Major Surgical Procedures
MERSI physicians perform the following surgical procedures:
The most advanced cataract surgery available: small incision, sutureless, with topical anesthesia per patient preference, employing state-of-the-art intraocular lens implants, especially those best tolerated for patients with a history of uveitis and/or glaucoma. Our surgeons also offer the latest Premium Lifestyle lenses.
Laser Cataract Surgery
Femtosecond Laser now offers patients the new standard in precision cataract surgery with the CATALYS Precision Laser System. Using CATALYS, the surgeon can provide a gentle, highly customized cataract procedure with precision not achievable with traditional manual techniques. This allows patients the opportunity to receive tailored treatment with advanced technology multi-focal lenses, which may reduce the need for glasses or contacts after surgery.
Amniotic membrane grafting, anterior segment, reconstruction, corneal transplantation, keratoprosthesis, pterygium excision, and limbal stem cell transplantation for ocular surface reconstruction are all performed on an ambulatory outpatient basis.
Glaucoma laser surgery, trabeculectomy filtering surgery, express shunt, endoscopic cyclophotocoagulation (ecp) and valve-tube surgery performed on an ambulatory outpatient basis.
Diagnostic and therapeutic pars plana vitrectomies with and without endolaser or epiretinal membrane peeling for patients with uveitis, diabetic retinopathy, retinal detachments, or epiretinal membranes are performed on an ambulatory outpatient basis. Admission may be required depending on the complexity of the case, which may also apply to scleral buckling or other vitreo-retinal surgeries.
Major surgeries are performed at the following facilities:
Minor Surgical Procedures at MERSI
The minor operating room at MERSI provides patients with the convenience of certain procedures to be performed in the comfort of the office without the need to travel to a separate facility. The minor operating room is the setting for procedures such as:
• Intravitreal injections (steroid, antibiotic, antiviral, antiangiogenic)
• Lid/conjunctival excisions or removal of surface lesions
• Conjunctival resection with biopsy
• Keratectomy with tissue adhesive to ulcerating cornea
• Laser iridotomy
• Forcep epilation and electro-epilation
• Blepharotomy for blepharitis
• YAG laser capsulotomy
• Argon laser photocoagulation
GENERAL PRE-OPERATIVE INSTRUCTIONS
1. You will need to have a pre-operative physical within one month of surgery. You will be given information to bring to your doctor regarding any testing that may be needed in addition to your physical.
2. The night before surgery, have nothing to eat or drink after midnight unless instructed otherwise. In the morning, if you have medications to take, you may do so with a small sip of water. If you are a diabetic, please discuss with the physician what medication you should take before surgery.
3. Please make arrangements for someone to take you home following surgery. You may only be released to a responsible adult.
4. If you have any questions or are uncomfortable about your surgery or become ill, please call prior to the surgery date.
GENERAL POST-OPERATIVE INSTRUCTIONS
For 12 hours following surgery do not operate an automobile or other machinery. You may wish to start eating lighter, with liquids and progressing to your regular diet as tolerated by your stomach.
Unless directed by your surgeon, do not remove your eye dressing and do not begin your eyedrops until after your first post-operative appointment.
You may take Tylenol or any other non-aspirin containing pain reliever as needed every 4 hours for pain. Continue your regular medications as directed by your physician including any eyedrops prescribed for the other eye.
If you have pain that is not significantly relieved by Tylenol or any other non-aspirin containing pain reliever within 45 minutes, please call the doctor oncall, 617-621-6377, available 24 hours a day.
Your first post-operative appointment will be the day following surgery. At this time, your dressing will be removed, and your eye will be examined. Your post-operative care schedule and medications will be reviewed.
Bathe or shower: For 3 weeks, do not get water or soap in the eye. To protect the eye from soap or water, please patch the eye securely with tape covering being careful not to apply pressure or have someone else shower hair by tipping head back in sink like at hairdresser.
For 3 weeks, do not bend at the waist to pick up objects on the floor. If you must, squat or bend at the knees and use your hand to stabilize yourself. Do not lift anything over 10 lbs.
