By David F. Chang MD
Newly opened in 2005, the Peninsula Eye Surgery Center is one of California’s largest outpatient surgery centers dedicated solely to eye surgery. With technological advances in microsurgery evolving faster than ever, modern eye surgery requires specialized equipment, nursing, and anesthesia staff. Peninsula Eye Surgery Center has been developed by leading Peninsula-based eye surgeons who share the vision of an outpatient ophthalmic surgical center of excellence. The result is a modern ambulatory surgery center, owned and operated by ophthalmologists, that specializes in serving the unique needs of eye surgical patients. No other such center exists in the geographic area between and including San Francisco and San Jose. We perform one of the largest volumes of eye surgery in Northern California, including cataract, glaucoma, and corneal operations, eye laser procedures, and leading edge refractive surgeries employing artificial lens implants.
Being one of the busiest eye surgical centers in the state allows us to provide state of the art ophthalmic surgical equipment and to employ a full time staff that specializes in eye surgery. To learn more about the Peninsula Eye Surgery Center, go to www.pesc2020.com
Medications: If you are diabetic, you will probably be instructed to skip your morning insulin or oral medication. This is because you will not be eating breakfast prior to your surgery. Unless instructed otherwise, you may take the rest of your usual medications with a sip of water. In particular, do not skip usual medications taken for your heart, blood pressure, or breathing conditions. You can and should bring any prescription inhalers and nitroglycerin pills with you.
Preop Eye Drop Medications:
These drops are only for the operative eye and will be continued following surgery as well. If you received OMNI or Ketorolac drops, use the drop at bedtime on the night before your surgery. Use another drop on the morning of your surgery. If your surgery is scheduled early in the morning, you can skip this morning dose.
If you normally take glaucoma eye medications, they can be used up to and including the morning of your surgery. Different drops can be used at the same time in any sequence, but should be separated by 3-5 minutes. You may be asked to complete a questionnaire regarding your medical history and any medications that you take. As a courtesy, a member of our nursing or anesthesia staff may contact you by phone prior to your surgery.
Meals: For early morning surgery, please do not eat or drink after midnight (except sips of water for your regular pill medicines). If your surgery is later in the day, you may have a light breakfast (toast and clear liquids, no milk) up until 5 hours before your scheduled arrival time. You can have clear liquids (water, fruit juices without pulp, carbonated beverages, clear tea, black coffee, clear broth or bouillon, but no milk) up until 2 hours before your scheduled arrival time.
Attire: You will not need to fully undress, but please do not wear an undershirt. Wear a loose short sleeve shirt that fully opens and buttons up in the front. Wear loose fitting pants, such as sweatpants, and comfortable shoes. Please do not wear makeup, hairpieces, or hairpins. Leave jewelry and any unnecessary valuables at home.
Because of the sedation, you should not drive following surgery and should arrange transportation home. We have a parking lot behind the surgery center. Approaching the surgery center via El Camino Real from the south, turn right into our driveway. The patient entrance is immediately on the right. After dropping you off, your driver can park in the rear. We ask that you not bring more than one companion. While most surgeries typically takes less than 30 minutes, the preparations and recovery time will make your visit last approximately 2 – 3 hours. If your driver leaves, please have them carry a cell phone so that they can be notified when you are ready to go home. You should be discharged from the center into the care of a responsible adult.
Please bring any insurance cards with you. For those without insurance, we request payment with a credit card or check upon arrival. You will be asked to sign a separate consent form for the surgery center – signifying your consent to have surgery. Please notify your surgeon if you would like to review this prior to your surgery date. Make every effort to have your questions answered by your surgeon before you arrive.
After registering, you will enter the preoperative area. The nursing staff will administer eye medications, such as dilating drops. An I.V. will be started in your arm so that sedatives can be administered during the operation. Because the eye medications require a significant amount of time to work, a relative or friend can accompany you during this waiting period in the preoperative area. If you do not speak English, please bring a companion who does. Some patients bring their own music with headphones.
You will receive sedatives to help you feel relaxed, but you won’t be completely asleep. Your eye will be numb, but you may feel drops and some mild pressure at times. Your lids will be held open so that you can’t blink. You will not see instruments or the surgery itself – you will only be able to see light and bright colors during the operation. Most patients relax and listen to the background music.
You will be able to return home after a brief rest in the recovery area. For cataract surgery, we do not expect to restrict your diet, your activities, your sleeping position, or the use of your eyes for TV or reading after surgery. Aspirin, Tylenol, or other over-the-counter pain relievers are usually adequate for any post-op aching. It is generally advisable to take a nap to decrease any residual effects from the sedatives. This also lessens the watering and the scratchy feeling that is normally felt during the first day.
You should expect the vision to be quite blurred at first. It is common for your pupil to remain enlarged from the dilating drops for up to 36 hours. The sedatives can blur your recollection of the day’s events. For this reason, it is best to save non-essential questions for your first postoperative office visit.
Instructions for YAG Laser patients
The YAG laser procedure is not true “surgery” and it is performed in a small treatment room rather than an operating room. You should prepare for this just as you would for an eye examination in your doctor’s office. Your regular medications, such as pills or eye drops, should be taken at the normal times. You will not change clothing, nor receive any sedation. Only the treated eye will be dilated, and it will be numbed with anesthetic drops.
You will be seated at an eye microscope similar to that used for a routine eye exam. The microscope is used to steady your head, and to focus and administer the laser treatment. A special focusing lens will be placed on the eye to control eye movements and to prevent the lids from closing. Because the amount of laser energy is so small, there is no effect on the other eye or other parts of your body. There is a clicking sensation as the laser is administered. Following the treatment, there may be temporary blurring during the first day. The eye may be slightly irritated later in the day, but pain is uncommon, and a bandage is not necessary.