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How does an eye surgery work?

Everything you need to know about the procedure of an eye surgery. This information about eye surgery can help you understand the procedure and what has to be observed. Here you can also see frequently asked questions about eye operations.

Please choose the surgery procedure, you want to read more about: 

Cataract surgery: How does it work?

Vitreous surgery or Retina surgery (vitrectomy): How does it work?

Eyelid operation (dermatochalasis, eyelid malpositions, etc.): How does it work?


 

Procedure of a cataract surgery:

Decision for surgery

I will perform a comprehensive initial examination to diagnose the condition of your eyes. That way, I can also exclude any diseases of the retina, which could occur at the same time as a cataract. Usually an OCT examination is advisable to examine the retina with a laser light.

Please note that you will get eye drops to dilate the pupils. You are therefore not allowed to drive on that day. During this appointment, we will talk about the disease, as well as everything related to the operation. Together, we will discuss possible dates, hospitals, in which I can perform the surgery and the type of anesthesia.

For anesthesia, there are two possibilities: either a sedation (sedoanalgesia) or a general anesthesia.This requires, that you do not eat or drink for at least six hours before the procedure.

A local anesthesia may also be an option for you – because of the very low complication rate, and the ease of use. Numbing eye drops will be applied to achieve painlessness during the operation. With this method, there is no prior fasting necessary and you can usually go home one hour after your eye surgery.

Depending on your health condition, some tests (blood count, ECG and chest X-ray) may be necessary before the eye operation. 

Shortly before the operation

I will give you a detailed explanation about the surgery and possible complications. During this appointment you will receive explanatory material with all the details and I will be happy to answer any open questions.

Then, I will perform measurements of your eye to accurately determine the correct power of the intraocular lens, which is an artificial lens that will replace your own lens after the operation. We will also discuss what kind of lens is ideal for you, a mono-focal lens, which will either correct your nearsightedness or farsightedness. In this case, you would need additional reading glasses or glasses for distance vision.

With a multifocal lens, you will no longer need glasses and a toric lens can even compensate for astigmatism.

Of course, you will also receive all the information about the costs involved.

We also discuss what happens after the surgery: which eye drops for approx. four weeks will be required and what you should avoid (no water contact, no sauna visit, not rubbing the eye, no physical exertion like heavy lifting for about a week).

After the surgery

If you have a local anesthesia, you can go home about an hour after the operation. Overall, the time required is approx. three hours.

With a general anesthesia, you have to stay in the hospital for about four to five hours after surgery, however you may then go home

The bandage you will receive after the surgery can be removed the next day. At the same time, you will start using the prescribed eye drops.

If you don’t feel any pain or discomfort you will come within a week after surgery in my medical practice for a checkup. If you have any complaints you can come anytime.

After approx. five weeks a new pair of glasses can then be prescribed.

 


Procedure of a vitreous surgery or a Retinal surgery (vitrectomy):

Decision for surgery

I will perform a comprehensive initial examination to diagnose the condition of your eyes. I will determine the nature of the disease of the posterior part of the eye (vitreous, macula, retina) and also whether you have a cataract as well. Please note that this exam requires eye drops to dilate your pupils and therefore you are not allowed to drive that day.

In addition, to rule out any disease of the posterior section, I will do an OCT examination, scanning the retina with a laser light.

During this appointment, we will discuss the nature of your condition, the progression of the disease, as well as important information concerning the operation, in case it is required. Together, we will discuss possible dates, hospitals, in which I can perform the surgery and the type of anesthesia.

In general, I perform retinal and vitreous surgery under general anesthesia, as the procedure may take some time, depending on the diagnosis between 1 and 2 hours. To remain in a supine position for such a long time could become uncomfortable and painful.

For anesthesia, there are generally two possibilities: either general anesthesia – which requires you not to eat or drink for at least six hours before the procedure. Alternatively, a local anesthesia with an additional injection of anesthetics doesn’t require prior fasting, and you can go home after about 1 hour after surgery if you are feeling fine.

For general anaesthesia – depending on your health – it might be necessary to have additional tests done before the eye surgery (blood count, ECG and chest X-ray).

 

Shortly before the operation

I will give you detailed explanations about the surgery and possible complications. During this appointment you will receive explanatory material with all the details and I will be happy to answer any open questions.

