#1 Ofloxacin (antibiotic, tan top, 5.0mL/80 drops). Take one drop in procedure eye four times daily – typically breakfast, lunch, dinner, and bedtime – for one week, then stop.
#2 Prednisolone (steroid, pink/white top, 5.0mL/80 drops). Take one drop in procedure eye four times daily – typically breakfast, lunch, dinner and bedtime – for two weeks, then decrease to two times daily for 2 weeks, then stop. It is important to work off this drop gradually to avoid rebound inflammation, or an increase in inner eye inflammation that is common after abrupt discontinuation of steroid medication. You can expect to have some crusting on your eyelashes after using this drop. Notify a Brinton Vision doctor if you have used steroid medicines before or if you start a new steroid medication (pill, cream, mist, inhaler, injection, prednisone, etc.) while taking the drops above. This combination can lead to a painless increase in eye pressure and vision loss. As long as you are taking a steroid eye drop you need to have your eye pressure checked in our office no less than every 4 weeks.
#3 Prolensa/Bromsite (NSAID, grey top, 3.0mL/5.0mL). Take one drop once a day at bedtime for four weeks then stop.
#4 Twist-top vials of preservative-free artificial tears Conveniently purchase through pharmacy with other post-operative drops, over the counter, or online. Take one drop 4x per day for 1 month, then taper as needed. These vials can be recapped for multiple uses (9-11 drops per vial), however throw away and use a new vial on the next day. Space out the antibiotic, steroid, NSAID, and artificial tear drops by approximately 5 minutes to avoid “washing out” the previous medication.
For patients with following medical history only: including history of diabetes, uveitis/eye inflammation, macular edema, retinal vein occlusion, retinal detachment, epiretinal membrane/retinal wrinkling – notify a Brinton Vision doctor. We recommend a longer post operative drop regimen to prevent inflammation that can affect your vision. Separating each eye procedure out by 3 months may be recommended by your Brinton Vision doctor. For patients with this medical history only: use #1 as listed above. #2 and #3 will be adjusted as follows with additional drop #4. Use artificial tears as described above under #4.
#2a Durezol/prednisolone (steroid, 10mL, 160 drops) Shake before using. Take one drop 4x daily for 2 weeks, 2x daily for 4 weeks, 1x daily for 2 weeks, then stop.
#3a Prolensa/Bromsite (NSAID, grey top, 3.0mL/5.0mL). Take one drop once a day at bedtime for nine weeks, starting one week prior to procedure and ending eight weeks after procedure.
#4a timolol 0.5% (maintains normal eye pressure, 15mL contains 300 drops) one drop 2x daily for 8 weeks (while taking steroid), then stop. Space out the antibiotic, steroid, NSAID, pressure drop, and artificial tear drops by approximately 5 minutes to avoid “washing out” the previous medication.
On day of the procedure, vision will appear blurry and should improve with time.
At the conclusion of your procedure we commonly use a medicine (Miostat) to return your dilated pupil size back to normal. This sometimes causes a temporary headache sensation. Your pupil may appear small and colors and lights may look dimmer for a day or two. The vision can also be unrealistically clear. These temporary effects go away and the vision settles into a natural place as the medicine wears off over the course of 2 to 10 days.
For 1 week: tape eye shield securely over eye while sleeping to prevent bumping or rubbing. Avoid Valsalva maneuver, where neck veins bulge and face turns red, which can be associated with heavy lifting or strenuous physical activity. After 1 week you may gradually return to normal activity.
You may notice flickering of lights when eyes are open, a blurred “crescent moon” toward the outer edge of your eye, fogginess, and some soreness following the procedure.
You may have a few red spots (like a broken blood vessel) on the white part of your eye around the edges outside the iris (colored part of your eye). These typically resolve on their own as your eye heals.
Sometimes this procedure is performed one eye at a time on separate days. If this is the case for you, in between procedures, you may 1) go without correction, 2) wear your current pair of glasses as-is, 3) wear your current pair of glasses and remove the lens over the eye that just had the procedure, 4) wear your own contact lens in the eye that has not had a procedure, or 5) have us place one of our contact lenses in the eye that has not had a procedure, which you may remove at night or sleep in if your second eye procedure is within 2 weeks. We will typically replace this lens in office at your 1 week post op appointment.
You may be surprised that the second eye procedure feels different. This should not be concerning. Most patients are more aware the second time around since they know what to expect.
If you experience light flashes, new or increasing floaters, cobwebs, or a shade/shadow/curtain/veil in your vision, report this promptly to Brinton Vision.
Special Instructions Specific to the Light Adjustable Lens
The RxSight Light Adjustable Lens (LAL) is similar to other intraocular lenses (IOLs) that can be implanted in your eye during CLR. The LAL reduces the need for glasses or contact lenses by being able to change its focusing power after it is implanted in the eye. The focusing power of the LAL is adjusted by a specific patterns of ultraviolet (UV) light produced by the RxSight Light Delivery Device (LDD), an instrument that your doctor uses in the office beginning 4 weeks after surgery. Up to three light adjustment treatments can be performed to improve your vision, with a separation of 1 to 2 weeks between treatments. When your doctor is satisfied with your visual outcome, the same LDD is used to lock-in the LAL and make the prescription
From immediately after surgery until 24 hours after the completion of the lock-in treatment, you will need to protect the LAL from UV light in the environment by wearing protective eyewear during all waking
Immediately after surgery, you must wear the special UV protective eyewear provided to you. The protective eyewear will protect the LAL from UV light from the sun and other UV sources that are common both indoors and outside. Before the LAL is locked in, you can experience a loss in vision if you are exposed to daylight or any other UV light source when you are not wearing protective eyewear.
Two pairs of UV protective eyewear will be provided to you, a clear pair and a dark tinted pair. When indoors, the clear pair must be worn at all times, as it is not always possible to know which light sources may affect the lens. Before moving outside, the clear eyewear must be changed to the dark tinted eyewear as sunlight carries a greater risk of changing the shape of the lens in an uncontrolled manner.
You do not have to wear the dark tinted pair outside at night, as there is no sunlight, however, you do need to wear the clear pair at night to protect the LAL from other UV light sources. The UV protective eyewear must be worn until your doctor tells you that you no longer need to wear them (usually 24 hours after final light treatment).
If you do not wear the required protective eyewear, the light treatments may not improve vision or may make your vision worse. If this happens, the LAL may have to be removed and replaced with a new lens to improve vision. This can lead to other complications from the additional surgery.