How much discomfort is to be expected after cataract surgery
Posted , 6 users are following.
I've had my first eye done on 03/29. The day following the surgery I had some pain when looking at light (even if the operated eye was closed and I looked with the other one), but that went away the next day.
Day 2 and 3 after surgery there was no pain at all, no discomfort, no dryness, nothing - smooth sailing. I didn't even bother with moisturizing eye drops.
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But since day 4 and up until now (day 6) it got worse, I started to get dry eye, my eye feels a bit raw and sensitive (but isn't reddened), I ocasionally feel a pricking pain at the location where I felt the pain on day 1 - I assume it's the location where one of the surgery cuts was made, but not sure. The pain was dull on day 1 (like someone poked you in the eye), now it feels more like a cut. Probably that spot getting sensitive when dry.
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I'm taking moisturizing eye drops now - but not sure if they are any good (my doctor did not specify any particular ones, just said to use some as needed additionally to the prescribed antibiotic eye drops).
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I also got new glaucoma drops for that eye, as my usual meds would increase likelihood of macular edema ocuring.
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Is discomfort like that more or less usual)?
Any recommendations on type of moisturizing eye drops that could help?
1 like, 18 replies
RonAKA BrianCyberEyes
Posted
I had similar issues for the morning after each eye was done with bright lights causing significant pain when my pupils were constricting. I think it was worse on the first eye as it was dark outside when driving to my day after surgery appointment. Brake lights and street lights were brutal even though I was wearing the super dark glasses. That effect was pretty much gone the following day.
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I did not use any dry eye drops as I was afraid of any contamination that might promote and infection in the eye. I just used the Vigamox antibiotic drops 4 times a day for the first week, plus the once a day Durezol anti-inflammatory corticosteroid. The once a day Durezol was prescribed for the full three weeks. I would think those drops would be the ones most effective in reducing the risk of pain and inflammation.
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After the prescribed drops routing was completed, I have occasionally used some Hydrasense Advance Dry Eye drops. I believe they are preservative free, so one has to be careful to not get them contaminated.
BrianCyberEyes RonAKA
Posted
Other than the initial pain on light exposure, how was your experience the following days? Was there no discomfort whatsoever, or occasional pain, itching, dryness, general sensitivity?
RonAKA BrianCyberEyes
Posted
I don't recall anything out of the ordinary. There were a few times I thought about using the HydraSense dry eye drops, but resisted. Now at 6 weeks I do use the drops occasionally, but not every day.
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What steroid drops are you using? My surgeon prefers Durezol over prednisolone. He prescribes Durezol at one drop per day for three weeks. If you use the prednisolone instead the prescription is three times a day or until the bottle runs out. The advantage of Durezol is that it is more effective at a lower dose and avoids some of the issues of prednisolone causing an increase in the eye pressure. Perhaps you should get your eye checked by the surgeon and if you are on prednisolone, consider a switch to Durezol. Inflammation after surgery can be an issue, so it would be worth getting it checked in any case.
RonAKA BrianCyberEyes
Posted
FWIW here are the instructions I got from the Surgeon with respect to post surgery issues.
"If you have a headache or mild discomfort in you eye, then you may take Tylenol or Advil. It is normal for the eye to feel as if something is in it (like a scratchy sensation). This is because of the incision used to remove the cataract....
Call the surgeon's office if:
BrianCyberEyes RonAKA
Posted
Those are useful instructions. I think I'm at the "scratchy feeling" stage, I don't have anything from the second list. My eye irritation was worsening at day 4 and 5, but subsided since and now on day 7 is pretty ok - eye just feels tired.
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I'm taking "Yellox" (substance: "Bromfenac" which is a nonsteroidal anti-inflammatory drug), twice daily. Then "Lotemax" (substance: "Loteprednol" - a corticosteroid) 3x a day for the first week, then twice daily for one week, and once daily for a last week.
And a third drug, which I had to use 2 days before the surgery and then 3x daily for a week after - called "Oftaquix" (substance: "Levofloxacin" - an antibiotic medication).
