Postoperative cataract care: the Aravind perspective

It is such a relief for a patient to hear these words from the operating ophthalmologist. All is well that ends well. However, it is essential for us as eye care professionals to make the patient aware that the end of a successful cataract operation is not the end of her or his treatment for cataract. Good postoperative care is as important as the care taken by the surgeon before and during surgery. At Aravind Eye Hospitals, we make a point of stressing good postoperative care, especially since excellent surgery can have a poor outcome if the postoperative care is not adequate. At Aravind many of our patients are operated on as day cases and others are admitted, particularly patients identified with cataract during outreach activities. For all cataract operations the procedure ends with the administration of intracameral antibiotics (for endophthalmitis prophylaxis). We use intracameral moxifloxacin for this, which has reduced postoperative endophthalmitis from 8 per 10,000 operations to 2 per 10,000.1 Following this, a drop of 5% povidone iodine is instilled into the conjunctival sac and the eye is patched. Patients are taken to a recovery room, where they are counselled regarding care to be taken during the postoperative period. The correct method of instilling drops is shown to them during counselling. Patients are instructed to clean the lid margins and adjoining area with surgical cotton (given to them in their postoperative medicine kit) and advised not let any fluid or foreign body enter the eye. Dark glasses (sunglasses) are recommended to be worn outdoors for protection and to reduce glare. Day surgery patients are sent home wearing an eye patch and eye shield and instructed to do the following on the day of surgery: