Hello, my name’s Tristan McMullen, I’m an eye surgery, specialising in surgery in and around the eye, particularly with eyelids and the face and I do cosmetic work as well.  I’ve been asked to talk about the care following surgery, post operative care and I’m quite particular about this because I think it can affect the results, particularly the speed of healing.  Obviously, the patient’s expectations are high and they want to get back to work or whatever it is and the more you can accelerate that, the better. Another perhaps more important point, one has to think about the safety of the surgery and post operative care is vital in this regard. 

I usually patch, as in apply an eye patch to one eye, I have yet to apply it to both eyes but I do warn patients that sometimes that might be an eventuality so they could wake up after surgery with both eyes covered. I usually cover whichever eye bruises more during surgery because there’s usually one eye that’s a little bit more bruised and oozy than the other and I have this patch applied and taken off in the morning.  Then I am very strict, probably a little bit too strict about ice.  I like patients to use ice 20 minutes of every waking hour which is a very tall order but it’s very easy to spot the patients that do and the patients that don’t follow this protocol.  The patients that apply ice for the first three post operative days usually look a lot better a lot quicker and after three days, I have them switch to hot compresses, 15 minutes, three times a day until the bruising goes which is obviously a much easier regime to follow. The ice can be either ice in a ziploc bag with water or perhaps easier still is just frozen peas wrapped up in a clean cloth which can be applied. You can have two bags of peas on the go, one in use and one in the freezer and you can alternate those and use them every 20 minutes.  As I say, it does make a big difference.

With regard to care after surgery, I have patients keep their head above their heart. I ask them particularly to avoid heavy lifting or bending so there’s no point, as I had last week, operating on a patient who’s proposing to move house so he had the choice; move the operation or move house so he’s postponed his surgery.  The rationale behind that is to prevent bruising and swelling or even bleeding behind the eyes which is the dreaded complication.

The sutures normally get removed at five to seven days and that’s usually arranged in-house and I have patients apply antibiotic ointment to the incision lines three times a day and I usually ask them to do this for two weeks, by which time they shouldn’t need any more.  Patients often have dry eye following surgery for a limited period and I have them use artificial tears by day on an as and when needed basis, i.e., if their eyes are feeling a bit gritty and scratchy, I get them to use the drops but most importantly, I get them to use a preparation called Lacrilube at night which I think should be used for approximately a month after surgery. 

Otherwise it’s rather patient depending, I usually advise patients they’re going to be bruised for a week and swollen for two and their return to work rather depends on the nature of the work; whether it involves physical labour or heavy lifting or whether it’s VDU use which can lead to dry eye. So that I usually discuss on a case by case basis but if patients expect to be bruised for a week and swollen for two, they usually find that that’s a rather conservative estimate and they’re usually, particularly if they use the ice, the swelling and bruising resolves much more quickly. I give that as an outside guideline so they’re not disappointed, if anything, they’re pleasantly surprised how quickly they heal.  Thank you.