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Patients

What to expect on your day of surgery

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Congratulations!
 
The Arizona Eye Anesthesia Team will be with you during this exciting, life-changing experience.

The Arizona Eye Anesthesia Team is a group of anesthesia professionals committed to delivering excellent anesthesia care for you as you undergo your eye procedure.  


Perhaps someone told you that cataract surgery is "routine." 
 
It is.

 

We do this five days a week, 52 weeks a year.
 
But you only get to do it twice.

 

We understand this is important to you.

 

We know that for you - this surgery is not routine in any way.   

We will work hard to make sure you are comfortable and safe on this important day.

You've come to the right place.


 

The Arizona Eye Anesthesia team is here

to make your experience safe and comfortable.

surgery day

Every Ambulatory Surgery Center is Different.

Because of this fact, the flow process - or how patients move through the facility - is quite variable for each center.

Below is an educated estimate of what you can expect to happen on your surgical day.

 

Please understand that the time estimates are merely educated estimates based on thousands of surgical days completed. Some days move fast... some are quite long.

Here’s what you can expect during your procedure for cataract surgery.

Upon arrival, you will check in with the front desk personnel. Make sure to bring your photo ID and Medical Insurance information.  

 

When it is your turn, the RN will call your name and bring you back to the pre-op area. Depending on the facility, you will leave your clothes and shoes on, but we may place a lightweight gown over your shirt.

 

Make sure to wear a button-down shirt if you have one. This makes it easier for us to place the EKG leads on your upper chest area.

In pre-op, we will check your vital signs, review your medical history, and place dilating drops in your eye.

One of our highly-skilled nurses will place a very small pediatric IV in your hand or arm, depending on your preference. Your anesthesia professional will use this IV to administer sedation to help you feel relaxed and comfortable.

 

This IV will be removed within a few minutes after surgery is completed.

You will meet your anesthesia professional who will also repeat many of the questions and discuss the anesthesthetic plan with you. 

 

An RN will take you to the operating room, where we will place monitors to monitor your heart (EKG), blood pressure, and oxygenation (pulse oximeter).

 

The nurse will wash your eyelid with a betadine solution and give you a second numbing drop.

 

We will hold your eyelid open during surgery, so you don’t have to worry about that blinking.

You will need to lay flat for the duration of the surgery. Please let us know if you need us to adjust the headrest for your neck, or elevate your legs to soothe your lower back. If you have any restrictions for positioning, let us know and we will work diligently to meet your needs.

What you will see during surgery:

When surgery begins, you will see three beautiful bright lights.

 

These are the lights from the surgeon's microscope. These lights will soon begin to look like colors. This is a beautiful illusion for you to enjoy!

You will not see anything scary.

 

You will not see any instruments or even your surgeon’s hands.

 

All you will see are lights and colors.  Enjoy the fantastic light show. It's all for you!

What you will feel:

The first thing you will feel during surgery, is relaxation.

 

Your anesthesiologist or CRNA will administer medications through your IV (intravenous) line. 

 

We usually use two medications for cataract anesthesia:

 

Versed (Midazolam):  Versed is a medication that is similar to Valium or Xanax. Versed helps you feel relaxed. 

 

Fentanyl:  Fentanyl  is a pain-relieving medication in the opioid family. Fentanyl has been in the news lately, but it is a very safe medication when administered by a highly-trained medical professional.

 

We have safely given fentanyl as a surgical anesthetic for more than 40 years.  

 

You will receive a small, diluted dose of fentanyl. 

 

This will help you feel comfortable as you lay on the OR bed.

 

Sensations you will have in your eye:

 

Your eye will be numb from the numbing drops and/or numbing gel, but you WILL feel the following sensations:

 

·    You will feel a gentle stretch on your eyelid as we hold it open. If you can relax the muscles around your eyes, this will ease the stretching sensation.

 

·    You will feel cool saline solution dripping on your eye to keep it moist and protected. It will feel like water dripping onto the surface of the eye. Your eye loves this saline as it is soothing and nourishing.

 

·    You will notice a gentle pressure sensation early in the surgery when your surgeon administers a local anesthetic to the cataract. This is very brief and very subtle.

 

·    You may notice slight pressure shifts in your eye throughout the surgery. We use ultrasound and water pressure to dissolve and delicately remove the cataract. 

 

 

If you feel anxious, you can always talk to let us know.

 

Please inform us if anything feels uncomfortable to you.

 

Nothing should pinch, burn, or ache within the eye.

