Time-lapse is an imaging technique used to create videos using a series of pictures taken at particular time intervals. It allows us to see in greater detail the development that occurs in certain intervals, which take place so slowly which are invisible to the naked eye. Thanks to time-lapse technology, we can see them more rapidly and in full detail. In time-lapse incubator, pictures of embryos will be takes at different time intervals (every 10 or 20 minutes, for instance), from different viewpoints. With the visual obtained the embryologist now can see the entire development process of each embryo individually or collectively - from the moment insemination is carried out until they are transferred, frozen, or thrown away.

One of the most remarkable advancements achieved in the past few years in the field of Assisted Reproduction is precisely the use of this technology to monitor embryo development in vitro.

The application of Time-lapse technology in the field of IVF are include three indispensable parts:
1. Time-lapse embryo culture - providing a stable and safe culture environment for embryo development
2. Time-lapse embryo monitoring - using high-resolution cameras to obtain rich embryo development data
3. Time-lapse consistent evaluation of embryos - to evaluate the developmental potential of embryos

The main limitation of traditional methods was that the evaluation of embryos was conducted only at particular stages of development. In other words, embryologist gather static information from a dynamic process. Subsequently, embryologist miss material information about the embryo development process.

Furthermore, evaluating the quality of embryos under the conventional microscope is not a recommended practice, as quality diminishes each time the embryos leave the incubator.

Thanks to time-lapse technology, embryologist can monitor embryo development without taking the embryos out of the incubator, thereby maintaining them in ideal culture conditions.

The use of time-lapse significantly improves live birth rates and reduced early pregnancy loss rates.

Reference：
1. Kovacs: Embryo selection: the role of time-lapse monitoring. Reproductive Biology and Endocrinology 2014 12:124.
2. Alpha scientists in reproductive medicine and ESHRE special interest group of embryology: The Istanbul consensus workshop on embryo assessments: proceedings of an expert meeting. Hum Reprod 2011, 26:1270–1283.
3. Kirkegaard K, Agerholm IE, Ingerslev HJ: Time-lapse monitoring as a tool for clinical embryo assessment. Hum Reprod 2012, 27:1277–1285.
4. Wong C, Chen AA, Behr B, Shen S: Time-lapse microscopy and image analysis in basic and clinical embryo development research. Reprod Biomed Online 2013, 26:120–129.

Many patient who has undergone in vitro fertilization (IVF) will have heard of the blastocyst culture techniques that can be used to improve the clinical pregnancy rate. When blastocyst culture processes are applied to in vitro cultures, further screening is possible. This ensures that the embryos are of high quality and have optimum developmental potential, thereby improving the clinical pregnancy rate.

After the eggs and sperm have been retrieved, insemination (IVF or ICSI) is performed in an embryology laboratory to create a fertilized egg, called a zygote. The zygote develops over three days until it has cleaved into 8-10 cells on Day 3. At this point, it is called a Day 3 cleavage embryo.

If the embryo continues to develop for an additional 2-3 days, the embryo will develop into a blastocyst. The process of development from a Day 3 cleavage embryo to a blastocyst is called blastocyst culture.

Blastocyst culture requires an optimal and constant culture environment. This includes a culture microenvironment with stable parameters such as temperature, osmotic pressure, and pH value, as well as a stable incubator and laboratory environment that is equipped with a high-efficiency laminar flow filtration system。

The process whereby blastocysts are transferred into the mother's uterus is called blastocyst transfer. Typically, under controlled physical conditions, the greater the success rate of blastocyst culture, the higher the success rate of IVF. 

Reference:

1.      中华医学会，2009，临床诊疗指南-辅助生殖技术与精子库分册，北京人民卫生出版社。

2.      American Society for Reproductive Medicine. Revised guidelines for human embryology and andrology laboratories. FertilSteril 2008; 90:S45-59

Considering the high cost, success rates, and possible side effects of assisted reproduction techniques (ART), early efforts to improve male fertility appear to be an attainable and worthwhile primary goal. Having healthy sperm is essential to the success of your fertility treatment. Since a full sperm regeneration cycle (spermatogenesis) takes about 76 days (about 3 months to be ejaculated), the quality of the sperm reflects the state of sperm health 3 months earlier. Therefore, it is beneficial for the husband to begin his preparation sooner rather than later.

