Cataract Surgery

Cataract Surgery

Cataract surgery is currently one of the most common and successful surgical procedures. In cataract surgery, the natural lens of the eye, which has become cloudy, is replaced with a transparent artificial lens. The technique commonly used for cataract surgery today is phacoemulsification. In this technique, ultrasound waves are used to break up the lens.
The instrument used to break up the lens is thin and enters the eye through an incision of about 3 millimeters. Since this incision is very small, stitches are usually not required, and it heals on its own. After removing the cloudy lens, a clear artificial lens is inserted into the eye and fixed in the appropriate place. The surgery typically lasts around 10 to 15 minutes and is usually performed under local anesthesia or general anesthesia.
Surgery is generally performed when cataracts cause a decrease in vision that interferes with daily activities.

Post-Surgery Care
        • The patient is usually asked to visit the doctor on the same day or the following day for a check-up and dressing removal.

        • Depending on the type of surgery and the doctor’s decision, the patient may be instructed to use a plastic shield, especially while sleeping. The shield is washable; wash it daily with soap and water, and after drying, place it on the eye using an elastic band or tape. During the day, sunglasses can be used.

        • Eye drops and oral medications are prescribed to the patient, and based on the doctor’s recommendation, these medications are gradually discontinued over a month. Medications should be used as directed.

        • To relieve pain, take the prescribed painkillers according to the doctor’s instructions.

        • In the first few weeks after surgery, the patient should not rub their eyes. They should also avoid applying pressure to the eyes. Never clean the eyes with rough fabrics or paper towels, as this could scratch the cornea.

        • On the day of surgery or the following day, you can resume your regular activities, such as reading books and watching TV. However, to evaluate your vision and determine the prescription for new glasses, you should wait 3 to 4 weeks. Consult your doctor about when to start driving.

        • Ask your doctor about showering, but you can wash the body, excluding the head and face, starting from the first day after surgery.

        • When washing your head and face (according to your doctor’s guidance), keep your eyes closed and do not apply pressure to the eyelids. Use baby shampoo and soap regularly.

        • Avoid using cosmetics (such as eyeliner, mascara, false eyelashes, etc.). Ask your doctor when it is safe to resume using them.

        • You can pray from the first day using either dry ablution (Tayammum) or ablution with a bandage, but avoid prostration for a week. Use your hand to bring the prayer mat close to your forehead.

        • There is no need to change your diet after surgery. Just prevent constipation by eating enough fruits, vegetables, and drinking plenty of water. Avoid foods that cause gas.

        • Neither cold nor hot weather will harm the operated eye.

        • If you experience eye pain, redness, sensitivity to light, vision loss, or pus discharge, immediately consult your doctor. If you cannot reach your surgeon, go to an emergency eye clinic.

        • After cataract surgery, follow-up exams are necessary. During these visits, the ophthalmologist will assess the results of the surgery and reassure you about the ongoing recovery of the eye.

Post-Surgery Complications
        • Although cataract surgery is one of the least complicated surgeries, problems can occasionally arise. These complications can range from vision loss to mild inflammation. Vision loss is very rare, but it can occur due to inflammation, bleeding during surgery, or retinal detachment, which may happen months or even years after surgery. Most complications are minor, such as corneal or retinal swelling, increased intraocular pressure, and eyelid inflammation, which can be treated with medication.

Vitrectomy

Anatomy of the Retina

The retina is the innermost layer of the eye and contains light receptors and neurons. This thin layer covers 75% of the inner surface of the eyeball.
The retina includes two types of cells: cone cells, which are responsible for color vision, and rod cells, which are responsible for vision in low light. The macula is a part of the retina located along the optical axis of the eye and plays a role in visual accuracy and sharpness.

? How does the retina work
      • After light enters the eye and passes through the lens, it eventually reaches the retina. The retina acts like the film in a camera. When light rays hit the retina, they are converted into neural signals and sent to the brain, where they are interpreted, allowing the eye to see.

? What is a Vitrectomy
        • Vitrectomy is a type of eye surgery used to treat certain retinal and vitreous disorders. The vitreous is a transparent, gel-like substance that fills the middle of the eye. Vitrectomy surgery often improves or stabilizes vision.
          During this surgery, the vitreous is removed and typically replaced with a solution.

Common Symptoms
        • The following symptoms usually occur in one eye but may affect both eyes:

          • Flashing lights in the field of vision
          • Blurred vision
          • Wavy or distorted images (sometimes)
          • Blind spots
          • Sudden vision loss

Cervical Disc

Causes of Cervical Disc Herniation

Any pressure on the spine can cause damage. Lifting heavy objects, improper sitting postures, and keeping the head down for extended periods can contribute to cervical disc herniation. Individuals with neck stiffness are at a higher risk of developing this condition.

