New Patient Questions
How long will my appointment take?
New patient consultation may involve extensive diagnostic testing, a thorough examination by the technician, and another focused examination by the surgeon. Plan for a total time of 2 hours. Return visits are generally significantly faster. There may be a medical or surgical emergency on the day of your visit as our doctors are often sent patients with urgent complex problems such as trauma or corneal ulceration. Thank you for being understanding of the fluctuations in the schedule that this may cause.
Will my pupils be dilated?
Most new patient exams require dilation to ensure a thorough examination at the time of consultation, but that may be deferred depending on the reason for consultation. Many people drive home with their pupils dilated, but bring a driver if you feel uncomfortable driving with dilated pupils. In either case, you will need dark sunglasses to protect your eyes and reduce light sensitivity and disorientation when leaving the office after pupil dilation. For more information about pupil dilation, please see the Mayo Clinic or the American Academy of Ophthalmology website.
Frequently Asked Surgery Questions
How long will surgery take?
Plan to be at the hospital 3-4 hours for cataract surgery and 4-5 hours for corneal transplant surgery. This includes the time for evaluation by the nurses prior to surgery, placing an IV, the surgery itself, and the recovery period following surgery.
How much time should I take off work?
Most people take 1-2 days off for routine cataract surgery and 1 week off for corneal transplant or other complex surgeries. This of course depends on the safety of the work you do, your visual requirements at your work, and how quickly your body heals.
Should I stop my medications prior to surgery?
You may take your normal medications prior to surgery, but please take them with only a small sip of water. If you are diabetic please check with your primary care doctor regarding how to modify your medications since you will not be eating or drinking after midnight on the day of surgery.
Should I stop all drops I am currently using before surgery?
Continue all drops you are using, especially any glaucoma drops. Further instructions will be given after surgery.
What is the expected vision after surgery?
Expect your vision to be blurry on the day of surgery as your body recovers. The time course for visual recovery depends on the type of surgery performed. LASIK and routine cataract surgery tend to have the quickest visual recovery with clear vision expected 1-2 days after surgery. Vision after PRK surgery improves significantly after 5-7 days, but usually fluctuates day by day for 1-3 months after surgery. Complex cataract surgery, corneal transplants, and other complex eye surgeries often require more time for visual recovery. DMEK and DSAEK patients can expect their vision to sharpen by 1-3 months, and full-thickness corneal transplant (PK) patients may require up to a year for full recovery of vision. After cataract surgery, a new glasses prescription can be given once the vision is stable, which is generally 2-4 weeks after surgery.
Discomfort and light sensitivity are expected for a few hours following LASIK or cataract surgery, 2-3 days for PRK, DMEK, and DSAEK, and up to a week following full thickness corneal transplant/PK. These symptoms should improve gradually as the body heals and are generally treated with over-the-counter pain medication such as Tylenol and ibuprofen if the patient is able to take them.
Restrictions after surgery?
There are no restrictions after cataract surgery or LASIK except no eye rubbing or swimming for 1 week. PRK patients should avoid direct eye exposure to sunlight or tanning beds for 6 months after surgery, and should preferably always protect their eyes from UV exposure. DMEK, DSAEK, and PK patients should avoid heavy lifting and bending past the waist for the first week after surgery. Patients receiving a PK must protect their eye for the rest of their life and avoid any kind of full-contact activities that could result in a direct blow to the eye. Following DMEK and DSAEK, patients may not fly or drive to an elevation greater than 2,000 ft to avoid elevated pressure caused by the bubble used to attach the transplant tissue. The bubble is generally only big enough to limit travel for 1 day following DSAEK and for 4-5 days following DMEK.
When can I drive again?
You may drive again when your visual acuity and peripheral vision meet the requirements set by the DMV. This will depend heavily on your vision prior to surgery and the status of your other eye. Please ask your surgeon for more information prior to your surgery so that arrangements can be made for transportation during your recovery period.
How many surgeries have Drs. Terry, Straiko, and Sanchez performed?
The doctors in our practice have each performed thousands of intraocular surgeries and have been fellowship/subspecialty trained in the field of corneal surgery, anterior segment reconstruction, and complex cataract and refractive surgery.
Probability of graft rejections, failure, etc
Cataract surgery, LASIK, and PRK have an incredibly high rate of success with the vast majority of patients achieving improvement in their vision and function as a result of surgery. In complex cataract and corneal transplant surgery, the odds of improvement of vision and/or symptoms depends on the specific situation. This is an excellent question for your surgeon during your consultation. Corneal transplant rejection is a rare complication that results from the immune system recognizing the corneal transplant tissue as foreign. The resultant inflammation may cause damage to the transplant and reduce the lifespan of the cornea. The risk of rejection following full thickness transplant (PK) is 17%, DSAEK is 9%, and DMEK is 0.5%. Most cases of rejection are treated with a short course of steroid drops. If the rejection episode is caught early, damage to the transplant may be minimal. If the inflammation is severe and lasts a prolonged period of time, the transplant may need to be replaced with a new one. Please call the office (503)413-8202 if you are having the symptoms of rejection after corneal transplant surgery – Redness, Sensitivity to light, decreased Vision, or Pain (RSVP).
When are sutures removed?
Not all eye surgeries require the use of sutures. LASIK, PRK, and most cataract surgery do not require any sutures. Sutures placed at the time of complex cataract surgery, DMEK, or DSAEK are generally removed between 1 week and 1 month after surgery, although dissolving sutures are occasionally used and may not need to be removed. Sutures placed for full thickness transplant (PK) or deep anterior lamellar keratoplasty (DALK) are removed between 3 months and 2 years after surgery depending on the signs of healing and the amount of astigmatism in the cornea.
When can I resume CL wear after Crosslinking? PK? DMEK
You may resume contact lens use when your eye has recovered from surgery and is stable. This varies based on your specific situation and surgery, but in general, contact lens use may be resumed 1-3 months after DMEK, 3 months after cross-linking, and 3-6 months after PK or DALK. Often a new contact lens fitting will need to be performed as the shape and power of the cornea often changes after surgery.
Do I have to undress for surgery?
Patients having surgery at Legacy Good Samaritan medical center are required to wear a hospital gown if they are having surgery in the operating room. LASIK and PRK patients may keep their usual clothes on as their surgery is performed in a separate procedure area.
What type of anesthesia/sedation is used?
The anesthesia method depends on the type of surgery and your specific situation. Most LASIK and PRK is done with an anti-anxiety pill and anesthetic eye drops. Cataract surgery anesthesia generally includes anesthetic eye drops and a modest amount of anti-anxiety and pain-relieving medication given through the IV. More complex surgery such as corneal transplants are performed with anesthetic injections around the eye, IV sedatives, and occasionally general anesthesia with the patient completely asleep.
How long will I need to use steroid drops after surgery?
Post-surgical eye drops are given to reduce the risk of infection and to control inflammation. The duration of drops depends on the complexity of the surgery and whether a patient is receiving a transplant tissue. Antibiotic drops are usually only prescribed for 1 week after surgery. Steroid drops are given for approximately 1-2 weeks after LASIK surgery, 4 weeks after cataract surgery, and for 1+ years after corneal transplant surgery. The steroid regimen will depend on how your body is responding to surgery and may vary between your first and second eye.