Day of Surgery Instructions: dmek cornea Transplant Surgery (Dr. Terry) Lying Down



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Day of Surgery Instructions: DMEK Cornea Transplant Surgery (Dr. Terry)
Lying Down:

  • Please lie down looking straight at the ceiling, or with your eyes closed, as much as possible the day of surgery. You may put a pillow under your head and knees to relieve strain from your lower back.

  • You can sit-up and walk around for 2-3 minutes at a time every hour to rest your back.

  • You may take longer 15-20 minute breaks to use the restroom or to eat a meal.

  • Please sleep on your back the night after surgery if possible, but any position of comfort is fine if you cannot sleep on your back. Do not sleep face-down.


Activity:

  • Please do not rub your eye.

  • Refrain from strenuous activity.

  • Do not swim or use a hot tub or a sauna.

  • Do not wear eye make-up.


Shield:

  • Please keep your eye shield on at all times until it is removed by our technicians tomorrow in clinic. Today is the only time you will have to wear your eye shield during the day.


Eye Drops:

  • Do not take any eye drops until tomorrow unless asked to do otherwise by your doctor.

  • Bring your eye drops to clinic if you have any questions about them.

  • Ask your doctor if you should resume taking eye drops that you were taking before surgery, such as glaucoma eye drops.


Other Medications:

  • You may take any over the counter pain reliever for mild pain.

  • Resume taking all of your usual medications.



What to expect:

  • Mild irritation and discomfort are normal.


Absolutely call the doctor if you experience any of the following:

  • Severe eye pain

  • Nausea

  • Vomiting

  • Severe headache


The cornea fellow doctor can be reached at 503-413-8202 twenty-four hours a day if you experience any of the above symptoms. Please ask for the “cornea fellow” doctor.

Postoperative Day 1 Instructions: DMEK Cornea Transplant Surgery (Dr. Terry)

Lying Down: 2 hours up, 2 hours down, for 2 days

  • Please lie down looking straight at the ceiling, or with your eyes closed for 2 hours at a time. You may put a pillow under your head and knees to relieve strain from your lower back.

  • Every 2 hours, you can sit up and walk around for 2 hours to rest your back.

  • Follow this routine for 2 days, starting the day after surgery.

  • Sleep starting on your back for the next 2 nights. If you must sleep on your side, sleep on the opposite side of your surgery. Do not sleep face-down.


Eye Drops:

  • Ofloxacin 1 drop 4 times daily until the bottle is empty, unless otherwise instructed. Refills are not needed.

  • Ketorolac 1 drop 3 times daily until the bottle is empty – usually about one month. Your doctor may ask you to take this medication for longer if you have diabetes or certain conditions. If this is the case, you may need refills. It is normal for this drop to sting for a little after you use it.

  • Prednisolone 1 drop every 2 hours until your 1-week follow-up appointment, or until otherwise instructed. Shake well. You have refills.

  • Refresh PM ointment at bedtime, unless otherwise instructed. You have refills. It is also available over the counter without a prescription.




  • Take eye drops 3-5 minutes apart so that they do not wash each other out. The order of the drops does not matter. Please wash your hands prior to taking the drops. Do not touch the tip of the bottle to your eyelid or any other surface as this may contaminate it. Shake Prednisolone 20 times before using it.




  • Apply Refresh PM ointment last because the oily consistency can reduce absorption of eye drops. If you have difficulty applying the ointment, try holding the capped tube under warm water or in your hand for a few minutes. This makes the ointment into an oil that is easier to apply. If Refresh PM makes your eyelids crusty in the morning, you can gently wipe your eyelids with a warm, moist towel.


Activity:

  • Please wear your eye shield at night for 1 week then stop. Secure it with tape, forehead to cheek.

  • Do not rub your eye because this could damage your cornea transplant.

  • Stay out of dusty and dirty environments while your eye is healing.

