1. Preoperative assessment
This usually takes place after you have been admitted to the hospital. I will ask you about your health and previous experiences with anaesthesia. Options for the type of anaesthesia will be discussed after a physical examination.
2. Anaesthesia
Most cataract surgery is performed under regional anaesthesia and sedation. An intravenous cannulae will initially be inserted and an appropriate amount of “twilight sleep” is then given. A regional block of local anaesthetic is performed with a very thin needle around and behind the eye. During the operation you will be drowsy and comfortable but still be able to hear things in theatre and can communicate with the operating team if there is any problem. You will not feel any discomfort as the eye has been anaesthetised. The advantage of this technique is that it avoids the risk of general anaesthesia, nausea and vomiting is rare, there is a more rapid recovery, postoperative discomfort is minimal, eating and drinking can be resumed soon afterwards and you can return home on the same day.
3. Postoperative care
After your operation I will continue to monitor your condition and recovery from anaesthesia. If you are going home on the day of surgery you should have an adult accompany you home and remain with you until the next day. You may eat and drink as you wish. You must not drive a car, operate machinery, sign any legal documents or drink alcohol on the day of surgery.
Preparation for surgery
1. Fasting
This is necessary to ensure that your stomach is empty to ensure that no food can go into your lungs and cause damage whilst during anaesthesia. You can have normal food up till 6 hours before anaesthesia and water sips until 2 hours before anaesthesia. The time of anaesthesia should be regarded as being the time you arrive to hospital.
2. Medications Please bring all medications to the hospital. You should take all your regular medications up to and including the day of surgery (with a small sip of water) except the following: - diuretics, insulin, tablets that lower your blood sugar or any blood thinning medications your surgeon has advised to stop. If you are on warfarin, please obtain an INR close to the day of surgery and bring the result to the hospital. If you are unsure about your medications, please do not hesitate to ask.
3. Smoking
Stop. The longer you stop smoking before anaesthesia the greater the benefit.
Risks of anaesthesia
Australia is one of the safest places in the world to have an anaesthetic partly due to the extensive specialty training of anaesthetic doctors. Regional blocks of local anaesthesia are safe and effective but may still have some potential side effects. A minor one is bruising around the eye, which usually disappears after a few days. Major complications are extremely rare and include bleeding behind the eye, perforation of the eye and damage to the nerves.
If you have any concerns, please contact my rooms or discuss them with me before your operation.