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.