For 3 weeks no vigorous, heavy, or strenuous activity/exercise; no swimming.
Post-operative Eye Care
Cleansing of the eye
Wash your hands before caring for the eye. If the lids are sticky or itchy, they may be gently cleaned with a cotton ball moistened with sterile water. Wipe from your nose toward you ear, in one direction only. Be careful not to rub or put pressure on the eye.
Protection of the eye
The operated eye should be protected at all times by either glasses (prescription or
sunglasses) or the metal shield for two weeks unless told otherwise.
For 2 weeks, the metal shield should be worn over the eye while sleeping.
Avoid sleeping on the side of your operated eye for 3 weeks.
Wear sunglasses outdoors; this is a good practice to employ for life for eye health regardless of surgery
How to use Eye Medications
Directions for use of your drops or ointment are on the label of the bottle or tube. Record the name of your medication in case the medicine is lost or spilled. Refrigerate drops only when the label has instructions to do so.
You must use your medications as often as the doctor has instructed. Unless you have been told to awaken and use medication during the night, medications are intended to be used during waking hours. Plan a schedule and make every effort to use the medicine as close to the prescribed time as possible.
Carry your medicines with you whenever you are away from home and continue to use them as usual. Be sure to bring them to your doctor at each visit and ask for any change in instructions.
It is not unusual for eye medications to sting or burn slightly for a few minutes when they are first used. Eye ointments may cause vision to be temporarily blurred, and may cause prolonged burning.
Instructions for Eye drops
1. Always wash your hands before putting drops in your eyes.
2. Shake the eye medication well if labeled to do so.
3. Carefully open the medication container. Be sure the tip of the dropper does not touch anything!! Place the cap on its side on a flat surface.
4. Tilt your head back, or if needed, lie down comfortably on your bed.
5. Place the ridge of the eyedrop bottle on the bridge of your nose with the dropper facing over the affected eye.
6. Look up. (If your eye is swollen, pull your lid down gently, forming a pocket between your eye and your lid.)
7. Squeeze bottle
8. Close your eye gently for 5 minutes.
9. Replace cap.
10. If you are using more than one medication, wait 5 minutes between each drop.
Instructions for Ointment
1. Always wash your hands.
2. Remove the cap from the tube and place it on its side on a flat surface. Be sure the
applicator end of the tube does not touch anything. To ensure that the ointment going into the eye is sterile, you may want to squeeze a small amount of it onto a wet cotton ball. Discard the cotton ball.
3. Hold the ointment in one hand and with the fingers of the other hand; pull down the lower lid of the eye.
4. Hold the applicator end of the tube close to the eye, but not touching and squeeze the
ointment in a ribbon about 1/2" along the inside of the lower lid while you look up.
5. Carefully replace the cap on the tube.
The following steps are recommended before using your eye drops or ointments:
1. Always wash your hands.
2. Wet a cotton ball with sterile water or saline.
3. Close the operated eye.
4. Wipe the eye gently from the inner corner outward, being careful not to apply pressure.
As you are making your plans, keep in mind that your post-operative visit the following day will be at MERSI, 1440 Main Street, Suite 201, Waltham, MA 02451. A list of hotels in Waltham is available here.
Parking is available at all centers or you can arrange to have a taxi deliver you to the front door. Surgisite of Waltham offers car service for free, please ask if interested.
It is not advisable to plan your transportation via MBTA.
You should be accompanied by another adult to assist you in returning home safely and to provide care at home.
On the day of surgery you will go through a brief check-in before being prepared for surgery.
After surgery you will rest in the recovery room. When the nurses feel you are ready you may dress, receive discharge instructions and medicines, rejoin your companion and leave the hospital.
Many health insurance policies require that you complete certain steps before you have surgery or are admitted to the hospital. It is extremely important that you understand these requirements so that you receive full financial coverage from your health insurance plan. In many cases prior authorization is required or you may be expected to pay a deductible or coinsurance to the surgeon and/or the surgical facility.
Please feel free to ask for clarification on what your health insurance plan may or may not cover by calling our Surgical Counselor, Debbie Davis, at 781-907-7927.