How to prepare for eye surgery

GEM Clinic Surgeons offer both Cataract and Glaucoma surgery

Surgical Guidelines

At the time of your appointment, GEM Clinic will provide you with paper copies of all the surgical guidelines, information and forms you will need to properly prepare for your eye surgery. An overview of the same information is provided here on the website.

Date of Surgery

We will endeavor to give you at least one month's notice of your surgical date and time. Please be advised that due to the surgical wait list and limited OR time, we are unable to provide alternative times and dates barring medical emergencies or unforeseen circumstances. Please let us know ahead of time if you have any strong preferences against certain time periods (eg. due to planned trips or other surgeries).

If you have any questions or concerns about your upcoming surgery, please call GEM Clinic and ask to speak to surgical slating or contact them at slating@gemclinic.ca.

Arrival Time

Arrive 1.5 hours before your scheduled time of surgery, unless otherwise instructed. For example, if you have been given a surgery time of 9:30 AM, you will need to arrive at 8 AM.

Location of Surgery

Surgeries are performed at the Misericordia Health Centre.

Cancelations and rescheduled surgeries

When you eat or drink on the day of surgery, your surgery may be canceled or postponed. Please follow the preparation instructions carefully.

Occasionally, due to eye emergencies or other unforeseen circumstances, there can be sudden changes to the schedule. This could require us to reschedule your surgery date or time, even on the day of surgery.

If your surgery has to be rescheduled for whatever reason, we do apologize for the inconvenience and will endeavor to give you a close alternate date.

If you are unable to keep your scheduled date for surgery, please give us a minimum 1 week notice so that we have time to book a replacement.

Prior to your surgery date

• Fill out and submit the assessment questionnaire to GEM Clinic. If this questionnaire is not received at least 3 weeks prior to your procedure it may result in the cancelation of your surgery.
  • Assessment Questionnaire for Cataract Surgery ONLY
  • Assessment Questionnaire for Glaucoma surgery or Glaucoma & Cataract combined surgery
• Book a pre-operative history and physical examination with your physician (if required). The surgical history and physical examination form must be completed by your family physician. If this form is not received at least 3 weeks prior to your procedure it may result in the cancelation of your surgery.
  • Pre-operative Assessment for Cataract Surgery ONLY
  • Pre-operative Assessment for Glaucoma surgery or Glaucoma & Cataract combined surgery
• Consent Form: You will need to sign a consent form granting permission to do the surgery.
• Consider intraocular lens options: If you are having cataract surgery, an artificial lens is implanted at the time of the surgery. The cost of the standard lens that corrects your vision at one distance only (usually far distance) is covered by Manitoba Health. You will need glasses to see the intermediate and near distances and correct for any astigmatism. If you are a candidate and opt for a premium lens that corrects for astigmatism (Toric), for different distances (enhanced monofocal, Multifocal or Extended Depth of Focus - EDOF) or both, these are an extra cost to you and may require extra pre-operative testing. You may not be a candidate for these lenses if you are having combined cataract and glaucoma surgery. If you have not received any information on these options and are interested, please let us know. Watch video - The IOL that fits your daily life
• Home Care: If you have Home Care please notify our office. We will fax post-operative orders to them ahead of time. If you require Home Care assistance because you are unable to administer your own drops and do not have family members/friends to assist you, please let us know at least 2 weeks prior to surgery.
• Work/Disability/Insurance forms: If you require work, disability or insurance forms to be completed, please provide these forms at least 2 weeks prior to your surgery date. Failure to do so will result in delays in completing your necessary forms. Please be advised that our office charges $50 per form and you will be responsible for any charges incurred unless we are otherwise notified that a third party has arranged to cover these costs.
• Time off work: For cataract surgery, plan to take 1-2 weeks off work. For combined cataract and glaucoma surgery or any type of glaucoma surgery, plan to take 4-6 weeks off work.
• Vacations: Do not plan vacations without consulting our office in case this interferes with adequate time for post-operative care. For cataract surgery, we advise you not to travel for at least one month after surgery. For combined cataract and glaucoma surgery or any glaucoma surgery, we advise you not to travel for at least 2-3 months after surgery.
• Smoking: Do not smoke 3-4 days prior to the operation and 1 week afterwards as smoking delays and impairs the healing process.
• Stopping blood thinners: If you are having cataract surgery alone, you do not need to stop your blood thinners. If you are having combined cataract and glaucoma surgery, or any glaucoma surgery alone, you must stop your blood thinners in consultation with your family doctor or specialist (1 week for aspirin or Plavix (clopidogrel); 3 days for Coumadin (warfarin), Xarelto® (rivaroxaban) or similar drugs). You can restart them 3 days after surgery (unless otherwise stated). Some herbal medications such as St. John's Wort and Gingko biloba have blood thinning effects and should be stopped 1 week prior to glaucoma surgery.

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On the day of surgery

• Arrive 1.5 hours before your surgery time.
• Register at Admitting/Patient Registration on the 1st Floor, located near the Urgent Care entrance. You will be given some registration papers and a wristband. You will then be instructed to proceed to Day Surgery on the 4th floor.
• At Day Surgery on the 4th Floor, you will be prepared for surgery. You will be asked to wear a hospital gown and remove your shoes. The nurses will prepare you by confirming your details and starting some preparatory eye drops. The nurses will be able to give you an idea of when you will be ready to be picked up at this time, so you can tell your ride.
• At the time of surgery, you will be taken just outside the operating room where details will be briefly reviewed again, and your surgeon will meet you just before the surgery.
• Anaesthesia: Although you will be awake for the surgery, you will have IV (intravenous) sedation as needed to keep you comfortable. Freezing gel will be applied to your eye for all surgeries just before you enter the operating room. Local anaesthetic is applied around your eye for all glaucoma surgeries. Most people are very comfortable throughout the surgery. If you are claustrophobic or have breathing or back problems, please let us know and we will do our best to make you comfortable.
• Length of Surgery: Cataract surgery alone takes about 15-20 minutes. GATT time varies and can take about 10-30 minutes depending on various factors. KDB goniotomy usually takes about 5 minutes. XEN® and Preserflo™ surgery for glaucoma takes about 20-30 minutes. Trabeculectomy surgery takes about 30-40 minutes. Ahmed or Baerveldt implant surgery takes about one hour. Revisions of glaucoma surgeries vary and can take 15 minutes to an hour depending of the type of revision. Your surgeon will give you specific information for clarity.
• Recovery Time: After your operation, you will be taken to the Recovery area for about 30 minutes and then discharged home (unless an overnight stay is recommended).
• Instructions and Follow-Up: You will be given detailed instructions on what eye drops to use and an appointment for follow-up before you leave the hospital. Your post-operative prescription for drops will be faxed to your pharmacy before your surgery.
  • If you are having cataract surgery alone, you will be booked for a SAME DAY FOLLOW-UP appointment at GEM Clinic. You will need to see your own Optometrist one week later and also about 4-6 weeks after the surgery to update your glasses. You will see your surgeon if any problems arise.
  • If you are having a glaucoma surgery, or cataract surgery combined with glaucoma surgery, you will be given an appointment to see your surgeon the next day. If you are scheduled to stay overnight at the hospital, you can come to the clinic after being discharged from the hospital, unless your surgeon is able to see you at the hospital before you leave (this is not always possible due to tight scheduling).

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