Restarting your vision: Things you need to know after glaucoma surgery

Author: Yan Quan, attending physician at Shanghai First People's Hospital

Reviewer: Wang Haiyan, deputy chief physician, Shanghai First People's Hospital

The success of glaucoma surgery does not mean the end of treatment. Postoperative observation and care are also crucial for patients to restart their vision. So what should glaucoma patients pay attention to after surgery?

Figure 1 Copyright image, no permission to reprint

1. Take medications as directed by the doctor after surgery: Glaucoma patients should follow the doctor's instructions to use eye drops on time and in the right amount after surgery, which is crucial for postoperative recovery and prevention of serious complications such as infection. Commonly used medications after surgery mainly include anti-inflammatory drugs and broad-spectrum antibiotic eye drops. Sometimes doctors will also ask patients to add ciliary muscle paralysis drugs and artificial tears according to their conditions.

(1) Anti-inflammatory drugs: used to reduce postoperative ocular inflammation. Commonly used in clinical practice are tobramycin dexamethasone eye drops, 4 times a day; and dexamethasone tobramycin eye ointment, once every night before bed.

(2) Broad-spectrum antibiotic eye drops: used to prevent eye infections and endophthalmitis. Levofloxacin eye drops are commonly used in clinical practice, 4 times a day.

(3) Ciliary muscle paralytics: This type of drug can paralyze the ciliary muscle, causing the lens-iris diaphragm to move backwards, thus preventing postoperative malignant glaucoma. Atropine eye ointment is commonly used in clinical practice, 1 to 2 times a day.

(4) Artificial tears: used to improve the ocular surface environment, promote surgical incision healing, and reduce foreign body sensation. Sodium hyaluronate eye drops are commonly used in clinical practice, 4 to 6 times a day.

Figure 2 Copyright image, no permission to reprint

2. Pay attention to eye hygiene: 2 to 3 weeks after glaucoma surgery is the peak period for infectious diseases such as endophthalmitis. Keeping the eyes clean and paying attention to eye hygiene are very effective in preventing infection. Always be careful not to rub your eyes with your hands or wipe your eyes with tissues. When washing your hair or taking a bath, prevent water from flowing into your eyes. In addition, you should rest at home more and avoid contact with polluted environments.

Figure 3 Copyright image, no permission to reprint

3. Maintain good living habits: Regular work and rest, adequate sleep, and a good mental state are conducive to the recovery of glaucoma patients after surgery. In life, patients need to pay attention to the following points.

(1) Light diet: Patients should eat light food after surgery, eat more fruits and vegetables, and keep bowel movements smooth. Avoid spicy and greasy food, as well as tobacco, alcohol, strong tea, etc. Glaucoma patients should be careful not to drink a large amount of water at one time, but should drink it in small amounts several times. If patients often drink 200 to 300 ml or even more water in one breath, their intraocular pressure burden will increase, which will also affect the therapeutic effect of the drug.

In addition, glaucoma patients should not take "tonics" in their diet after surgery. Because the most commonly used glaucoma surgery in clinical practice is external drainage surgery, also known as trabeculectomy. During the operation, the doctor will make a filtration channel inside and outside the patient's eye so that the aqueous humor in the patient's eye can flow to the outside of the eye, thereby reducing intraocular pressure. If the patient consumes too much high-protein and other high-nutrition foods, or even traditional Chinese medicine that promotes tissue healing, after the operation, it may cause scarring of the filtration channel and cause the failure of the operation.

(2) Appropriate exercise: After surgery, you can do some physical activities, such as walking, but be careful not to overdo it. Avoid strenuous exercise, weight bearing, breath holding, prone position, etc., which will increase abdominal pressure and cause increased intraocular pressure, and easily induce surgical complications such as hyphema and choroidal detachment.

(3) Patients should avoid staying in the dark for too long after surgery, because in a dark environment, the pupils of a person tend to dilate, causing increased intraocular pressure. When watching electronic products such as television, computers, and mobile phones, a light should be turned on indoors so that the room is not too dark, and the viewing time should not be too long.

Figure 4 Copyright image, no permission to reprint

4. Regular follow-up visits: Patients should have regular follow-up visits 1 week, 1 month, and 2 months after surgery to measure intraocular pressure, assess eye recovery, and the condition of the filtration bleb. If any discomfort occurs, go to the hospital in time to avoid delaying the condition.