1. Balanced diet 

 A dad-to-be’s diet should include a variety of fresh fruits and vegetables, especially greens, as well as a moderate intake of vegetable protein and healthy fats, as well as foods rich in folic acids, such as soybeans, eggs, asparagus, lentils, and sprouts. Reduce intake of refined sugar, alcohol, fruit juice, etc., and eat less takeout, fast food, fried food, and sweet desserts. For irregular diet, man can properly supplement some multivitamin preparations, including vitamins A, C, and E, and trace elements zinc, selenium, etc. Advice to quit smoking and minimize alcohol consumption, to supplement folic acid in an appropriate amount if the husband has a folic acid deficiency or tobacco and alcohol addiction, in turn, improves the quality of the husband's sperm.

2. Healthy lifestyle 

 Avoiding sedentary and appropriate exercise can balance hormones in the body, reduce body fat and decrease psychological stress and enhance libido. Find the amount of exercise that works for you, and do not over-exercise which leads to fatigue. Increasing outdoor activities and exposure to sunshine were associated with higher vitamin D levels in men, thereby improving sperm quality.

3. Regular work and rest 

Studies have shown that sleep quality affects the quantity and quality of sperm directly. The male who falls asleep between 20:00 – 22:00 has higher sperm quality and greater fertility. In addition, regular work and rest are also in line with the characteristics of male sex hormone secretion, which is conducive to improving hormone levels, thereby improving male fertility.

4. Prepare before semen collection 

 To ensure the quality of sperm, avoiding exposure to a high-temperature environment is advised, for example, no sauna or no hot sitting baths. Abstain from intercourse for 2-7 days. Pay attention to personal hygiene. Wash hands and clean the genitals before semen collection.

Compare to the wife, the husband is easier to cope with during IVF treatment, as the wife bears most of the treatment and emotional stress. Therefore the husband should take further steps to support their wife thus reducing the stress caused by drugs and procedures. This is very important to get a positive outcome from IVF treatment.

In addition, the husband should take care of his health. Consult professional advice if you have the underlying disease and take medicine for a long time.

Reference
[1]Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion [J]. Fertil Steril. 2022 Jan;117(1):53-63.
[2] The effect of cigarette smoking, alcohol consumption and fruit and vegetable consumption on IVF outcomes: a review and presentation of original data[J]. Reproductive Biology & Endocrinology, 2015, 13(1):134.Daniel M .
[3] Can Male Fertility Be Improved Prior to Assisted Reproduction through The Control of Uncommonly Considered Factors?[J]. International Journal of Fertility & Sterility, 2013, 6(4):214-223.

1. What is surgical abortion?

Surgical abortion (Dilation and Curettage also known as D&C) is a commonly used method to terminate the first trimester of pregnancy. It is suitable for those who are less than 10 weeks pregnant. The procedure involves the extraction of pregnancy tissue (such as villi, sacs, etc.) from the uterus by surgical measure to terminate the pregnancy.

In order to facilitate the suction device and other instruments into the uterine cavity, the need to use a cervical dilator to gradually expand the cervix, plus the negative pressure suction process and the final curettage process, these will bring discomfort to you, even pain. During the operation, the patient’s relaxed mood and active cooperation with the surgeon can reduce discomfort to a certain extent. Many hospitals now have the option of performing a D&C under anesthetic analgesia, which can reduce discomfort but also increase the additional risk of anesthesia.

2. What is the effect of D&C on the body?

All operations have the potential for complications. Although the procedure is generally safe, it can lead to uterine damage in special circumstances, such as many time miscarriages, only a few months after the last delivery (or miscarriage), or excessive uterine forward flexion.

Artificial abortion too soon and too many, will cause greater damage to the endometrium, adverse impact on the future pregnancy. Therefore, unwanted pregnancies should be avoided as much as possible, and when they do occur, early termination is less damaging.