  • Refrain from strenuous activity and try not to bend below the waist for 1 week after surgery.

  • Do not swim or use a hot tub or a sauna for at least 2 weeks after surgery.

  • Shower and wash your face as you normally would, but do not rub your eye.

  • Do not wear eye make-up for 2 weeks after surgery.



What to expect:

  • All eyes are different, but in general you can expect comfort and vision to improve steadily. Your vision will be extremely poor while the bubble blocks your pupil. This usually lasts 1-2 weeks.

  • Blurry vision and mild irritation, discomfort, tearing, and redness are normal.

  • Stinging with eye drops is normal.

  • It is normal for your current pair of glasses or contact lenses to no longer work after you have eye surgery because the surgery changes your prescription. You will be checked for a new prescription between 4 and 6 weeks after surgery, or when your eye stabilizes.


Increasing redness, pain, extreme light sensitivity, and decreasing vision are not normal. If any of these symptoms occur, call the doctor on-call at 503-413-8202.

Postoperative Week 1 Instructions: DMEK Cornea Transplant Surgery (Dr. Terry)
Eye Drops:

  • Ofloxacin 1 drop 4 times daily until the bottle is empty, unless otherwise instructed. Refills are not needed.

  • Ketorolac 1 drop 3 times daily until the bottle is empty – usually about one month. Your doctor may ask you to take this medication for longer if you have diabetes or certain conditions. If this is the case, you may need refills. It is normal for this drop to sting for a little after you use it.

  • Prednisolone 1 drop 4 times daily until your 3-month follow-up appointment, or until otherwise instructed. Shake well. You have refills.

  • Refresh PM ointment at bedtime, unless otherwise instructed. You have refills. It is also available over the counter without a prescription.




  • Take eye drops 3-5 minutes apart so that they do not wash each other out. The order of the drops does not matter. Please wash your hands prior to taking the drops. Do not touch the tip of the bottle to your eyelid or any other surface as this may contaminate it. Shake Prednisolone 20 times before using it.




  • 3 months after surgery you will stop using Prednisolone and start using Fluorometholone (FML) – 3 times daily for 2 months, 2 times daily for 1 month, then once daily until otherwise instructed. www.GoodRx.com has pricing and coupons available for FML prescriptions, but some coupons cannot be combined with Medicare. Prednisolone and FML are steroid eye drops that are very important to the health of your cornea transplant. Never stop taking your steroid eye drops without asking your doctor first. Always call the office for a refill if you need one, but do not worry about missing one or two days of the medication. Shake Prednisolone and FML 20 times before using them.




  • Apply Refresh PM ointment last because the oily consistency can reduce absorption of eye drops. If you have difficulty applying the ointment, try holding the capped tube under warm water or in your hand for a few minutes. This makes the ointment into an oil that is easier to apply. If Refresh PM makes your eyelids crusty in the morning, you can gently wipe your eyelids with a warm, moist towel.


Activity:

  • Do not rub your eye because this could damage your cornea transplant.

  • Stay out of dusty and dirty environments while your eye is healing.

  • Refrain from strenuous activity and try not to bend below the waist for 1 week after surgery.

  • Do not swim or use a hot tub or a sauna for at least 2 weeks after surgery.

  • Shower and wash your face as you normally would, but do not rub your eye.

  • Do not wear eye make-up for 2 weeks after surgery.

What to expect:

  • All eyes are different, but in general you can expect comfort and vision to improve steadily.

  • Blurry vision and mild irritation, discomfort, tearing, and redness are normal.

  • Stinging with eye drops is normal.

  • It is normal for your current pair of glasses or contact lenses to no longer work after you have eye surgery because the surgery changes your prescription. You will be checked for a new prescription between 4 and 6 weeks after surgery, or when your eye stabilizes.


Increasing redness, pain, extreme light sensitivity, and decreasing vision are not normal. If any of these symptoms occur, call the doctor on-call at 503-413-8202.


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