Symptoms
      • Patients with cervical disc herniation often experience joint pain, burning sensations, numbness, or tingling in the hands. The location of the pain varies depending on which disc is herniated and which nerve is affected.

Recommendations After Cervical Disc Surgery
        • When reading, keep your reading material elevated. Stand up every 30 minutes while working.

        • Do not lift objects weighing more than one kilogram. Keep objects close to your body when lifting them.

        • Walking is allowed starting the day after surgery, and activity levels should gradually increase based on tolerance.

        • Avoid using your mobile phone unless necessary.

        • While driving and sleeping, use a soft foam cervical collar. Rest on a firm mattress with an orthopedic pillow at a height that aligns the head and neck with the body. Both prolonged immobility and excessive activity that strains the muscles can be harmful.

        • Never sleep on your stomach. When getting out of bed, first turn onto your side, then lower your legs off the bed, sit up, and stand. Follow the reverse steps when lying down. You can support your head with one hand while changing positions to reduce pressure on the neck.

        • Avoid exposing the wound to water for at least five days after surgery.

        • Postoperative pain at the surgical site is normal for several weeks. If radiating pain in the arms has decreased or improved, it indicates a successful surgery. The surgical site pain will gradually subside. However, tingling in the hands may persist from before the surgery or appear after surgery, requiring one to two months for improvement.

How to Take Care of Yourself at Home
        • Take your medications as prescribed. If you are taking anti-inflammatory drugs, take them with food, and inform your doctor if you experience blurred vision or ringing in the ears.

        • Consult your doctor before starting physical therapy or exercise.

        • Perform prayers while seated at a desk, raising the prayer stone to your forehead.

        • Eat foods rich in vitamin C and protein

Avoid
        • Driving, standing, or sitting for more than 30 minutes at a time.

        • Bending your neck. If necessary, straighten it periodically. Adjust your chair height or raise your desk to avoid excessive neck flexion.

        • Wearing inappropriate footwear; use shoes with medium-height heels

Post-Discharge Instructions
          1. Take your medications on time.

          2. Check the movement, sensation, and color of fingers and toes, especially the hands.

          3. Use a chair when sitting.

          4. Consume milk and dairy products.

          5. Use a Western-style toilet and prevent constipation.

          6. Keep the stitches clean and dry, covering them with a dressing. Change the dressing daily.

          7. After cervical disc surgery, wear a cervical collar continuously for six weeks.

          8. Avoid bending the neck forward or backward and refrain from rotating it.

          9. Avoid sleeping on your stomach. Keep your head in a stable position and refrain from using too many pillows, as they may cause unintended neck bending.

          10. Contact your doctor immediately if you experience any of the following symptoms:

          • Fever

          • Chills

          • Redness or discharge from the surgical site

          • Increased pain

          1. Wash your neck twice a day with mild soap.

          2. Always wear your cervical collar unless advised otherwise by your doctor. When removing it, keep your neck stable.

          3. Avoid driving until permitted by your doctor. Refrain from long car trips, as the vibrations can negatively affect the spinal cord.

          4. When looking from side to side, move your entire upper body along with your neck. The neck should always remain in a stable position.

Warning Signs - Seek Immediate Medical Attention If You Experience
        • Any discharge from the surgical site

        • Unusual swelling at the surgical site, hands, or feet

        • Persistent fever for more than two days

        • Severe headache

        • Allergic reactions to medication, such as itching, redness, or gastrointestinal symptoms

        • Difficulty urinating or loss of bladder control

        • Severe and progressive arm pain, especially if accompanied by weakness or difficulty walking

        •  

Spinal Fixation: Pre- and Post-Surgery Care

? What is Spinal Fixation

Fixation means stabilizing the vertebrae of the spine using screws and plates to reduce pain and improve movement.

If the vertebrae in your back or neck have issues and their movement causes pain, your doctor may recommend spinal fixation surgery.

? Why is this Surgery Beneficial for Me
      • Reduces pain and pressure on the nerves
      • Improves movement and function of the back or neck
      • Prevents the spinal condition from worsening
? What Should I Do Before Surgery
      • Before Surgery:

        • Eat a light meal and avoid eating anything 8 hours before the surgery.
        • Complete all necessary tests and imaging.
        • Inform your doctor if you are taking any medications.
? What Care is Needed After Surgery
      • After Surgery:

        • Rest, but stay active: Start walking gradually in the first few days to prevent muscle weakness.
        • Sleeping position: Lie down with your knees slightly bent.
        • Avoid lifting heavy objects!
        • Wear a brace or neck collar (if prescribed by your doctor).
        • Physical therapy: Specific exercises will help you recover faster over time.
? What Symptoms Are Concerning and Require a Doctor’s Attention
      • If you experience any of the following, contact your doctor immediately:

        • Severe and unbearable pain
        • Significant numbness or weakness in the arms or legs
        • High fever or abnormal discharge from the surgical site
? What is Life Like After Surgery
        • After a few months, you can gradually return to daily activities.
        • Light exercises like walking and swimming help strengthen the back.
        • Intense activities like weightlifting are prohibited unless approved by your doctor.