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It's probably not too useful to compare drugs by the brand name, as here in Europe those will be different than what you would get in North America, also I imagine, there are lots of variants available in both regions as well (at least in different countries in Europe).
RonAKA BrianCyberEyes
Posted
Interesting. My surgeon does not use a NSAID, but I know some do. He also does not do any antibiotics before surgery, but I know some do. Lotemax is an older corticosteroid, and I don't hear about it being used often here. If it is a suspension I suspect you will want to be sure it is well agitated before using it. People seem to get prednisolone or Durezol. It seems that every surgeon has a different eye drop dosing regime.
BrianCyberEyes RonAKA
Posted
Not sure how it is in common cases, but I've been reading that for patients with higher risk of macular edema (like me, with Retinitis Pigmentosa), NSAIDs are suggested to lower that risk significantly when taken for 2-3 months after surgery.
What does "in suspension" mean in that regard and why is it especially important with that drug? I shake all of mine before use.
RonAKA BrianCyberEyes
Posted
When I did my research on Durezol vs earlier drops like prednisolone, apparently one of the problems was the active ingredients not staying suspended. Durezol is claimed to have some technology to keep them suspended without any agitation. This is a milky suspension and I shook it up regardless...
lucy24197 BrianCyberEyes
Edited
My doc's office said you can use preservative free drops as often as you need to. I tried a bunch of different brands and different ones worked better at different times. It's not uncommon to have dry eye issues for months after cataract surgery. Some of the nerves than communicate the need for tears get cut during the surgery, so your eye can suffer dryness for a long time.I've mostly used Systane or Refresh drops. My eye still is happier with one kind of drops sometimes and another drop other times. It's quite frustrating!
valerio01538 BrianCyberEyes
Posted
In my first left eye surgery, I remember that, a few hours after the surgery, I felt a little pain, which only went away after I started using the eye drops. One of the eye drops (I don't remember which one) burned when I applied it. I also remember the sensation of something scraping when moving the eye, certainly because of the incisions that were made in the surgery. Already with my second eye, which was less than 1 week ago, I didn't feel any pain, no burning and practically no sensation of something scraping. It is important to consider that the cataract of the first eye was in a much more advanced state than that of the second. As for eye drops, here in South America (Brazil), the prescription in my two surgeries was as follows: Tropicamide 10mg/ml 1 drop every 15 minutes 2 hours before surgery. After surgery, Moxifloxacin Hydrochloride 5.45 mg/ml + Dexamethasone Disodium Phosphate 1.10 mg/ml - 1 drop every 4 hours for 10 days. Prednisolone Acetate 10mg/ml - 1 drop every 4 hours for 5 days, then every 6 hours for another 5 days, then every 8 hours for another 5 days and finally every 12 hours for 5 days. Ketorolac trometamol 5mg/ml - 1 drop every 8 hours for 30 days. I had to make a spreadsheet in Excel to control. Luckily I didn't need to take hydrating eye drops.
BrianCyberEyes valerio01538
Posted
That really seems a lot. When taking drops every 4 hours, do you need to wake up midway through the night, or is this only meant during the day?
valerio01538 BrianCyberEyes
Posted
The prescription was given to me in print, without much explanation, but I consulted my doctor and he said I wouldn't have to wake up for the drops. I managed to divide the day from 08:00 in the morning until midnight and fulfill the prescription as much as possible.
john20510 BrianCyberEyes
Posted
Do they give you eye drops that numb the pain for the days after the operation or do you take pain killer tablets
RonAKA john20510
Posted
I did not get any drops to numb the pain, and did not need them. Some surgeons will prescribe NSAID drops which I guess may control the pain to some degree. I also did not take or need any tablets. But as I mentioned earlier the instructions were to take Tylenol or Advil if needed.
BrianCyberEyes john20510
Posted
There isn't really a lot of actual pain, just discomfort. If you need painkillers, you probably should see your doctor as soon as possible.