THE DAY OF YOUR LASER PROCEDURE BEFORE THE PROCEDURE: There are no restrictions with regard to eating, drinking or medications on the day of surgery. You are encouraged to eat prior to arriving for your procedure. Excessive caffeine should be avoided. Wear comfortable clothing. All traces of make-up should be removed. We ask that you abstain from wearing perfume, cologne or aftershave for the 24 hours before your procedure, as it can interfere with the laser. Bring your medicated eye drops with you. Contact lenses must be removed from the operative eyes prior to the day of your procedure: 3 weeks for gas permeable or hard lenses, and 1 week for daily wear soft lenses. You will need to arrange transportation on the day of your procedure. You will not be permitted to drive yourself home. IN THE PRE-OP AREA: Please bring all of your paperwork with you on the day of your procedure. You will be asked to sign the consent form in the presence of a technician. You will meet with your surgeon, Dr. Mark Golden, prior to the procedure. He will answer any questions that you may have and discuss the procedure as it applies to you. Payment is required in full before your procedure. If you require financing, please have this arranged before your appointment for surgery. Call the office if you would like assistance. Once all of the paper work is completed and you have met Dr. Golden, you will be offered Valium to help you relax. The Valium takes 20-30 minutes to take effect. INSIDE THE LASER ROOM: The procedure takes less than 10-15 minutes for both eyes. Your non-operated eye will be covered during the procedure to help you focus with the operated eye. It is important to keep both eyes open during the procedure to minimize discomfort. You will be instructed to look at a flashing red target light. Dr. Golden will help you to maintain your fixation. The laser makes a clicking or snapping sound and a funny smell is notice by some. AFTER SURGERY: When the surgery is complete, Dr. Golden will examine the operated eye(s) in the Exam Room. You will be given a kit containing sun glasses, protective goggles, and artificial tears. Instructions for use of the eye medications will be given to you, verbally as well as written in your “Post-op Instructions”. Your driver should then take you home to rest. It is best to sleep for the several hours after your procedure and plan to spend the rest of the day with your eyes closed as much as possible. Drops should start about 4 hours after surgery, but don’t wake up just to take your drops. Sleep is the best way to heal. EXPECTATIONS: There are a number of key features about the way your eyes will feel and how your vision will behave that are normal and temporary. After your procedure you will recognize that you are no longer nearsighted but your vision may still be foggy. A half hour after your procedure, the numbing medicine wears off and the eyes start to feel sore and scratchy for several hours. There may also be tearing. Your eyes may be sensitive to bright light and may burn when attempting to open them. Do not be alarmed, these symptoms are normal and temporary. The remedy for this is sleep, or keeping your eyes closed as much as possible for the remainder of the day. Most people see well enough to drive and work the day after surgery. Those with very high nearsightedness or astigmatism
or those with hyperopia may take longer to stabilize. Typically, eyes require 3 to 4 months for the vision to completely stabilize. This is part of the healing process. If your vision is blurry beyond the 20/40 level, temporary glasses may be required. Later, if your doctor feels you could benefit from enhancement, this would be done at 3 months. The vision must stabilize first. Most people have glare at night causing some difficulty with driving at night. This usually resolves within a few months. You should not drive or operate hazardous equipment if you are not comfortable with your vision. Everyone has dry eyes after surgery. Preservative free tear drops should be used for the first week and then tear drops with preservatives work well.
GUIDELINES FOR APPROPRIATE STRESS ULCER PROPHYLAXIS The following information, derived from the ASHP guidelines, can be used as a screening tool to determine appropriateness of prophylaxis. Medical Intensive Care Unit patients ONE OR MORE OF THE FOLLOWING RISK FACTORS • Likely to require mechanical ventilation for > 48 hours • Non-intentional coagulapathy, i.e. not on warfarin