Superficial Keratectomy Surgery

Dear Respected Patient,

Please read this handout on the day you receive it, bring it to all of your appointments before and after surgery, and on the day of your eye surgery.

 Please obtain your eye drops (with the attached prescription) and artificial tears before the day of surgery. People who are prepared for surgery and who take part in their care enjoy a better experience and can recover in less time with fewer or no problems. The information in this handout will help to get you, your family and your home ready for surgery.

Thank you for allowing us to help with your care. We wish you a pleasant surgical experience and a quick recovery.

 Sincerely,

 Team Seema Eye Care

Preoperative Instructions

  1. Your surgery will take place at the Holy Cross Surgical Services (101 2210 2nd St SW).
  2. Before the day of surgery, please arrange to have a responsible person to:
    1. Bring you to and from the Holy Cross Surgical Services or hospital (by car or taxi). You will NOT be allowed to drive yourself home or take a bus.
    2. Stay at the Holy Cross Surgical Services during your stay if you need a translator or if you require help and stay with you for at least 24 hours after surgery (if possible).
    3. Help you with daily activities as needed and to follow post-op instructions.
  3. NO FOOD OR DRINK AFTER MIDNIGHT the day before surgery.
    1. If this rule is not strictly followed, your surgery will be cancelled.
    2. No alcoholic beverages for 24 hours before surgery.
  4. Medications
    1. Your surgeon has recommended the use of non-preservative artificial tears. Please start these drops 4 times per day, 14 days before eye surgery. Superficial Keratectomy Surgery
    2. Please take all your regular high blood pressure medications (with small sips of water only) on the morning of your surgery, unless told otherwise by your surgeon or family physician.
    3. DO NOT TAKE INSULIN or DIURETICS (please bring them with you to take after surgery).
    4. If you are currently using eye drops, please ask your surgeon for specific directions about stopping or continuing these after the surgery.
    5. Please have acetaminophen (Tylenol®) at home to use if you have discomfort after surgery.
    6. A post-operative kit is available for purchase at Seema Eye Care Centre, which includes protective sunglasses, skin tape, eye shields and a bag for your prescriptions and instructions. You may need to purchase additional skin tape.

Day of Surgery

What to Bring and Wear to the Surgical Centre Inc.

  • Please bring your Alberta Health Care Card, a form of photo ID and proof of substitute Medical Insurance Plan if required.
  • Please bring a translator if you do not understand English.
  • Please wear comfortable clothing (e.g. loose pants and short or loose sleeves, and lowheeled, non-slip shoes).
  • Please DO NOT WEAR jewelry, make-up or false eyelashes. Face cream is okay. Acrylic nails and nail polish are okay, but avoid dark coloured, metallic polish.
  • Bring your surgical kit (if purchased), all of your prescribed eye drops and other regular medications on the day of the surgery to be started immediately after the surgery.
  • Bring sunglasses to wear home in case your eyes are sensitive to light.
  • You may brush your teeth, bathe or shower, and wear your hearing aid or dentures on the morning of the surgery.

What to Expect

  • The surgery takes about 15-45 minutes but expect to be at the Holy Cross Surgical Services for 2 to 4 hours. Sometimes the surgery may be a bit later than planned, at other times earlier.
  • Check-in at the Holy Cross Surgical Services a nurse will ask questions, lie you down, put eye drops in your eye and you will meet the Anesthesiologist. If you are nervous, you will be offered medication to help you relax.
  • If you are able, you will walk with a nurse into/out of the operating room. In the operating room, you will be laid down on a bed, monitors are placed, your eye will be cleaned and your face will be covered with a sterile drape.
  • The eyelid (of the operated eye) is kept open with a small, comfortable clip. Please keep both eyes open (under the drape) and blink normally. Your eye surgeon will ask you to look up, down, left, right or at the microscope lights and hold these gaze positions for 1 to 3 minutes at a time.
  • During surgery, you may experience mild pressure or pulling, see unusual shapes, movements and/or very brilliant colours.