3. What should be paid attention to before the D&C?

Preoperative medical history should be truthfully provided, and necessary preoperative examinations should be completed to determine whether surgery can be performed and whether there are any high-risk factors (such as the presence of genital tract infection, lactation, etc.). You can ask your doctor about the operation and sign the informed consent form after you are fully informed.

The day before the operation should do a good personal hygiene, better take a bath, change clothes, wash perineum area. Do not have intercourse, pay attention to rest, appropriate nutritional diet.

If the patient is selected to receive D&C under anesthesia, on the date of surgery: before the operation, solid food (including milk and granular drinks) should be avoided for 6 hours, water should be forbidden for 2 hours, and empty your bladder.

4. Consider the contraceptive measures implementing after the operation to avoid another accidental pregnancy

Make full use of the time before the operation to communicate with the doctor, understand the various contraceptive options available after the operation and how to use them effectively;

• IUD can be placed at the same time of operation.

• or start taking short-acting oral contraceptives immediately after surgery;

• or use a condom when having sex again

Post-Surgical Abortion education

Will I have symptoms after a surgical abortion?

• Pain and cramping in the lower belly. This lasts for a few hours.

• Bleeding from the vagina. This is usually lighter than after a medication abortion. The bleeding can last for up to 2 weeks.

Should I call my doctor or nurse after an abortion?

Call right away if:

• Your bleeding is heavy enough to soak through 1 menstrual pad each hour, for at least 2 hours, and you are still bleeding

• Your pain is really bad (it makes you double over or makes it hard to move), and you don’t feel better with pain medicines, such as ibuprofen (sample brand names: Motrin, Advil)

• You have a fever higher than 100.4°F (38°C)

• Bad-smelling discharge comes out of your vagina

Incomplete abortion

In some cases, abortion does not work completely. In other words, they do not always get rid of all the pregnancy tissue. If that happens to you, you will need to take additional medicine or have a procedure to remove any leftover tissue. Signs that an abortion was not complete include:

• Not bleeding after a medication abortion

• Still having pregnancy symptoms, such as nausea and tender breasts, 1 week or more after your abortion

• Bleeding for more than 2 weeks after an abortion

• Not having a period in the first 6 weeks after an abortion

Is there anything I should do differently after an abortion?

Do not have sex or put anything into your vagina for 2 weeks after an abortion. If you do, you could get a very serious infection.

What if I want to get pregnant again someday?

Having an abortion does not make it harder to get pregnant again. Abortions do not harm your health, and they do not harm the health of your future babies.

Reference:
Shanghai maternal and child health center
UpToDate

Medical abortion is a non-operative approach to termination of pregnancy. This approach allows the pregnant woman to have an abortion with light pain and avoid the risk of surgery. However medical abortion still can do harm to your uterine membrane. Furthermore, about 10% patients will probably experience incomplete abortion or failed abortion. Therefore that follow-up after a medical abortion is helpful for recovery.

What respects should be pay attention after medical abortion?

Observation

One hour observation is necessary after the expelling of gestational sac, and can be discharged home if you are not having discomfort. If there is abdominal pain, vaginal bleeding more, your doctor will take appropriate measures to control it.

What may happen after leaving the hospital?

• Vaginal bleeding: A small amount of vaginal bleeding may occur for a period of time after a medical abortion, lasting longer than after a surgical abortion. If the bleeding is larger than the normal amount of menstruation (compared with the amount of bleeding on the same day of menstruation), or the time of vaginal bleeding is more than 2 weeks, you should go to the hospital in time.

• Abdominal pain: mild lower abdominal pain within a few days after the procedure. If there is more severe abdominal pain. Need to go to the hospital in time.

• Fever: there should be no fever under normal conditions. If you feel cold or uncomfortable, take your temperature. Such as a significant increase in body temperature, or accompanied by severe abdominal pain, or accompanied by a large number of vaginal bleeding, timely return to the hospital.

Follow-up visits:

• Those who did not discharge the pregnancy sac during observation should return to the hospital for further consultation 1 week after medication.

