1 / 22

CHAPTER 16

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.

fritz
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. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CHAPTER 16 Ophthalmic Surgery

  2. 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

  3. 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

  4. 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

  5. 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)

  6. 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

  7. 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

  8. 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

  9. Instruments, Routine Equipment, and Supplies (cont’d.) • Needle holders • Castroviejo: locking or nonlocking • Refer to Figure 16-3 • Microsurgical needle holder

  10. Instruments, Routine Equipment, and Supplies (cont’d.) • Scalpels • Graefe cataract knife • Keratomes • Razor fragments • Diamond knife • Oscillating knife • Beaver blades • No. 15 knife blade

  11. 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

  12. 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

  13. 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)

  14. 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

  15. 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

  16. 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)

  17. 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

  18. Surgical Intervention • A variety of surgical procedures and approaches are available • There are elements of consistency in every ophthalmic procedure • Practical considerations • Procedural considerations

  19. Surgical Intervention (cont’d.) • Procedures • Laparotomy  • Surgical repair of chalzion • Transconjunctival approach • Surgical repair of entropion • Iridectomy • Strabismus correction: recession/resection • Adjustable suture surgery

  20. Surgical Intervention (cont’d.) • Scleral buckle • Dacryocystorhinostomy • Enucleation • Keratoplasty (corneal transplant) • Cataract extraction • Extracapsular • Intracapsular • Vitrectomy • Repair of traumatic eyelid laceration

  21. 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

More Related