IMMEDIATELY AFTER Superficial Keratectomy Surgery

  • After surgery, a patch and a shield are placed over your eye with tape. Please start your Tobradex eye drops same day, and leave the patch on until your follow-up appointment the next morning.
  • You are discharged home when you are alert and stable.
  • You may eat normally and resume taking all your regular medications after surgery.
  • Some achiness, soreness, scratchiness, tearing and mild burning are all normal symptoms immediately after the surgery and during the first few days after

Postoperative Instructions

  1. You will receive a prescription for medicated eye drops and will use non preservative artificial tears as outlined in the drop schedule below.
    1. Hylo and i-drop non-preservative artificial tears are available at Seema Eye Care Centre
  2. When using two or more eye medications, always wait 5 minutes after instilling the first eye medication before instilling the next one.
  3. Please start drops after the surgery (same day) and follow this medication schedule:

  4. Use the chart below to track drops for the first month by filling in a circle every time you use a medication drop. Always wait 5 minutes after instilling the first medication before instilling the next one.
  5. After your Operation:
    1. It is recommended to take 1 week off work to ensure proper healing.
    2. Be careful no to rub, bump, or press on your operative eye for 1 month
    3. Do no go swimming, use a hot tub, spa or whirlpool for at least 10 days to reduce the risk of infections. • Avoid dirty, dusty and smoky environments for 1 month. The first reflex might be to rub the eye which we do not want you to do.
    4. Do not use eye makeup, colognes, or aftershave for 1 week.
    5. No driving for 1 week or as stated by your eye surgeon.
    6. Wear sunglasses for comfort as needed. You may be slightly more light sensitive for the first couple of weeks after surgery.
    7. Reading, writing, working on a computer and TV watching are permitted but only for very short periods for 1 week after surgery. If you feel fatigue, pressure or strain in your eye, STOP the activity immediately and rest your eye.
    8. Do not schedule dental work, massage or chiropractic work for 1 week after surgery.
    9. Air travel is allowed after 4 weeks, please consult with your eye surgeon before flying.
    10. Use recommended artificial tears on a regular basis the first month after surgery even if you do not feel as though you need them.
    11. Your glasses prescription can be updated 2 months after surgery when the vision has stabilized.
  6. Common Symptoms during Recovery:
    1. It is common to experience varying degrees of discomfort beginning 30 to 90 minutes following the surgery as the numbing drops begin to wear off. Many patients describe this sensation as feeling like an eyelash is in the eye or lodged beneath the contact lens. This rarely lasts more than a few days and is a normal part of the healing process.
    2. Remember that the doctor will put a contact lens in your eye directly after surgery to act as a bandage. It is important not to remove the contact lens for any reason because without it, the pain will increase and your eye may not heal normally.
    3. A contact lens that has fallen out accidentally should NOT be reinserted. If you do so, the contact lens has likely been contaminated therefore increasing the risk of infection, which could permanently affect your vision. Instead, continue using your eye drops, gently tape the eye closed and call us so that we can insert a new contact lens that same day or the following morning.
    4. The bandage contact lens in combination with lubricating drops, prescription eye drops and mild, oral analgesics should provide relief. Also, you can place a cold washcloth or an ice pack over the eye to help relieve discomfort (10 minutes on, 10 minutes off and repeat as needed). In most cases, the bandage contact lens will be removed by the doctors on the 5 th or 6th postoperative day. After this, the eye will become more comfortable and your vision will begin to improve.
    5. Your eye may remain red (residual blood under the autograft) for 1 month after surgery. This is a normal part of the healing process.
    6. You may experience watery eyes, a runny nose, light sensitivity, and eye redness during the early postoperative period. This is normal and is caused by the post-surgical eye irritation.
    7. You may experience “hazy” vision during the recovery period. The vision should begin to stabilize after the bandage contact lens is removed from your eye. Although visual recovery is slower for some patients, most experience improved vision by one month.
    8. Some patients have dry eye symptoms causing a sandy sensation or eye tenderness. This may persist for several weeks following the surgery and is best treated with frequent artificial tear use.
    9. Infection is very rare but is the most serious problem that can present after this procedure. It is important to be evaluated immediately if you experience extreme pain, eye redness, sudden blurred vision and/or discharge.
    10. It is very important that you make it to all of your postoperative examinations so that if any changes or complications arise, they can be addressed immediately.

Please be aware that there is a possibility that your surgical date may be moved or postponed in the event of an emergency surgery that requires your surgeons operating time. Please note that this is an infrequent occurrence and in the event that your surgery needs to be moved you will be contacted by Seema Eye Care Centre as soon as possible.