Macular Hole
Post-Operative Instructions

It is normal for the eye to feel sore after surgery.  Over the first few days this will greatly improve.  It is okay to take Tylenol for discomfort.

 

A gas bubble is usually placed in the eye.  With the gas bubble it is normal to only see movement, this is similar to looking through a fish bowl.  Dr. Adatia usually has his patients’ position face down for the first 4 days after surgery.  You can get up to eat and to go to the bathroom, as well as to place drops.  After 4 days positioning is less important and you are asked to not sleep on your back, but on your sides or your belly.  It is important not to fly in an aeroplane until the gas is gone.  The changes in cabin pressure can cause the gas to expand which can cut off the circulation in the eye.  Similarly, if driving to the mountains, it is recommended you stop for 10 minutes every 30 minutes of driving to let the eye pressure stabilize.  Similarly diving is not recommended.

 

A blue band is placed on your arm and it is to remain until the gas bubble is gone.  This is like a medical alert bracelet informing paramedics and anesthetists that certain anesthesia is not to be used as it can cause the gas in the eye to expand. 

 

Three drops are required four times a day.  It is recommended that you take the drops at breakfast, lunch, dinner and bedtime.  You do not have to wake up in the middle of the night to take the drops.  It is important to wait about 3 to 5 minutes between the drops, as if one is placed right after the others, then the first drop can get washed out and it is as if it was never applied.

 

The drop regimen is typically as below:

Lotemax (Pink Cap): 4 times a day for one month.  Then stop.  This is a steroid drop to reduce inflammation.

 

Zymar (This is the smallest bottle): 4 times a day for at least one week.  It can be used longer, until the bottle is completed.  This is an antibiotic drop to reduce the risk of infection.

 

Prolensa: 4 times a day for two weeks, then stop.  This is a nonsteroidal anti-inflammatory drug (NSAID).

Sometimes, pressure drops are added, as often the pressure can be elevated post -surgery.  Dr. Adatia will inform you if this is needed.