 

These sensations are easily remedied and are very unlikely.

 

The surgical procedure of removing a cataract and placing a new intraocular lens (IOL) takes approximately 10-25 minutes depending on the surgeon, the lens choice, the severity of the cataract, and other co-existing eye states (i.e. previous trauma, pseudoexfoliation, scarring, etc.).

 

Your job is to lay as still as possible and remain quiet unless something feels uncomfortable. 

 

After surgery, the RN will take you to the Post-Anesthesia Care Unit (PACU), where you will be monitored and watched by a highly-specialized nurse who is trained in post-operative management of our surgical patients.

 

This nurse will remove your IV and help you dress and prepare to go home. Your PACU stay is usually 10-15 minutes in length.

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Common Questions

How long will I be at the surgery center?

 

This is a simple question with a complex answer! 

 

Surgical preparation and times vary significantly from place to place.

 

Most surgery centers tell you plan for  2-4 hours.  

 

Below is an example of common time estimates for a patient who is assigned to arrive at the center at 08:00 

 

8:00 Arrive at the surgery center. Check-in with the front desk. 

Make sure to bring a photo ID and insurance information.

 

8:20 RN takes you back to the pre-op room. Vital signs taken. More questions asked. Eye drops and IV started by RN.   

 

8:20 – 9:00 Prepare to be bored. This is the time that we wait for your pupil to dilate. 

Some people dilate quickly…other eyes are slow to respond.

 

9:00 – 9:15 The surgeon, anesthesia professional, and RN will each come to say hello. 

The anesthesia team will ask about your health history and discuss your anesthetic needs.

9:15-9:30 An Circulating nurse - a specialized RN with years of operating room experience -  will take you to the OR, reattach the monitors and wash your eyelid with a surgical prep.

 

9:49 The anesthesia professional will arrive and administer relaxing medications. This person (anesthesiologist or CRNA) will be with you throughout the surgery.

 

9:45 – 10:00 The surgeon will arrive, wash her hands, and will put on a sterile gown and gloves.  Procedure begins.

 

10:00 – 10:30 You’ll be taken to PACU and monitored. Your family member or friend will pick you up according to the systems set up by the surgery center.

 

Some ASCs move faster, while others require at least 4 hours.

 

Your facility will inform you of what you can expect.

 

 

What do I need to bring with me on the day of surgery?

1. Government-issued photo ID

2. Medical insurance information (if you have any)

3. Credit card or check for copays

4. A person to drive you home. 

We are required by law to ensure a responsible adult over 18 years of age is present to drive you home. 

5. A list of your medications 

6. If you have medications that you might need immediately before or after surgery, please bring those medications with you.

Some common medications that people need to bring include:

Parkinson’s medications like Carbidopa/Levodopa (Sinemet)

Pain Medications like Percocet, Oxycodone, and Vicodin

High Blood Pressure Medication like Lisinopril, Metoprolol

 

7. A snack for after surgery. 

If you are a person who needs to eat right away, we recommend you bring a snack to eat immediately after surgery.

 

What should I wear?

1. Wear a shirt that buttons down the front (if you have one). This makes it easier to place the EKG pads.

2. Bring something warm! 

Some people wear a vest or a cardigan sweater. The OR and pre-op areas are notoriously cold.

3. Dress comfortably. You’ll be lying on a gurney that is not engineered for comfort!

4. Socks and shoes – keep those toes warm!

 

Do not wear sweaters with many fibers like angora, as these fibers can interfere with surgery by becoming airborne and entering the sterile surgical field.

 

If you have a cat or dog, please use a lint roller to clear their fur from your clothes.

 

Do not wear jewelry – we don’t want it to get lost!

 

What about my hearing aid?

Wear your hearing aids to the facility for sure! We need to be able to talk to you easily. We will remove the hearing aid on the side of the eye being operated on because we don’t want it to get wet. We will hang it in a bag on the IV pole of your bed. We will make sure it is not lost.  You can place it in your ear immediately after surgery.

 

What about dentures?

Wear those, too! You will not need to remove these at any time during your visit to the ASC. 

 

What about my eyeglasses?

Bring your eyeglasses with you. We will store them in a bag underneath your bed or on the IV pole. They will always be with you, although not “on” you during your stay.

What do I do if I have a cold?

If you are coughing or significantly congested, please call the ambulatory surgery center and let them know. Coughing will interfere with the surgical procedure, and congestion can make a very uncomfortable few hours for you. We will discuss your situation with you on an individual basis and create a plan that is safest for you.

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