• If the pregnancy sac has been discharged during observation, the patient should return to the hospital 2 weeks after the procedure.

• All patients for medical abortion are expected to have a 6th week follow-up visit especially when your Menstruation did not recover in time.

Prevention of infection:

• Before menstruation returns back, do not have a sexual life, avoid the use of vaginal tampon, tub bath, etc., especially after a medical abortion.

• Keep the perineum clean, change sanitary pad and underwear frequently.

Back to normal life:

• Two weeks of rest is recommended after medical abortion.

• Pay attention to nutrition. Add foods rich in protein, iron and vitamins.

• Avoid early post-abortion intense exercise and heavy physical activity, so as not to increase abdominal pain and vaginal bleeding.

• If you plan to have another pregnancy, you should wait 6 months after the abortion to recover well. Because the endometrium after abortion by different degrees of damage, and need to have a recovery process, such early pregnancy is adverse to fertilized eggs implantation and development, easy to cause spontaneous abortion.

Implement contraceptive measures to avoid another unwanted pregnancy:

• There is no safe period after an abortion, and once sex is restored, another unwanted pregnancy may occur.

• After resuming sex, reliable contraceptive methods:

• Short-acting oral contraceptives: they can be used once the abortion is successful.

• Intrauterine device: can be placed after menstruation recovery.

• Condoms: can be used once sex resumes.

• Calendar calculate method, before menstruation did not restore regularly, or cannot be mastered correctly, is not recommended to use.

Reference:
Shanghai maternal and child health center

The recommendations that follow are intended as a general guide to you at home.

• Pain Control

It is common to have discomfort after surgery. You may have discomfort from the incision and muscle aches. Getting up and moving around can ease some of the discomfort. Take your pain medicine as ordered. Some medicine may upset an empty stomach. To prevent nausea, you should take the medicine with food.

Some of your pain medicine may contain acetaminophen. Acetaminophen can cause liver damage if you take too much. Do not take more than 3000mg in 24 hours. If you are taking narcotic pain medication or sleeping medication, do not drink any alcohol. You should not drive any vehicles while taking narcotics.

• Constipation

It is common to not have a bowel movement for several days after surgery. Some pain medications can also cause constipation. To help your bowels stay regular:

◦ Drink more liquids

◦ Eat more whole grains, fruits and vegetables

◦ Get regular exercise(a 15-minute walk is a good start)

◦ Take stool softeners

• Activity

The most important thing is to use good common sense in planning your activities. If it hurts, do not do it. Do not do anything to the point of exhaustion. Rest if you get tired. After minimally invasive procedures (such as laparoscopy, hysteroscopy, vaginal surgeries, and robotic procedures), you should be up and moving about freely soon after the surgery. Gradually increase your activities as follows:

◦ You are allowed to climb stairs, but try not to become too tired.

◦ Avoid heavy lifting, not more than a 4 liter bottle of water.

◦ Avoid strenuous exercise or sports for 6 weeks after major surgery.

◦ You should not drive for 24 hours after receiving general anesthesia. After that, do not drive until you can do so without discomfort and without using prescription pain medicine. This can take from 3 to 7 days.

◦ You may shower and wash your hair.

◦ No intercourse, douching, or tampons for at least 2 weeks. You may be restricted longer (6 weeks or more) if you had vaginal surgery or a hysterectomy.

• Caring for Your Incision

It is important to keep your incision clean and dry to prevent infection. Leave any covering over the incision in place for a week unless otherwise instructed. Call immediately if a large amount of fluid starts to drain or redness develops. You should wear comfortable clothing. Do not wear soiled or tight clothing over the wound. If you have paper strips of tape (Steri-Strips®) on the skin over your incision, leave them on until they fall off. These may offer extra support as your incision heals.

Once home, you may shower and care for the incision as follows:

◦ Always wash your hands before and after touching your incision.

◦ Soapy water can run over the incision.

◦ Rinse well.

◦ Pat the incision dry with a clean towel, rather than rubbing.

You may use a hair dryer on low heat to dry your incisions.