Post-Discharge Recommendations for Lumbar Disc Surgery

Introduction

The lumbar spine is involved in nearly all body movements, particularly standing and sitting, making it vulnerable to injury or post-surgical pain. Therefore, patients should follow these essential guidelines after surgery

Dear Patient, Please Follow These Instructions After Discharge
      • If your doctor has prescribed a lumbar brace, always wear it before walking.
      • Resuming daily activities, work, and driving must be approved by your doctor.
      • Your diet should include fresh vegetables, fruits, lean meats, and dairy products.
      • If you are overweight, consider a special diet after your recovery period.
      • To prevent weight gain due to reduced mobility after surgery, avoid starchy foods (such as rice, potatoes, sweets, pasta) and high-fat foods.
      • Avoid bending, twisting, or rotating your torso during the first four weeks after surgery.
      • After each shower, change your wound dressing using sterile techniques.
      • Light leg exercises can be started from the second day after surgery.
      • Physical therapy and exercise are very beneficial after surgery. However, start them only after consulting your doctor.
      • Eat a diet rich in vitamin C and protein to support healing.
      • Take only the medications prescribed by your doctor. Avoid self-medication. If you experience pain, use the prescribed painkillers.
      • Contact your doctor immediately if you experience any of the following:
        • Discharge from the surgical site
        • Chills or fever
        • Persistent back pain that does not respond to painkillers
        • Progressive numbness or weakness in the lower limbs
      • Visit your doctor 7-10 days after discharge for a follow-up.
      • Stitches should be removed 8-10 days after surgery with your doctor’s approval.
      • Showering is allowed 48 hours after surgery, and water contact with the wound is not problematic.
      • Avoid lifting heavy objects.
      • Use a Western-style toilet (sitting toilet).
      • Sleep on a flat, medium-firm mattress (avoid very soft or very hard mattresses, as well as foam or spring mattresses; a cotton mattress is recommended).
      • Use a chair when sitting, ensuring your back is fully upright. Avoid sitting on sofas.
      • Walking is allowed from the second day after surgery and should gradually increase over the following days.
Additional Instructions
      • Change the wound dressing every three days (only once).
      • Check for sensation and movement in the lower limbs regularly.
      • Take medications on time.
      • Use a Western-style toilet.
      • Avoid driving for at least one to two months.
      • Refrain from sexual activity for three months

Scoliosis and Surgical Care

? What is Scoliosis

Scoliosis is an abnormal lateral curvature of the spine, causing it to appear in an “S” or “C” shape. This condition can occur in any part of the spine but is most commonly seen in the thoracic (chest) or lower back region. Scoliosis may develop during childhood or adolescence and, if progressive, can lead to complications such as back pain, physical deformities, and, in severe cases, respiratory problems.

 

Surgical Methods for Scoliosis
    • Scoliosis surgery aims to correct spinal curvature, stabilize the spine, and prevent further progression. The most common surgical procedure is spinal fusion, in which the affected vertebrae are fused to form a solid bone. To achieve this, the surgeon uses bone grafts along with implants such as rods, screws, and hooks to align and stabilize the spine.

      This surgery is typically performed posteriorly (from the back), but in some cases, anterior (from the front) or a combination of both approaches may be used. The choice of surgical method depends on the location and severity of the curvature, the patient’s age, and other individual factors.

Preoperative Care
    • Medical Evaluations:

      • Comprehensive Examination: The doctor reviews the patient’s medical history and conducts a physical examination.
      • Imaging Tests: X-ray, MRI, or CT scans are performed to assess the spinal curvature in detail.

      Physical Preparation:

      • Physical Therapy: Specific exercises recommended by a physiotherapist to strengthen muscles and improve flexibility.
      • Healthy Nutrition: A well-balanced diet rich in vitamins and minerals to boost immunity and promote healing.

      Psychological Preparation:

      • Counseling: Discussing surgery details, benefits, risks, and postoperative expectations with the doctor.
      • Emotional Support: Consulting a psychologist if needed to reduce anxiety and stress related to surgery.

      Pre-Surgery Instructions:

      • Fasting: Avoid eating and drinking at least 8 hours before surgery.
      • Hygiene: Take a shower with an antiseptic soap the night before and the morning of the surgery.
      • Medications: Inform the doctor about all medications being taken and follow instructions on whether to continue or stop them before surgery.
Postoperative Care
      • Pain Management:

        • Medications: Use prescribed pain relievers to control postoperative pain.
        • Non-Pharmacological Methods: Deep breathing, meditation, and music therapy can help reduce pain and stress.

