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35 Cards in this Set
- Front
- Back
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Why would a patient with dementia have additional risk oof cataract surgery post-op copmlications?
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Risk of rubbing the eye=increased risk of endophthalmitis & wound leak
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What activities should you recommend the patient refrain from post cataract surgery?
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1. no lifting more than 20lbs for 2 weeks
2. no bending past the waist 3. no tap water in the eyes |
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How long should a cataract patient wear a shield to keep tap water out of the eyes?
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2 weeks
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How long does a cataract surgery patient use antibiotic? vigamox or zymar
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1 day prior and 1 week post op
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How can using anesthesia cause temporary diplopia?
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restricts EOM motion, have the patient wear a patch for 1-2 days (until the anesthetic wears off)
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What side effect results when iris/ciliary sensation is relieved with intracameral lidocaine?
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mild amaurosis, loss of vision
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What does intracameral administration of a drug mean?
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into the anterior chamber
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Is deafness, limited cooperation, language incompatifibility with the surgeon, and prolonged suirgery/complex cases consideredabsolute or relative CI to topical anesthesia?
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Relative (Absolute CI: Allergy)
Need peribulbar for longer procedures |
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What is the preferred type of phaco incision? Where is the incision usually made?
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clear cornea (63% preferred), commonly done temporally where the k-diameter is the greatest
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Since the cornea is horizontally oval, where would you put your incision to relax a steeper cornea at 180?
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nasal and temporal
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Which corneal limbus is located more posteriorly, temporal or superior limbus?
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temporal limbus. A temporal incision induces less astigmatism than a superior incision
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How does a scleral pocket incision lower the risk of endopthalmitis compared to CCI?
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longer tunnel than CCI produces a better seal
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Why does a scleral tunnel procedure require more anesthesia?
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because you must cauterize
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Why is a scleral pocket incision easiser to convert to an ECCE when compared to a CCI?
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deeper anesthesia is in place
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What is the average central corneal thickness?
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540-550 microns
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Why does LRI have a less predictable response in younger patients?
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they heal differently (more inflammation)
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What % Povidone Iodine is used in the cul-de-sac, lids, and lashes prior to a CCI? What percent will this decrease the risk of endopthalmitis?
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5%, will decrease the risk of endopthalmitis by 75-80%
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Which 2 sustances are given intracamerally during a clear corneal incision?
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1% nonpreserved Lidocaine followed by viscoelastic
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Which type of phaco surgery is less likely to cause wound burn, due to less thermal energy induced?
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torsional phaco: It works at a lower frequency than traditional phaco, smaller incision, decreased repulsion, decreased turbulence, increased cutting efficiency
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Which type of phaco doesn't get material bouncing off the back of hte cornea as much....more efficient at sucking up floating material?
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torsional phaco
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What is a corneal would burn usually caused by?
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indadequate flow through the phaco tip
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Where do you make a scleral relaxing incision to minimize inducedastigmatism
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just peripheral to the k-incision
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If the posterior capsule is ruptured, you need to clean up as much vitreous as possible. What substance will stain the vitreous making it easier to see and s;uck out?
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kenalog
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What do you call separation of the iris from the iris root?
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iridodialysis
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What can be done for damaged IOL haptics?
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If the haptic becomes damaged, you must get a new IOL
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What type of hemorrhage is worse with larger incisions (ECCE) and may occur secondary to any intraocular surgery?
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suprachoroidal hemorrhage
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What are the symptoms of suprachoroidal hemorrhage?
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severe pain and loss of vision
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What is the big clue that a suprachoroidal hemorrhage may have occured? What do you do about it?
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shallowing of the anterior chamber, if the AC starts to collapse during surgery inject more viscoelastic
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What are the risk factors for a suprachoroidal (expulsive) hemorrhage?
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atherosclerosis, HTN, DM, >70 years of age, cough, strain, struggle, vitreous loss during surgery, and IOP>18 and HR>85
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What medications are used to manage a suprachoroidal hemorrhage?
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diamoxx and mannitol (IV)
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What effect does intraoperative floppy iris syndrome have on dilation
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Intraoperative floppy iris syndrome makes it difficult to get a good dilation because of ineffective pupil stretch.
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Hypermature cataracts may require indocyanine green (ICG) stain. ICG is used to stain which part of the lens? How do you get it out?
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lens capsule, ICS is washed out with viscoelastic
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Why does a limbal relaxing incision have a less predictable response in younger patients?
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they heal differently (more inflammation)
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What % Povidone Iodine is used in the cul-de-sac, lids, and lashes prior to CCI? What percent does this decrease the risk of endopthalmitis?
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5%, will decrease the risk of endopthalmitis by 75-80%
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What two substances are given intracamerally during a CCI?
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1%
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