CATARACT EWAP JUNE 2023 27 patients know preoperatively that they’ll have a 24- to 48-hour recovery with their vision. She stresses that each eye will heal differently. Dr. Braga-Mele said she likes to use a quote she learned from Dee Stephenson, MD: “Your eyes are like sisters, but they’re not twins.” She said patients understand that right away. “Each eye will heal differently and react differently to the procedure. The minute you say it’s normal, that alleviates a lot of the tension for the patient,” she said. She added, “Most patients forget what I told them, so you have to reiterate right after the second eye is done.” When Dr. Braga-Mele sees patients the morning after surgery, she’ll immediately address this. “I’ll say that it’s completely normal for the second eye to seem like it took longer.” Dr. Braga-Mele also does bilateral same-day cataract surgery, though not on all of her patients, and she plans to start a study looking at whether the second eye has any issues with this. In her experience, when patients have bilateral same-day cataract surgery, they don’t compare eyes as much and treat it more like one procedure. No matter the timing between the procedures, Dr. Braga-Mele stressed the importance of educating the patient preoperatively, as well as right after the second eye on day 1 postop. “Patients will sometimes think they need to see immediately after surgery,” Dr. Braga-Mele said. “I always say, ‘You don’t have a hip replacement and expect to run a marathon the next day, so you can’t have eye surgery and expect to see perfectly the next day.’” She sets the expectation of 1–3 months. Most importantly, Dr. BragaMele said you need to under promise and over deliver, and “you definitely have to do that more for the second eye than the first eye.” Patients are generally more at ease going into the second procedure and expect vision to recover quickly while also comparing it to the first eye. The comparison is the problem, so that’s why patient education is so important. EWAP References 1. Venkateswaran N, et al. Comparison of patient perceptions of first- and second-eye cataract surgeries. J Cataract Refract Surg. 2021;47:819–820. 2. Adatia FA, et al. Documenting the subjective patient experience of first versus second cataract surgery. J Cataract Refract Surg. 2015;41:116–121. Editors’ note: Dr. Braga-Mele is Professor of Ophthalmology, University of Toronto, Toronto, Canada. Dr. Finklea practices at Wills Eye Hospital, Philadelphia, Pennsylvania. Neither declared any relevant financial interests.
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