Download Perioperative Eye Care:

I. Phacoemulsification / IOL
A. Description
1. A microsurgical procedure where a cataract (opacity or cloudiness of the natural lens)
is removed using advanced ultrasound equipment and a foldable intraocular lens is
implanted
B. Indication
1. Recommended when the patient’s vision is impaired resulting in a decrease in their
quality of life
2. Cataracts may also be removed when medically necessary
C. Postop
1. Rx Antibiotic drops qid x 1 wk
2. Rx Anti-inflammatory drops qid x 1 wk, then slow taper off (3, 2, 1 / wk)
3. Examine @ 1 d, 1 wk, and 1 m
II. Posterior Capsulotomy (PC)
A. Description
1. A laser procedure where the hazy capsule situated behind the IOL implant is removed
B. Indication
1. Recommended when the patient’s vision is impaired resulting in a decrease in their
quality of life
2. Posterior Capsular Haze may also be removed when medically necessary
C. Postop
1. Rx Anti-inflammatory drops bid x 1 wk
2. Examine 1 – 24 hours after procedure, 1 week, and 1 m
III. Penetrating Keratoplasty (PKP)
A. Description
1. A microsurgical procedure where the diseased cornea is removed and a donor cornea
is sewn into place
B. Indication
1. Recommended when the patient’s vision is significantly impaired secondary to a
corneal opacity and cannot be corrected by glasses and / or contact lens
C. Postop
1. Rx Antibiotic drops qid x 1 m, and Anti-inflammatory drops qid x 12 wks, then very
slow taper off
2. Examine @ 1 d, 3 d, 1 wk, 2 wk, 1 m, 2 m, 3m, 4m, 5m, and 6m
IV. Laser Assisted In-Situ Keratomileusis
A. Description
1. A refractive surgical procedure that has the capability of correcting myopia, hyperopia
and astigmatism
B. Indication
1. Recommended to patients who want to decrease their dependency on glasses and / or
contact lenses
C. Postop
1. Rx Antibiotic drops qid x 1 wk and Anti-inflammatory drops qid x 2 wks
2. Also Rx preservative free lubricants qid x 1m
3. Examine @ 1 d, 1 wk, 1 m, 3m, and 6m
V. Argon Laser Trabeculoplasty (ALT)
A. Description
1. A laser procedure for open angle glaucoma where a laser beam is directed into the
trabecular meshwork allowing for an increased drainage of aqueous fluid
B. Indication
1. Recommended when medication therapy is insufficient in controlling pressure and the
progression of glaucoma
C. Postop
1. Continue all Glaucoma drops as directed
2. Rx Anti-inflammatory drops QID x 1 wk
3. Examine 1 – 24 hours after procedure and @ 1 week
VI. Diode Laser Trabeculoplasty (DLT)
A. Description
1. A laser procedure for open angle glaucoma where a laser beam is directed into the
trabecular meshwork allowing for an increased drainage of aqueous fluid
B. Indication
1. Recommended when medication therapy is insufficient in controlling pressure and the
progression of glaucoma
C. Postop
1. Continue all Glaucoma drops as directed
2. Rx Anti-inflammatory drops QID x 1 wk
3. Examine 1 – 24 hours after procedure and @ 1 week
VII. Selective Laser Trabeculoplasty (SLT)
A. Description
1. A laser procedure where a laser beam is directed into the trabecular meshwork
allowing for an increased drainage of aqueous fluid
B. Indication
1. Recommended for patients with open angle glaucoma when medication therapy is
insufficient in controlling pressure / progression of glaucoma
C. Postop
1. Continue all Glaucoma drops as directed
2. Rx Anti-inflammatory drops QID x 1 wk
3. Examine 1 – 24 hours after procedure and @ 1 week
VIII. Laser Peripheral Iridotomy (PI)
A. Description
1. A laser procedure which creates a tiny opening in the peripheral iris, allowing aqueous
fluid to flow from behind the iris directly to the anterior chamber
B. Indication
1. Recommended for patients with narrow angles, narrow angle glaucoma, or acute angle
closure glaucoma
C. Postop
1. Discontinue glaucoma drops unless mixed mechanism
2. Rx Anti-inflammatory drops QID x 1 wk
3. Examine 1 – 24 hours after procedure and @ 1 week and 1 month
IX. Glaucoma Filtration Procedure
A. Description
1. A microsurgical procedure called a trabeculectomy which creates a new passageway
by which aqueous fluid inside the eye can escape thereby lowering the pressure
B. Indication
1. Recommended for patients with open angle glaucoma which continues to progress
despite the use of medications and / or laser treatments
C. Postop
1. Discontinue glaucoma drops
2. Rx Antibiotic drops qid x 1 m, and Anti-inflammatory drops qid x 8 wks, then taper off
3. Examine @ 1 d, 3 d, 1 wk, 2 wk, 1 m, 2 m, and 3 m
X. Glaucoma Drainage Device
A. Description
1. A microsurgical procedure which a Glaucoma Drainage Device, also known as tube
shunts is implanted to maintain an artificial drainage pathway
B. Indication
1. Recommended for patients with a history of trabeculectomy failure or complex
glaucomas ( i.e. neovascular glaucoma, glaucoma associated with uveitis)
C. Postop
1. Continue glaucoma drops
2. Rx Antibiotic drops qid x 1 m, and Anti-inflammatory drops qid x 12 - 16 wks, then
taper off
3. Examine @ 1 d, 3 d, 1 wk, 2 wk, 1 m, 2 m, 3 m, 4m, 5m and 6m
XI. Laser Cyclophotocoagulation (CPC)
A. Description
1. A laser procedure is used to destroy part of the ciliary body, thus decreasing aqueous
production and lowering intra ocular pressure
B. Indication
1. Recommended for patients when other means of glaucoma treatment has failed to
properly control high pressures
C. Postop
1. Continue glaucoma drops
2. Rx Cycloplegic drops qid x 1 wk and Anti-inflammatory drops qid x 4 wks, then taper
off
3. Examine @ 1 d, 3 d, 1 wk, 2 wk, 1 m, 2m, and 3 m
XII. Blepharoplasty
A. Description
1. A surgical eyelid procedure which may correct drooping upper eyelids and puffy bags
below the eyes
B. Indication
1. Recommended for patients when their superior peripheral vision is diminished due to
limitations in the upper and lateral fields
C. Postop
1. Cold Packs x 72 hours
2. Rx Antibiotic / Anti-Inflammatory Combo ung bid to wound site and oral pain
medication
3. Examine @ 1 d, 1 wk, 1 m, and 3 m
XIII. Focal Photocoagulation (FP)
A. Description
1. A laser procedure to help prevent further leakage from capillaries and microaneurysms
B. Indication
1. Recommended for patients with Clinically Significant Macular Edema (CSME) and
chronic macular edema reducing vision below 20/40 associated with a Branch Retinal
Vein Occlusion (BRVO)
C. Postop
1. Rx Anti-inflammatory drops QID x 1 wk
2. Examine 1 – 24 hours after procedure, 1 week, 1 m and 3m
XIV. Pan Retinal Photocoagulation (PRP)
A. Description
1. A laser procedure to help treat the ischemic peripheral retina, causing regression of the
neovascular tissue
B. Indication
1. Recommended for patients with Proliferative Diabetic Retinopathy (PDR)
C. Postop
1. Rx Anti-inflammatory drops QID x 1 wk
2. Examine 1 – 24 hours after procedure, 1 week, 1 m, 2m and 3m