Immediate Sequential (Same Day) Bilateral Cataract Surgery
Î Assuming the patient prefers cataract surgery in both eyes, immediate
sequential bilateral surgery has advantages and disadvantages
that must be carefully weighed and discussed. Foremost is the
risk of potentially blinding complications in both eyes, such as
endophthalmitis or TASS. For this reason, the second eye should be
treated like the eye of a different patient using separate povidone
iodine prepping, draping, instrumentation, and different supply lot
numbers such as irrigating solutions, OVD, and medications. (III, G, S)
Î If a complication should occur intraoperatively during the first eye
surgery, then surgery on the second eye should be reconsidered and
done at a later date. (III, G, S)
Postoperative Management
Typical Criteria for Discharge After Ambulatory Surgery
• Vital signs are stable
• Preoperative mental state is restored
• Nausea and vomiting are controlled
• Pain is absent or minimal
• An escort is available if necessary
• Postsurgical care has been reviewed with the patient and/or escort and written
postoperative instructions have been provided
• A follow-up appointment has been scheduled
Situations Under Which Extended Observation Might Be
Warranted
• Medical conditions are present that require prolonged postoperative observation by
nurses or other skilled personnel
• Patient is mentally debilitated or diagnosed as mentally ill
• Patient cannot exercise self-care (or responsible care is unavailable) during the
immediate postoperative petriod
• Patient is functionally monocular and has had cataract surgery in the eye on which he
or she is dependent
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