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Nursing paper on phacoemulsification and intraocular lens implantation for cataract
Perioperative nursing of phacoemulsification and intraocular lens implantation Key words: cataract; Intraocular lens implantation; Phacoemulsification of cataract requires not only the superb skill of the operator, but also a lot of preparation work by ophthalmologists before and after the operation, so the perioperative nursing work of this operation plays a vital role in preventing infection and achieving the expected goal after the operation. Since 2000, the ophthalmology department of our hospital has successfully implemented phacoemulsification and intraocular lens implantation in cooperation with superior hospitals, and all of them have achieved satisfactory results. The nursing experience before and after operation is reported as follows. 1 clinical data 1. 1 patients in this group 102 cases, including 64 males and 38 females, the oldest being 78 years old and the youngest being 12 years old, including traumatic cataract 1 case and congenital cataract/kloc. 1.2 preoperative preparation 1.2. 1 ophthalmic examination: preoperative examination of vision, color vision, light positioning and intraocular pressure, so as to know the history of patients' eye diseases in detail, that is, etiology, time, infection, history of inflammatory attack, glaucoma, high myopia and other ophthalmic diseases, and then understand the history of external eye diseases. All the above diseases have an important influence on the surgical effect, so we should report to the doctor in time, do ophthalmic A-ultrasound examination and determine the choice of intraocular lens. 1.2.2 General examination: Patients should be given necessary routine examination before operation, such as chest X-ray, liver and kidney function, electrocardiogram and blood sugar examination. Ask about the patient's past history, pay attention to whether the patient has diabetes, properly control blood sugar before operation, measure the patient's blood pressure before operation, and report to the doctor in time, and ask the relevant specialist to handle it to decide whether cataract surgery is feasible. 1.3 preoperative patient preparation 1.3. 1 psychological preparation: because phacoemulsification is a new technology, patients know little about it. Nurses should take the initiative to introduce the advanced nature and reliability of surgery, and use appropriate language to explain preoperative preparation, how to cooperate during surgery, matters needing attention after surgery, and how to relieve patients' anxiety, fear and nervousness, so as to achieve the best physical and mental state. At the same time, we should warmly receive patients, talk with them in kind language and answer their questions in time.

1.3.2 Preoperative preparation: Generally, antibiotic eye drops are applied to the eyes 3 days before operation, 5-6 times a day, and the lacrimal passage is washed to observe whether there is secretion flowing out, the conjunctival sac is washed, and the eyelashes of the patients are cut off. After operation, ask the patient not to cough or sneeze. If you want to cough or sneeze, you can press the tip of your tongue against the maxilla to relieve the impulse, so as to avoid intraoperative bleeding and vitreous outflow, which will affect the surgical effect. 1.3.3 mydriasis: before operation 1h, compound tropicamide was applied to the eyes for 2 ~ 3 times, and the pupil should be expanded to 5 ~ 6mm. 1.4 postoperative care1.4./postoperative observation and care: after phacoemulsification, patients can get out of bed or go home to rest, but it is still very important to accurately understand and judge the early symptoms and signs of complications and take effective measures in time. After cataract surgery, especially after intraocular lens implantation, there will be different degrees of inflammatory reaction symptoms due to surgical stimulation, which is related to physical and chemical stimulation such as mechanical trauma during surgery. Routine treatment after 1.4.2: after d 1, change sterile gauze, and add dexamethasone 5mg to chloramphenicol eye drops, 4-6 times a day. If the reaction is serious, gentamicin and dexamethasone can be injected under the bulbar conjunctiva every day, and the drug can be stopped after the inflammation subsides. If the operation is smooth and the reaction is mild, mydriasis is not needed. If there is exudation in the anterior chamber, the pupil should be dilated. 1.4.3 life care: you can eat general food after operation, but you should eat less irritating food, don't drink alcohol, don't do strenuous exercise to avoid eye damage, give life care to the elderly and infirm, and don't wash your hair within 5 days after operation. 1.4.4 postoperative precautions: a few patients may have symptoms of intraocular lens foreign body reaction within 5 ~ 7 days after operation, and they should be required to go to the hospital for reexamination within 5 ~ 7 days. If there are symptoms such as eye pain, photophobia and conjunctival congestion, you should go to the hospital for examination at any time. If there is nothing unusual, you can go to the hospital for a long time. 1.5 Nursing care of surgical complications 1.5. 1 Nursing care of postoperative hyphema. Conservative treatment is generally used for postoperative hyphema. The key point of nursing is to guide patients to stay in bed, reduce activities, do a good job in life care, pay special attention to diet care, eat more fruit juice or semi-liquid diet, eat more crude fiber food, prevent dry stool and exert oneself when defecating. 1.5.2 secondary glaucoma, cataract, early intraocular pressure increase is very common, mostly due to excessive residual lens cortex blocking the angle of the chamber and residual viscoelastic agent blocking the angle of the chamber. Elevated intraocular pressure will cause permanent damage to the optic nerve, so it is necessary to order antihypertensive drugs in time and apply them all over the body. At this time, the patient's psychological burden is very heavy, which will produce very disappointed emotions. We should patiently give psychological counseling to patients, point out the negative influence of depression on intraocular pressure, and relieve psychological pressure in order to facilitate the early recovery of the disease.