Following your IOL-VIP surgery

Immediately after your IOL VIP surgery
The day after your IOL VIP surgery
How quickly will your vision improve?
When can you resume normal activities?
What can you do to help make the operation a success?
Do you have follow up consultations after surgery?
Who needs computer exercises after surgery and why?
Will you still be able to use your low vision aids?
What are the risks and complications?

 

Immediately after your IOL VIP surgery

After the operation you will return to the ward with a pad and plastic shield covering the operated eye. This remains in place overnight.

You will be given a combination antibiotic and anti-inflammatory eye drop to take home, with written instructions on how to instil this and the frequency with which it should be used. We will make sure you know how to care for your eye when you get home.

Whilst resting after the operation you will be offered refreshments. You may leave the hospital when you feel ready.

During the first few hours after your operation the eye may water and feel sore. This is nothing to worry about and your normal headache tablets should settle any discomfort.

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The day after your IOL VIP surgery

The pad covering your eye can be removed on the morning after your surgery. You do not need to use it thereafter, although some patients prefer to wear the clear plastic shield for the first few nights for peace of mind.

You may find the eye a little sticky and there might have been a slight discharge overnight. This is quite normal and you should cleanse the eye only if necessary, by wiping gently across your closed eyelids with cotton wool dampened with clean water.

You should then start your eye drops, noting the detailed written instructions given to you before you left hospital.

If you are running out of drops before your appointment at the clinic, you can request a repeat prescription from your GP.

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How quickly will your vision improve?

The telescopic effect may be noticeable almost immediately, but your best vision cannot be obtained until new spectacles have been prescribed. The IOL VIP telescopic lens system inevitably causes a shift towards long-sightedness and a change in your spectacle prescription.

To help as quickly as possible our optometrist will provide a temporary prescription within the first couple of weeks. You will need to wait six weeks before getting more permanent new spectacles.

Patients who have already had cataract surgery, in whom telescopic implants are added to the existing lens, are rendered highly long-sighted, such that vision without spectacle help may be almost impossible.

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When can you resume normal activity?

You may return to your normal daily activities as soon as you feel ready to do so. As a guide however, for the first two weeks you should refrain from swimming, strenuous activities, heavy lifting and wearing eye make up.

It is acceptable to travel (including by air) following IOL VIP implantation. However, please remember that you will need to continue putting drops in the eye for approximately two months.

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What can you do to help make the operation a success

Following your IOL VIP procedure it is very important that you instil the eye drops as instructed as this will help prevent any complications such as infection or inflammation in the eye.

You should avoid knocking or rubbing the eye, but you may touch the surrounding area. Although it is safe to have a shower or bath, take care when washing your hair to avoid getting soapy water in your eye.

The eye can seem more sensitive to bright light for the first few days and you may find dark glasses helpful, especially in strong sunlight.

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Do you have follow up consultations after the surgery?

Yes. You will be seen by the optometrist approximately one week after surgery, when temporary spectacles will be prescribed.

Your eye will be checked two to three weeks after the operation and then, according to the visual outcome, computer exercises may be recommended.

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Who needs computer exercises after surgery and why?

For those patients who have reasonable central vision the telescopic effect of an increase in image size alone will produce the desired outcome, making computer exercises unnecessary.

Other patients, with more serious disease right at the centre of the macula, may be helped to find their best point of vision. This is known as a “Preferred Retinal Locus” (PRL).

A computer programme can be used as an effective way of helping to find, and then adapt to this new location. This is done by watching a series of flashing words for about twenty minutes each day in the month or so after the operation.

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Will you still be able to use your low vision aids?

Yes. The IOL VIP produces a new and better baseline on top of which low vision aids (LVAs) for both near and distance may be used.

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What are the risks and complications?

The aim and potential outcome of IOL VIP implantation will be discussed with you in clinic and again prior to your operation.

Our team operates from modern private hospitals where the equipment and products used in the operating theatre are of the highest standard. Every effort is made to minimise risk and ensure your operation is safe.

Serious problems during or after IOL VIP implantation are rare, however every surgical procedure has risks and potential complications.

Complications at the time of surgery:

  • Tearing of the lens capsule. Capsular rupture makes it difficult to place the new lens within the capsular bag. If we are unable to position the implant lens safely, standard cataract surgery will be performed rather than implanting the IOL VIP twin lenses.

  • Loss of lens material into the eye. Dislocation of all or part of the natural lens into the back of the eye during surgery necessitates a more complex procedure (vitrectomy) to remove the lens fragments. Again in this situation it may be necessary to implant a standard lens rather than the IOL VIP system.

Complications early in your recovery:

  • Endophthalmitis. Infection in the eye, affecting less than one in a thousand cases, is a rare but potentially devastating complication. All aspects of comfort and vision should improve over the first few days following surgery, but if there is any deterioration you should contact us immediately or attend the Eye Casualty Department. Prompt treatment improves the chance of avoiding permanent visual loss.

  • Bruising of the eye or eyelids. The local anaesthetic used may cause some bruising around the eye, particularly on the lower lid.

  • Double vision. The local anaesthetic injection used to numb your eye takes some time to wear off and may leave one or more of the muscles around the eye weak for the first few hours. This causes double vision, which resolves spontaneously.

  • A temporary increase in the intra-ocular pressure in the eye. This necessitates an additional course of eye drops or tablets. Patients with advanced cataract or known glaucoma may be asked to take oral medication to prevent this.

  • Allergy to eye drops. Ocular allergy typically causes lid swelling, itching or redness. If this happens please let us know and we can prescribe an alternative drop. Some patients are allergic to the preservative used in eye drops and if you have previously had a reaction, please inform us prior to surgery so that we can prescribe a preservative-free option.

  • Corneal oedema. Clouding of the cornea is rare and usually clears within a couple of weeks.

  • Cystoid macular oedema. Swelling of the central macular area of the retina causes blurred vision. This usually resolves within a few weeks of using additional eye drops.

Complications late in your recovery:

  • Thickening of the posterior part of the capsular bag. This can occur at any time after IOL VIP implantation. The new lens implanted in your eye cannot develop cataract like your natural lens, but some patients develop similar symptoms of mistiness over time. This is easily corrected with a simple and painless laser procedure known as YAG capsulotomy, which allows light once again to pass without interruption to the retina.

  • Retinal detachment. This is a sight-threatening condition in which the retina becomes separated from the inner wall of the eye. In most cases the retina can be re-attached and vision restored, but action should be taken promptly. If you notice floaters, flashing lights or a shadow blocking out part of your field of vision, you should contact us immediately or attend the Eye Casualty Department.

  • Glaucoma. Any ocular surgery can increase the risk of glaucoma in later years. Glaucoma is damage to the main optic nerve of the eye, caused by an unsuitably high pressure in the eye. It can nearly always be controlled with eye drops, although prolonged or even indefinite use may be required.

  • Dry eyes. This is a common symptom with increasing age, for which many sufferers use simple lubricating drops. Interfering with the conjunctiva on the surface of the eye can upset the production of mucus, which is an important constituent of the tear film. In most cases this is temporary, responding to simple measures such as ocular lubricants and warm compress bathing. We will advise you on a treatment regime if required.

Information explaining how to care for your eye together with contact telephone numbers will be given to you on discharge from hospital.

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