One known side effect of a vitrectomy is the formation of cataract or the acceleration of it. We will therefore also discuss whether a combined operation (cataract surgery and vitrectomy) would make sense in your case. If this is the case, I will perform additional measurements of your eye to accurately determine the correct power of the intraocular lens, which is an artificial lens that will replace your own lens after the operation.

We will also discuss what kind of lens is ideal for you, a mono focal lens, which will either correct your nearsightedness or farsightedness. In this case you would need additional reading glasses or glasses for distance vision. With a multifocal lens, you will no longer need glasses and a toric lens can even compensate for astigmatism.

Of course, you will also receive all the information about the costs involved.

We also discuss what happens after the surgery: which eye drops for approx. four weeks will be required and what you should avoid (no water contact, no sauna visit, not rubbing the eye, no physical exertion like heavy lifting for about a week).

After the surgery

After general anesthesia you usually have to stay at the hospital for one or two nights. I will release you if no complaints occur; depending on the duration of the surgery usually in the morning after the surgery or on the following day.

In the case of local anaesthesia you can go home a few hours after the procedure. You can remove the bandage you will receive after the surgery, the next day yourself and start with the application of the prescribed eye drops, or I remove the bandage in the ordination, as i will have to check your condition the next day.

In case you had a vitrectomy and a cataract surgery you can get a prescription for new glasses after approx. five weeks. If only a vitrectomy has been done, there is usually no change in the refractive power of the eye so that no new glasses will be required.


 

Procedure of an eyelid operation

Decision for surgery

First, I will perform a comprehensive initial examination to diagnose the condition of your eyes – this applies to eyelid malformations, eyelid dysplasia (dermatochalasis) and other eyelid problems. You may come by car because I will not need to administer pupil-widening eye drops for this examination.

During this appointment, we will talk about the disease, as well as everything related to the operation. Together, we will discuss possible dates and hospitals, where I can perform this operation, and the type of anesthesia. Of course, you will also receive all the information about the costs involved.

Most of these procedures can be performed under local anesthesia. The affected area of your eyelid skin is anesthetized by an injection to ensure you will feel no pain during surgery. Fasting prior to the operation is not necessary.

These procedures are also possible under general anesthesia. There are two possibilities: Either a sedation (sedoanalgesia) or a general anesthesia. This requires that you do not eat for at least six hours before the procedure. Depending on your health, it may also be necessary to do additional tests before the operation (blood count, ECG and chest X-ray).

 

Shortly before the operation

I will give you again detailed explanations about the surgery and possible complications. During this appointment you will receive explanatory material with all the details and I will be happy to answer any open questions.

To be on the safe side, I will always have newly formed tissue histologically examined, the evaluation usually takes 1 to 2 weeks.

If your condition is an excess of skin in the upper or lower eyelid (dermatochalasis) I will perform a visual field testing, so that this operation will be necessary for medical reasons and may be approved by health insurance. Again, no pupil dilating drops are required and you can come by car.

If you are taking blood-thinning medication (thrombo ACE, aspirin, heart protection ACE, Tomapyrin, Sintrom, Marcoumar, Pradaxa, Eliquis or similar), you may have to consult your internist and pause the intake for some days up to a week before the operation.

We will also talk about what to do after the operation: which eye ointment will have to be applied for approx. one week and what you should avoid (for example: no water contact for about a week, no sauna visits, no rubbing of the eye).

After the surgery

If you receive a local anesthesia, the surgery can be performed as an outpatient or a day-clinic procedure and you can go home an hour or two after the surgery. Depending on the extent of the operation, the time required is between one and three hours.

In case of sedoanalgesia or general anesthesia, do not eat or drink until about six hours before the surgery. After the operation, you will be taken care of for about four to five hours in the hospital and may then go home. The bandage you will receive after the surgery can be removed the following day. At the same time, you will start applying the prescribed eye therapy. If you are doing fine, you will come to my practice in approx. 1 to 2 weeks for a checkup.

If you have any complaints, you can and should come at any time. If a removal of stiches is required, I will do this about 1 week after surgery in my practice.

 


 

I hope this information about the procedure of an eye surgery is helpful.

Do you have any questions? Here you can read frequently asked questions about eye operations. For further questions you can contact me through my practice (even outside of office hours), the practice will quickly forward requests to me personally. Furthermore, you may contact me also via email.