        Physical Activity:

        • Early Mobilization: Begin moving and walking under medical supervision as soon as possible to prevent complications such as blood clots.
        • Restrictions: Avoid lifting heavy objects, bending, or twisting the back until permitted by the doctor.

        Wound Care:

        • Hygiene: Keep the surgical site clean and dry and change dressings as instructed by the doctor.
        • Infection Monitoring: Check the wound daily for redness, swelling, discharge, or foul odor and report any abnormalities.

        Nutrition:

        • Diet: Consume foods rich in protein, vitamin C, and calcium to support healing and strengthen the immune system.
Returning to Daily Activities
        • Timeline: Returning to routine activities such as work or school may take several weeks to months, depending on medical advice.
        • Exercise: Begin light physical activity with the doctor’s approval and avoid contact sports or strenuous activities until full spinal recovery.
Warning Signs After Surgery
      • Contact your doctor or healthcare provider immediately if you experience:

        • Severe and persistent pain that does not improve with painkillers or worsens over time.
        • Signs of infection: Fever above 38°C (100.4°F), chills, redness, swelling, or discharge from the surgical site.

Limb Amputation

Amputation

Amputation refers to the removal of a part of the body or a limb

Causes of Amputation
    • Amputation may be necessary due to severe infections resistant to treatment, accidents, congenital or acquired deformities, frostbite, malignant tumors, diabetes, or gangrene caused by bites. However, the most common cause is progressive vascular disease.

      The purpose of amputating a damaged (necrotic or gangrenous) limb is to preserve the remaining healthy parts of the body. Diagnostic tests such as angiography or Doppler ultrasound can help determine the appropriate level of amputation.

      After surgery, the patient remains under medical supervision in the hospital for 3 to 7 days. Elderly individuals or patients with additional health conditions may require a longer stay. The main objectives of this recovery period include:

      1. Pain management
      2. Wound care
      3. Muscle contraction and relaxation exercises
      4. Training on safe bed mobility to prevent complications
      5. Training on walking with crutches and assistive devices
      6. Learning to manage daily activities independently
Early Complications of Amputation
    • 1. Infection:

      Infection may occur after any amputation surgery.

      • Superficial infections may resolve with antibiotic treatment.
      • Deep infections may require another surgery to remove dead and infected tissue.
      • In some cases, removing a few stitches at the surgical site can help drain secretions and improve infection control.

      2. Necrosis (Tissue Death) in the Stump:

      The stump is the remaining part of the amputated limb.

      • Sometimes, poor blood circulation in part of the stump can lead to tissue death and blackened skin.
      • The dead tissue must be surgically removed to prevent infection.

      3. Hematoma (Blood Collection):

      • A hematoma is a collection of blood within a closed space, usually caused by improperly sealed blood vessels.
      • In such cases, the hematoma must be drained, and the stump should be compressed with a bandage to prevent further bleeding.
      • If left untreated, a hematoma can increase the risk of infection.

      4. Blood Clots in the Limb’s Veins:

      To prevent deep vein thrombosis (DVT), patients may be prescribed anticoagulant medications as per the doctor’s recommendation.

Late Complications of Amputation
      • 1. Phantom Limb Sensation and Pain:

        Some patients continue to feel the presence of the missing limb, and in some cases, they may experience severe pain in the absent limb (phantom limb pain).

        2. Stump Pain:

        • Pain in the stump is caused by abnormal nerve growth at the amputation site.
        • Corticosteroid injections in the affected nerve may help reduce pain.
        • If pain persists, surgical removal of the nerve endings may be required.

        3. Joint Stiffness and Restricted Mobility:

        • If post-surgical stretching exercises are not performed correctly, the joint near the amputation site may become stiff and lose mobility.
        • Treatment involves physical therapy and stretching exercises to regain movement.
        • If therapy is unsuccessful, surgery may be needed.
        • Prosthetic limbs significantly aid the patient after healing.
Wound Care and Dressing
      • The type of wound care depends on the level of amputation:

        • Below-Knee Amputation:

          • The limb should be placed in a splint (orthosis) to maintain proper alignment.
          • Fluid drainage from the wound is necessary to prevent contractures, which can affect walking and the use of prosthetics.
        • Upper Limb Amputation:

          • The loss of arm function can make self-care activities such as eating, bathing, and hygiene maintenance more challenging.
Key Post-Amputation Care Guidelines
      • ✅ Use crutches or a walker for mobility.
        ✅ Follow a high-protein diet.
        ✅ Drink plenty of fluids.
        ✅ Keep the stump elevated above heart level to reduce swelling.
        ✅ Consider psychological counseling if needed.
        Change dressings daily.
        ✅ Report bleeding, fever, chills, or foul-smelling discharge immediately.