◦ Do not soak the incisions in a tub until you are told you may do so.

◦ Starting on the 4th day following surgery, restart washing the incision with CHG every day for 2 weeks unless instructed otherwise by your surgeon.

◦ Do not use lotions, cream or ointments on the wound unless they have been ordered by your doctor.

• Diet

You may eat and drink as tolerated. Go easy at first, with clear liquids, soup or broth, and crackers, before you progress to solid food. Eat foods that are easy to digest while avoiding fatty foods until your digestion returns to normal. Increase fiber and fluids if you get constipated.

• Follow-up Visit

Please plan to return for a postoperative check 1 to 2 weeks after your procedure. If an appointment has not been made for you, call your doctor’s office to be scheduled.

When to Call Your Doctor

Contact your doctor if you notice any of the following:

• Temperature over 38 ℃ (100.2℉), chills or sweats

• Drainage or fluid from the incision that continues or is foul-smelling

• Increased tenderness or soreness at the wound

• Wound edges that are no longer together

• Redness or swelling at the wound site

• Vaginal bleeding heavier than a period or foul-smelling discharge

• Difficulty urinating or urinary frequency, urgency, or burning

• Worsening pain

• Chest pain, shortness of breath, dizziness

• Pain in the calves or legs

• Nausea or vomiting

• Unable to drink fluids or keep fluids down

• If any symptom is getting worse with time

• If you do not feel well, or just aren’t sure whether your symptoms are normal

Dear Mr./Ms.                 :

Thank you for choosing the Ophthalmology Clinic of Jiahui Health for your eye surgery. We will give you a brief introduction to the preoperative preparations required, preoperative medications and postoperative precautions you need to understand for the purposes of promoting a smooth procedure and helping you understand the postoperative precautions to accelerate recovery.

1. What is vitrectomy:

• It is a method to treat diseases of the vitreous and retina under an operating microscope with the help of a vitreous cutter.

2. Preoperative preparations:
1）Preoperative irrigation of the conjunctival sac will be performed to remove intraocular foreign bodies and secretions and reduce postoperative infection.

2）Preoperatively, we will cut off the eyelashes for skin preparation to provide a better surgical field and reduce intraoperative and postoperative infections.

3. Medication instructions

1）Apply Tobramycin and Dexamethasone Eye Drops to the operative eye: 6 times daily for the first three days, followed by QID since the forth day, discontinuing two weeks later.

2）Apply Tobramycin and Dexamethasone Ophthalmic Ointment to the operative eye: QN, discontinuing two weeks later.

3）Additionally apply Gatifloxacin Eye Gel to the operative eye: QN, discontinuing two weeks later.

4）Apply Pranoprofen Eye Drops to the operative eye: TID two weeks later, discontinuing after it is used up

5）Apply Tropicamide Eye Drops to the operative eye: 6 times daily for the first three days, followed by 4 times a day since the forth day.

6）Each eye drop should be applied alternately, with an interval of more than 10 minutes. Eye drops should be applied at 1 drop/time. Intraocular water intake should be avoided within one month after surgery, and all drugs should be administered after the gauze is opened on the second morning of surgery.

7）Time for postoperative routine follow-up visit: one week, two weeks, one month, two months, and three months after surgery.

4. Postoperative precautions

1）Generally, absolute bed rest is not required for patients undergoing vitrectomy (without intraocular fillers); they may lie supine, but eyeball movements should be restricted in case of postoperative bleeding. Patients with intraocular fillers (gas or silicone oil fillers) pressing against retinal tears need to face down while resting for 8-10 hours daily for the fillers are lighter than water; the extent and specific position should be adjusted depending on the condition under the doctor’s guidance. Special emphasis should be placed on that: correct resting and sleeping postures directly affect the effect of surgery and can reduce the occurrence and exacerbation of postoperative cataracts. Please be sure to follow the doctor's guidance.

