Perioperative Nursing Care of Ambulatory Cataract Operation

【Major Points】

Ambulatory cataract surgery does not require fasting status.
Before the operation, keep face clean, go to the toilet, and remove all your accessories, or nails polish.
During the operation, maintain face-up lie down position, do not move at will and do not touch surgical site.
Within one month after surgery, avoid water into your eyes while wash head or face to prevent infection.

What is the ambulatory cataract surgery?
Cataract surgery is performed under local anesthesia. The surgeon will remove the turbid eye lens and then replace intraocular lens to improve your eyesight. Please check in with operating room reception counter on your operative schedule day. Fasting status ( no food or water) is not required. After operation, you can go home on the same day.

What care will you receive during surgery?
Upon registration to the end of surgery, regarding your condition perioperative nurse will provide individual nursing care, keep you warm, privacy and safety during your procedure.

Pre-operation preparation:
On the day of surgery, bring the health insurance card, operation notice, surgical consent form, anesthesia consent form, and other outpatient documents to the operating room (OR).
1. Confirm the surgery information:
  When you enter the OR, in order to performing accurate surgery, different medical staff will repeatedly ask your name, birthday, and location and procedure of the operation to confirm all information is consistent with the intended operation.
2. Preparation for local anesthesia:
  Ask about your medication history, allergies, and whether you have a history of hypertension and asthma, as a reference for surgical safety. Give you local anesthesia and dilating eye drops, and help you take oral medications.
3. Going to the toilet:
  When you hear broadcasting your name, please go to the toilet first, then approach the OR station.
4. Change into surgical gown:
  You must wipe lipstick, remove nail polish and change the surgical gowns before entering the OR. Personal clothing including underwear and socks are not allowed.
5. Remove accessories:
  Electrosurgical Unit may be employed to stop bleeding during surgery. To avoid electric burns, metal objects and accessories such as glasses, artificial dentures, hairpins, necklaces, rings, amulets, etc. must be removed before entering the OR.
6. The hearing aid does not need to be removed to facilitate communication with medical staff during the operation.
Intra-operation preparation:
1. Warmth and Privacy:
  Body exposure will be minimized during the procedure; according to body temperature and warming needs, heating equipment or warm blankets will be provided.
2. Disinfection of the surgical site:
  During disinfection, there will be a cold feeling. Please do not touch the disinfection area with your hands to avoid wound infection after surgery.
3. Cover the surgical site with sterile drape:
  To avoid surgical site infection, the surgical site (eye) will be draped to expose only the operative eye. Do not have to worry about breathing issue. Nursing staff will set up oxygen tubes under the sheet and provide sufficient oxygen.
4. Administration of local anesthesia:
  Use a smaller needle to inject anesthesia around the surgical site during surgery. During the operation, having sensation of touch and pull is normal. If you feel pain or discomfort, please notice the medical staff at any time to increase the administration of local anesthetics.
Post operation care:
1. Nursing staff will clean your face and the wound, the wound be covered by eye pads.
2. Follow the doctor's schedule to take off the eye pads and begin putting in the eye drops. .

Home care notifications:

Please avoid embracing children, carrying weights, to defecate or coughing too hard, swimming, strenuously exercise, falling down and do not bend over more than 90 degrees. .
Do not rub your eyes. You may wear sunglasses or eye cover if the sun is too shining. Please wear an eye patch over the operative eye during sleep.
Prevent water into your eyes when you wash your head or face after surgery one month. Please do not drive or ride a motorcycle within one month after surgery.
There is normality that you might feel fear of light, tears, mild pain and friction and discomfort briefly after the operation. If you have unusual pain, bleeding, swelling, vision charged and discharged increase, please go to emergency room immediately.
There isn't any contraindicated diet except for hard to chewing or spicy food.
Nursing staff will make an appointment for you. Please go to the clinic on the appointment date.
Please apply eye drops correctly and on time, do wash your hand before applying eye drops.

Reference

Khezri, M. B., Akrami, A., Majdi, M., Gahandideh, B., & Mohammadi, N. (2002). Effect of cryotherapy on pain scores and satisfaction levels of patients in cataract surgery under topical anesthesia: A prospective randomized double-blind trial. BMC research notes, 15(1), 234. https://doi.org/10.1186/s13104-022-06125-w
Nizami, A. A., Gulani, A. C., & Redmond , S. B. (2022). Cataract (Nursing). StatPearls.
Taylan, S., & Celik, G. K. (2022).The effect of preoperative fear and related factors on patients’ postcataract surgery comfort level: A Regression Study. Journal of Perianesthesia Nursing, 37(3), 398-403. https://doi.org/10.1016/j.jopan.2021.08.014
Zaluski, S., Amzallag, T., Bouchut, P., Pinsard, L., Theron, J. P., Tellouck-Morincomme, J., & Baffert, S. (2023). Perioperative time and economic impact of an intracameral combination of mydriatics and anaesthetics in routine cataract surgery. European Journal of Ophthalmology, 33(1), 239-246. https://doi.org/10.1177/11206721221101359

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