Instructions After Surgery

By David F. Chang MD

Postoperative Instructions & Eye Drops   

  • Steroid: Inveltys, or Loteprednol, or Prednisolone*. Use one drop TWICE daily. *If prednisolone, shake the bottle 12 times before each use.
  • Anti-inflammatory**: Bromsite (once daily) or Ketorolac (twice daily). ** These drops frequently sting
  • Artificial tears (optional): These are over-the-counter lubricating drops, and they are optional. They contain no medication and don’t require a prescription. However, the front surface of the eye (the cornea) can temporarily be drier after surgery. An occasional sandy or sharp feeling may result. Using artificial tears up to 4 times daily can improve the overall comfort of the eye. Available at pharmacies and grocery stores, any of the many available brands work well for most patients. If you have never used them, Systane and Refresh are popular brands. “Unpreserved” artificial tears are preferred for more frequent users.

Use drops #1 and #2 at least once after you return home after surgery. Both medications improve comfort and suppress inflammation. If you return home before 3 PM, use the steroid drop twice. Drops are only for the operated eye and can be used together, in any sequence, if separated by at least 3 minutes (otherwise one rinses the other out). It is normal that some drops may sting. Close the eye gently for a minute after instilling a drop. Drops placed in one eye never affect the opposite eye. If you think you missed but are not sure, it is safe to instill another drop. It is impossible to “overdose” the eye with drop medications.

If both eyes have undergone surgery, you can use the same bottle for both eyes. Please refer to Chapter 7 (on postop care) of Dr. Chang’s cataract book for helpful hints and illustrations. Postop eye drop medications should be continued for 4-6 weeks after surgery for each eye. If you run out after 2 or 3 weeks, it is best to refill them. Because they help the comfort of the eye, you always have the option to use them even longer to finish what is left in the bottle(s). In other words, many patients use them completely up. They are harmless and help to suppress any unwanted inflammation inside of the eyeball.

Refills: We always authorize multiple refills on your original prescription that was sent to the pharmacy. Please contact your pharmacy directly (i.e., not our office) for refills. If you used Now Rx pharmacy call (408) 882-3558 or (650) 386-5761 and they will deliver the refills directly to your home.


Visual Recovery: Be patient. You should not expect to see well immediately after any eye operation, and you may be very blurry for at least several days. Typically, the vision is clear and more stable by 1 week following surgery. There is normal variability in the recovery rate between different patients, and even between both eyes of the same patient. Advanced cataracts are associated with a longer period of blurry vision. Although it is natural, comparing the recovery of one eye to another (or to that of a friend or relative) often raises unnecessary concern over normal differences. The amount of initial blur during the first week has no bearing on your final vision. Optimal focus for both reading and far distance may require your eyeglass prescription to be updated.

Normal discomfort on the day of surgery:  Your eye received many anesthetic drops during surgery. While numb, the eye lacks the normal reflex to frequently blink or close, and this often leads to the front surface (the cornea) getting very dry. This may cause scratchiness, a burning or sandy sensation, and reflex watering. Taking a nap after you return home, or otherwise keeping the eye closed if it is scratchy, will usually help with this discomfort. This is also why the eye typically feels much better the following morning, after the eyelids have been closed all night.

Other normal early postoperative symptoms:  eye watering and redness; a scratchy or sandy sensation; stinging with the eye drops; blurry, fluctuating, or shimmering vision; sensitivity to bright lights; a curved shadow or light reflection off to the side; some halos at night. The pupil may be slightly larger or smaller for the first 2 days. Since the artificial lens blocks ultraviolet light, sunglasses are optional for comfort, but not required for safety.

Activities: Because it’s tender, avoid pressing or rubbing the eye for 2 weeks. There are no physical restrictions following small incision cataract surgery. There is no problem with bending, stooping, lifting, coughing, or straining. Exercise is fine, including golf, tennis, jogging and aerobics. Because soap and water are not harmful, you may shower, wash your face and hair, and wear makeup. We advise that you not to swim for one week. You may read and watch TV as much as you like. You may resume work and driving when you feel ready. There is no restriction on airplane travel.

(All postop visits are at the Los Altos office)

If you suddenly lose your vision after it has initially cleared, then call our office.

David F. Chang MD 650-948-9123

762 Altos Oaks Drive, Los Altos, CA

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