2）The eyelids are the lowest in prone position, so surgery-induced inflammatory edema is most evident in the eyelids, and the affected eye will be severely swollen, which gradually relieves 3-5 days after surgery when observation or cold compresses may be performed. A prone position should be maintained 1-2 weeks postoperatively, and it may be shifted as instructed by your doctor. Long-acting gas is generally absorbed slowly 1-2 months after surgery, while silicone oil often needs to be removed surgically.

3）Patients should apply eye drops regularly and correctly, take medicine in time, eat more vegetables, and avoid spicy, stimulating and hard food to keep bowels open. The medical staff should be informed of headache, nausea, vomiting, eye pain, eye distension, severe wound pain, insomnia, etc. (if any) in time. Eyes should not be touched or rubbed with hands casually; hands should be washed before applying eye drops, and at least 10 minutes of rest with eyes closed is required after applying eye drops. It is necessary to avoid strong light stimulation, keep indoor light soft, and possibly wear colored safety glasses when going out. Doctor’s instructions should be followed to adjust medication frequency or reduce dosage in time. There is no need to worry in case of increased intraocular pressure; please communicate with doctor timely, adjust medication and apply intraocular tension-lowering drugs.

4）Regular reviews are required to monitor visual acuity, intraocular tension, retinal fundus and visual field. Please seek medical attention timely to prevent recurrence in case of any abnormality. A review is required 1 week after gas filling, and the intervals between subsequent reviews are gradually extended after the gas is completely absorbed. For patients with silicone oil fillers, it takes 3 months to half a year before taking out the silicone oil in hospital. The specific time for oil removal should be recommended by the doctor according to ordinary follow-ups, and discussed with the doctor. Long-term retention of silicone oil in the eyes may induce emulsification, cataract, glaucoma, corneal zonal degeneration and other complications, but there are significant individual differences - some people develop significant complications in a relatively short period of time, while others, especially the elderly who are less active, may not develop significant complications for a long time. Please pay timely visits to hospital for examination in case of eye pain, significant decline of vision, and other symptoms, to prevent the vision from damage by silicone oil emulsification and other complications in the later stage.

5）Activities should be restricted: excessive activities should be restricted for half a year after surgery, and heavy physical labor should be restricted for one year. For patients filled with C3F8, before the gas is fully absorbed, they should avoid working at height, taking an airplane or traveling to the plateau, so as to avoid a series of complications such as central retinal artery/vein occlusion. Strenuous exercises such as running and jumping should be avoided in 3 months after surgery, and diving, boxing and other sports that may hurt the eyes are strictly prohibited; regular reviews are required.

6）Patients should keep optimistic and comfortable; be prepared to fight the disease for a long time. It is important to realize that if cataracts are not removed at the time of vitrectomy, they may appear earlier or worsen in your intraoperative eye.

7）Please seek medical attention timely in case of severe headache, nausea, vomiting, eye pain, severe wound pain, insomnia and other conditions, and call the hospital prior to your visits.

Dear Mr./Ms.                                :

Thank you for choosing the Ophthalmology Clinic of Jiahui Health for your eye surgery. We will give you a brief introduction to the preoperative preparations required, preoperative medications and postoperative precautions you need to understand for the purposes of promoting a smooth procedure and helping you understand the postoperative precautions to accelerate recovery.

1. Strabismus is a disease related to both eyes; thus, to correct the eye position, surgery is sometimes performed on both eyes, and sometimes only on either eye. A decision should be made by the surgeon depending on the patient’s specific condition and the preoperative and intraoperative examination results of eye position.

2. This surgery does not affect visual acuity and diopter. Patients with postoperative ametropia still need to wear glasses. The spectacle lens power may be adjusted according to the eye position.

3. It is normal to have strabismus after strabotomy without wearing glasses.

 
4. The following intraoperative and postoperative complications may occur, commonly including:

 
1) Pain and congestion of the operative eye

2) Postoperative diplopia

3) Inadequate correction or overcorrection of postoperative eye position

4) Poor healing of conjunctival wounds

5) Postoperative decline of short-term corrective effect

6) Partial non-concomitant strabismus (paralytic strabismus)

Eyeball movements cannot be recovered after surgery; diplopia does not subside or only partially improves

7) Some special types of strabismus require more than one operation

5. Systemic surgical complications: As with all surgeries, other complications may arise from anesthesia, drug reactions or other factors affecting other parts of the body, including the oculocardiac reflex and anesthesia accidents.

