29 - Cataract Surgery Postoperative Care Flashcards
What are some signs and symptoms requiring urgent referral to an eye doctor?
- post-op infection
- glaucoma
- inflammation or any suspected issues in healing
We talk about 4 types of meds in this chapter. What are they?
- Meds to prevent infection
- Meds to prevent a rise in IOP
- Meds to prevent cystoid macular edema
- Meds to improve healing
Inflammation more common within ___ hrs of surgery
48
Infection most common how long after surgery?
between 3 and 7 days
If someone complains of itching of the eye, it indicates what?
either an allergy to meds or dry eye
How long do you give antibacterials for?
7-10 days post surgery
A bunch of different antibiotics can be used, can do antibiotic/steroid combo to improve ______
adherence
Intracameral administration of vancomycin linked with rare disorder called what?
HORV (hemorrhagic occlusive retinal vasculitis)
How long do we give glaucoma meds for (these are being given to decrease IOP)?
as long as IOP is elevated
How long do we give anti-inflammatory agents for?
3-4 weeks
Why do we use anti-inflammatory meds?
-Used for a few weeks post-op to decrease inflammation and the risk of developing cystoid macular edema
What drugs can we use to decrease inflammation?
-NSAIDs and/or corticosteroids
What meds are used to improve healing?
-opthalmic dilators and cycloplegics
How long are opthalmic dilators and cycloplegics used for?
for first few weeks after surgery
How do opthalmic dilators and cycloplegics work?
These meds are used to keep the iris away from the implant during early healing period and to improve comfort by decreasing ciliary muscle spasm
Examples of opthalmic dilators and cycloplegics
- cyclopentolate
- phenylephrine
- tropicamide
Separate eye drops by at least ___ mins
5
How do patients who have a systemic CI to one of the eye drops deal?
Tell them to block inner canthus (put pressure on it) to prevent the drop from being systemically absorbed
Reassure them that the eye drop post-surgery is more important than the very slight risk of some small systemic absorption of the drug
Signs of endophthalmitis
- vision worsening
- floaters
- eye redness
What types of meds may be stopped prior to surgery?
insulin, or SU, meglitinides - doses may be modified or med may be held day before or day of surgery due to risk of hypoglycemia
_____ may be held due to risk of lactic acidosis
metformin
More frequent monitoring of ____ ____ may be required
blood glucose
What are some classes of glaucoma meds used to decrease IOP?
- alpha agonists
- beta blockers
- carbonic anhydrase inhibitors (oral or topical)
- prostaglandin analogues
Examples of alpha 2 agonists
brimonidine, apraclonidine
Examples of beta blockers
timolol, betaxolol
Examples of carbonic anhydrase inhibitors (topical)
brinzolamide, dorazolamide
Examples of prostaglandin analogues
latanoprost, bimatroprost
Examples of carbonic anhydrase inhibitors (oral)
acetazolamide, methazolamide
Don’t use carbonic anhydrase inhibitors in patients with a ____ allergy
slufa
OD =
right eye
OS =
left eye
OU =
both eyes
Discard eye drops ___ weeks after opening
4
What is the pathophys of cataracts?
proteins called crystallins clump and cloud the lens of the eye
What is a common s/e after surgery?
mild foreign body sensation
When do antibiotics need to be started?
immediately after surgery
Close eye and wait how long between adding another drop of the same med?
1 minute
