Pain medicine: This is available after the procedure but most patients do not require it.
- Nausea: Some nausea may occur after eye surgery. If it becomes a serious problem anti-nausea medicines may be prescribed.
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Risk of Surgery Not Related to Anesthesia
- Complications are rare.
- Infection: Because most eye surgeries are small, clean and very superficial the risk of infection is extremely low, less than 1/10,000. It is normal for the eyes to be red, swollen and sore after surgery, however these symptoms should not worsen after surgery. If they do, you must notify your doctor because they may indicate an infection. Antibiotic drops or ointment will be given to you prior to going home. These must be used as instructed to lessen the risk of infection. Antibiotic ointment is placed on the patient’s eyes after the surgery, prior to waking up from anesthesia. Serious eye infections could lead to blindness or loss of the eye. In our 40 years of practice no patient has lost sight because of this complication.
- Bleeding during surgery: Because eye surgeries are very superficial, bleeding is often minimal (as in a few drops of blood.) Our patients have never required blood transfusions. This fact decreases the risk of blood born infections such as AIDS, or hepatitis. Because the eye has a very thin, transparent skin it is normal for the white part of the eye to be very red after surgery. This clears up after 1-2 weeks.
- Bleeding after surgery: It is common to have some blood tinged tears the day after surgery.
- Blindness: Loss of sight is extremely rare in strabismus or pediatric eye surgery. Your doctor can review this risk with you. This risk varies depending on the procedure that is required. As stated above no patient in our pediatric and strabismus practice has lost sight because of eye surgery.
- Scarring: This is as well an extremely rare risk. Because eye surgery is considered micro-surgery, most eye surgeries leave scars that are only noticeable or visible with a microscope. Your eye surgeon often uses an operating microscope or special magnifying glasses called loupes to perform very delicate surgeries. The surgical incisions are often made behind and under the eye lid which covers any residual signs.
- Need for further surgery: The long term course of strabismus is usually very satisfactory but it may be difficult to predict what will be required to achieve the ideal goals. In some instances more than one procedure is required to attain the expected long term surgical goal. This may be required months or decades later. Your doctor will discuss the chances of requiring further surgery depending on your condition and the planned procedure.
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