6. Since it is impossible to list all the complications of this surgery, the above list does not cover them all.

 
7. Due to undercorrection or overcorrection of the operative eye position, a second correction or training may be required after surgery.

 
8. Purpose of strabotomy: Not only for beauty, but more importantly, to create conditions for the establishment of normal binocular vision and stereoscopic vision. Therefore, postoperative comprehensive treatment and training are still necessary, and surgery is merely an important means of comprehensive treatment. Moreover, the eye position may change for a quite long time after strabotomy, so regular follow-up visits and doctor’s guidance are required.

9. Postoperative medication guidance:

1) For medication, please follow the discharge instructions in the discharge summary

2) Please apply appropriate ice compress within 2 days after surgery

Dear Mr./Ms. :                    

Thank you for choosing the Ophthalmology Clinic of Jiahui Health for your eye surgery. We will give you a brief introduction to the preoperative preparations required, preoperative medications and postoperative precautions you need to understand for the purposes of promoting a smooth procedure and helping you understand the postoperative precautions to accelerate recovery.

1. Purpose of entropion and trichiasis surgery:

1) To improve ocular surface irritation induced by entropion and trichiasis, and reduce the risk of ocular surface complications

2) To improve appearance

2. The following intraoperative and postoperative complications may occur, commonly including:

1) Postoperative overcorrection, undercorrection, angular deformity, aberrant lashes, conjunctival prolapse, etc., requiring re-adjustment under anesthesia

2) Postoperative recurrence of entropion and trichiasis, requiring re-operation

3) Postoperative scar hyperplasia

3. Systemic surgical complications: As with all surgeries, other complications may arise from anesthesia, drug reactions or other factors affecting other parts of the body, including the oculocardiac reflex and anesthesia accidents

4. Since it is impossible to list all the complications of this surgery, the above list does not cover them all

5. Postoperative medication guidance:

1) For medication, please follow the discharge instructions in the discharge summary

2) Please apply appropriate ice compress within 2 days after surgery

6. Please pay visits to the attending physician’s Ophthalmology Clinic for follow-up visit and stitch removal 1 week after surgery.

Preoperative Instructions for Cataract Surgery

Dear Mr./Ms.________________:

Sincerely thank you for choosing Jiahui International Hospital to provide you with cataract surgery. We provide this manual to help you understand what you need to prepare for this surgery. Proper preparation will help you cope with the surgery easily and facilitate your postoperative recovery. Please read this manual carefully and feel free to ask questions to learn more about surgical announcements.

Pre-operation

1）Instructions for Use of Preoperative Eye Drops:

Antibiotic eye drops should be applied to the operative eye 3 days before surgery, 1 drop/time QID.

2）Please refer to the figure below for the usage of eye drops

4）Please clean your eyes and avoid makeup on the day of surgery.

5）If local anesthesia is applied, normal food intake is allowed before surgery; fasting and water restriction are not required.

6）Attention should be paid to preoperative changes in blood glucose for diabetic patients: for vitreoretinal surgery, 2-hour postprandial blood glucose should be monitored on the day of surgery; if the blood glucose level is above 13mmol/dl, surgery will be rescheduled until it remains below 13mmol/dl.

7）Please inform your doctor or nurse in case of preoperative eye infection or inflammation.

8）Instructions for registration time: on the day of surgery, if you will undergo local anesthesia, please arrive at the front desk (next to the pharmacy) on the first floor of the Clinic one hour before surgery, and an operation room nurse will pick you up to the Operating 

Room; if you plan to undergo general anesthesia, please arrive at the front desk of the hospital 2 hours in advance since your surgical team needs to make some preparations for you and take notes for some documents before general anesthesia.

Postoperative Instructions for Cataract Surgery

1.Postoperative use of eye drops: apply eye drops for 2-4 weeks (as instructed), 6 times daily for the first three days and QID thereafter, or as instructed; use of mydriatics: 6 times daily for the first three days and QID thereafter, or as instructed; different eye drops should be applied at an interval of more than 10 minutes, 1 drop/time.

