Chapter 16
This presentation is the property of its rightful owner.
Sponsored Links
1 / 22

CHAPTER 16 PowerPoint PPT Presentation


  • 62 Views
  • Uploaded on
  • Presentation posted in: General

CHAPTER 16. Ophthalmic Surgery. Objectives. After studying this chapter, you will be able to: Recognize the anatomy of the eye Summarize the pathology that prompts surgical intervention of the eye and related terminology Determine any special preoperative preparation procedures.

Download Presentation

CHAPTER 16

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Chapter 16

CHAPTER 16

Ophthalmic Surgery


Objectives

Objectives

  • After studying this chapter, you will be able to:

    • Recognize the anatomy of the eye

    • Summarize the pathology that prompts surgical intervention of the eye and related terminology

    • Determine any special preoperative preparation procedures


Objectives cont d

Objectives (cont’d.)

  • Indicate the names and uses of ophthalmic instruments, supplies, and drugs

  • Indicate the names and uses of special equipment

  • Determine the intraoperative preparation of the patient undergoing an ophthalmic procedure

  • Summarize the surgical steps of ophthalmic procedures


Objectives cont d1

Objectives (cont’d.)

  • Interpret the purpose and expected outcomes of the ophthalmic procedure

  • Recognize the immediate postoperative care and possible complications of the ophthalmic procedure

  • Assess any specific variations related to the preoperative, intraoperative, and postoperative care of the ophthalmic patient


Introduction to ophthalmic surgery

Introduction to Ophthalmic Surgery

  • Ophthalmic surgery

    • Specialty of microsurgery since

    • Involves use of the microscope on the majority of procedures and microinstruments

  • Surgical technologist

    • Must have knowledge of how to set up and run the microscope, and be familiar with other specialty equipment (e.g., phaco machine)


Introduction to ophthalmic surgery cont d

Introduction to Ophthalmic Surgery (cont’d.)

  • Surgical technologist must also have fine motor skills

    • Properly handle small instruments without damaging them

    • Properly pass small instruments to the surgeon in position of use so he/she does not have to look up from the microscope


Introduction to ophthalmic surgery cont d1

Introduction to Ophthalmic Surgery (cont’d.)

  • Surgical technologist must become used to looking through the microscope

    • Assist the surgeon during procedure (e.g., irrigating the eye, cutting a small-diameter suture, etc.)

  • Purpose of this chapter

    • Familiarize the student with the ophthalmic procedures commonly performed as preparation for surgical rotation


Instruments routine equipment and supplies

Instruments, Routine Equipment, and Supplies

  • Forceps

    • Colibri forceps

    • Nontoothed forceps

    • Bishop-Harmon iris forceps

      • Refer to Figure 16-1

    • Desmarres chalazion forceps

      • Refer to Figure 16-2


Instruments routine equipment and supplies cont d

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Needle holders

    • Castroviejo: locking or nonlocking

      • Refer to Figure 16-3

    • Microsurgical needle holder


Instruments routine equipment and supplies cont d1

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Scalpels

    • Graefe cataract knife

    • Keratomes

    • Razor fragments

    • Diamond knife

    • Oscillating knife

    • Beaver blades

    • No. 15 knife blade


Instruments routine equipment and supplies cont d2

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Hooks and retractors

    • Scleral hooks: scleral retraction

    • Kilner hook: reconstructive surgery

    • Desmarres lid retractors

      • Refer to Figure 16-4

    • Iris retractor

    • Eye speculum


Instruments routine equipment and supplies cont d3

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Scissors

    • Westcott scissors; spring action microscissors

    • Small spring scissors

    • McPherson-Vannas iris scissors

      • Refer to Figure 16-5

  • Miscellaneous

    • Bowman probe

      • Refer to Figure 16-6


Instruments routine equipment and supplies cont d4

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Routine equipment

    • Ophthalmic stretcher with attachable wrist rest for the surgeon

    • Donut for positioning the head

    • Electrosurgical unit (ESU)


Instruments routine equipment and supplies cont d5

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Special equipment

    • Phacoemulsifier: uses ultrasonic energy to fragment the hard lens material, which then can be aspirated from the eye

    • Operating microscope: magnifies surgical site through use of lenses

    • Vitreoretinal system: provides light, suction, diathermy, and intraoperative access to the surgeon


Instruments routine equipment and supplies cont d6

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Argon OR Nd:YAG laser: used for photocoagulation or photodynamic therapy

  • Cryotherapy unit: uses localized cold temperature to seal tears and holes much as a diathermy unit; CO2 gas passed is under pressure through flexible tubes to the tip of a probe


Instruments routine equipment and supplies cont d7

Instruments, Routine Equipment, and Supplies (cont’d.)

  • Routine supplies

    • Prep set

    • Eye or head and neck back table pack (depending on procedure)

    • Wexcel sponges

    • Sterile gloves

    • Sterile cotton swabs

    • Suture material (surgeon’s preference)


Instruments routine equipment and supplies cont d8

Instruments, Routine Equipment, and Supplies (cont’d.)

  • BSS

  • 27- and 30-gauge disposable needles, straight and angled

  • Needles and sutures

    • Refer to Tables 16-1 and 16-2


Surgical intervention

Surgical Intervention

  • A variety of surgical procedures and approaches are available

    • There are elements of consistency in every ophthalmic procedure

      • Practical considerations

      • Procedural considerations


Surgical intervention cont d

Surgical Intervention (cont’d.)

  • Procedures

    • Laparotomy 

    • Surgical repair of chalzion

    • Transconjunctival approach

    • Surgical repair of entropion

    • Iridectomy

    • Strabismus correction: recession/resection

    • Adjustable suture surgery


Surgical intervention cont d1

Surgical Intervention (cont’d.)

  • Scleral buckle

  • Dacryocystorhinostomy

  • Enucleation

  • Keratoplasty (corneal transplant)

  • Cataract extraction

    • Extracapsular

    • Intracapsular

  • Vitrectomy

  • Repair of traumatic eyelid laceration


Summary

Summary

  • This chapter reviewed:

    • The pathology that prompts surgical intervention of the eye

    • Ophthalmic instruments

    • Special equipment

    • Surgical steps of ophthalmic procedures

    • Preoperative, intraoperative, and postoperative preparation and care


  • Login