Cataracts Surgery: Pre- and Post-Op Pearls for Optometrists

Did you know? Cataract extraction is the most prevalent surgical procedure of all medical specialties with an estimated 3.7 million cases per year in the USA, 7 million in Europe and 20 million worldwide. As the demand for clear vision grows with our aging population, optometrists play a vital role in pre- and post-operative care for cataract patients. This article will cover some of the best practices to consider.

Pre-Op: Setting the Stage for Success

Your expertise shines during the pre-operative phase.  A comprehensive eye exam helps assess the patient’s baseline vision and identify any pre-existing conditions that might influence surgical outcomes.  It’s essential to assess the patient’s overall ocular health, paying close attention to the retina and optic nerve, as conditions like diabetic retinopathy or glaucoma could complicate the surgery or recovery process.

Don’t forget to manage expectations! Explain the procedure, potential visual improvements and the adjustment period to a new intraocular lens (IOL). A detailed discussion about the patient’s vision goals post-surgery is also paramount. This conversation should cover the various IOL options and what visual outcomes they can expect. Here are some more practical tips:

  • Measure and discuss refractive error: This data is crucial for the ophthalmologist to select the most appropriate IOL power for the desired post-surgical refraction.
  • Consider corneal topography: Topography helps identify pre-existing corneal aberrations that might impact post-operative vision quality, especially for patients seeking premium IOL options.
  • Address ocular surface disease: Dry eye or blepharitis can significantly impact post-surgical comfort and healing. Optimize the ocular surface before surgery to minimize complications.

Post-Op: Partnering for Optimal Recovery

The post-operative period is where your collaborative care with the ophthalmologist comes into play.  Schedule follow-up appointments within the first week and at regular intervals to monitor healing, assess visual acuity and adjust medications as needed. Be vigilant for potential complications like endophthalmitis or cystoid macular edema (CME). Monitoring for inflammation or infection is critical during these visits. Utilizing slit-lamp microscopy helps in evaluating the IOL placement and the anterior chamber’s health.

Here’s how you can excel in post-operative care:

  • Educate on post-operative care: Encouraging patients to adhere to their prescribed medication regimen and providing clear instructions on its use is vital for preventing inflammation and infection. Optometrists should also advise patients on symptoms that warrant immediate attention Remind patients to wear eye protection and avoid strenuous activities during the recovery period.
  • Manage medication tapers: Carefully follow the ophthalmologist’s recommendations for tapering steroid drops to minimize the risk of complications like elevated IOP.
  • Address vision concerns: Patients may experience blurry vision initially or require adjustments to their spectacle prescription as their eyes adapt to the new IOL.

By providing exceptional pre- and post-operative care, you become an invaluable partner in your patients’ cataract care. Remember, clear communication, meticulous monitoring and a collaborative approach with the ophthalmologist ensure the best possible outcomes for your patients.

SOURCES: BMJ Open Ophthalmology, Touch Opthamalogy, Ophthalmology and Therapy, Cataract and Refractive Surgery Today