2.Within one month after cataract surgery, the doctor will prescribe hormonic and antibiotic eye drops for the affected eye to prevent adhesions of pupil after mydriasis. If you have been using hormonic eye drops for a long time, it is necessary to observe whether there is eye distension, eye pain and other signs of increased intraocular pressure; please inform your doctor in time if any of the above symptoms.

3.Postoperative symptoms or discomfort: please don't be panic if you have the following symptoms, which are normal phenomena:

Eyes may be photophobic and blurry after mydriasis

Postoperative eyes have foreign body sensation and mild hyperemia.

Within one month after surgery, if you need to go out, it is recommended to wear glasses or sunglasses in strong sunlight to prevent dust, sunlight and wind from getting into your eyes. Your eyes may feel itchy during recovery, but do not rub them with your hands.

4.Postoperative home eye care:

No water is allowed in the operative eye within one month after surgery (special attention should be paid when washing hair).

If there is a little secretion in the operative eye, please wipe it gently with a clean cotton swab.

Activities: Do not drive after surgery until a permission is obtained from your doctor; within three months after surgery, please avoid strenuous exercises, eye squeezing, eye rubbing and head movements, such as wagging your head.

Rest: If you feel tired, please take more rest.

5.Follow-up visits

Please visit the clinic on time as required by your doctor: follow-up visits are generally scheduled in 1 day, 1 week, 2 weeks and 1 month after surgery

6.Please contact your doctor or go to the nearest hospital immediately in any of the following cases:

Pain or vision loss persists for several weeks after surgery.

Postoperative symptoms of headache and nausea (increased intraocular pressure) persist for 2 hours, or sharp loss of vision occurs.

Eye pain, significant eye distension, loss of vision, increased secretion, and severe tearing occur postoperatively.

Postoperative Instructions for Cataract Surgery

1.Postoperative use of eye drops: apply eye drops for 2-4 weeks (as instructed), 6 times daily for the first three days and QID thereafter, or as instructed; use of mydriatics: 6 times daily for the first three days and QID thereafter, or as instructed; different eye drops should be applied at an interval of more than 10 minutes, 1 drop/time.

2.Within one month after cataract surgery, the doctor will prescribe hormonic and antibiotic eye drops for the affected eye to prevent adhesions of pupil after mydriasis. If you have been using hormonic eye drops for a long time, it is necessary to observe whether there is eye distension, eye pain and other signs of increased intraocular pressure; please inform your doctor in time if any of the above symptoms.

3.Postoperative symptoms or discomfort: please don't be panic if you have the following symptoms, which are normal phenomena:

Eyes may be photophobic and blurry after mydriasis

Postoperative eyes have foreign body sensation and mild hyperemia.

Within one month after surgery, if you need to go out, it is recommended to wear glasses or sunglasses in strong sunlight to prevent dust, sunlight and wind from getting into your eyes. Your eyes may feel itchy during recovery, but do not rub them with your hands.

4.Postoperative home eye care:

No water is allowed in the operative eye within one month after surgery (special attention should be paid when washing hair).

If there is a little secretion in the operative eye, please wipe it gently with a clean cotton swab.

Activities: Do not drive after surgery until a permission is obtained from your doctor; within three months after surgery, please avoid strenuous exercises, eye squeezing, eye rubbing and head movements, such as wagging your head.

Rest: If you feel tired, please take more rest.

5.Follow-up visits

Please visit the clinic on time as required by your doctor: follow-up visits are generally scheduled in 1 day, 1 week, 2 weeks and 1 month after surgery

6.Please contact your doctor or go to the nearest hospital immediately in any of the following cases:

Pain or vision loss persists for several weeks after surgery.

Postoperative symptoms of headache and nausea (increased intraocular pressure) persist for 2 hours, or sharp loss of vision occurs.

Eye pain, significant eye distension, loss of vision, increased secretion, and severe tearing occur postoperatively.