Ophthalmology Surgery Flashcards
What is the best operation in terms of QOLYs?
Cataract surgery
What operation is most commonly done for cataracts in the UK?
Extracapsular lens extraction and phacoemulsification
What anaesthesia is used for cataract surgery?
Local injected or anaesthetic eye drops
What post-operative care is needed for a pt after cataract surgery?
Topical abx, topical steroids, avoid strenuous activity.
What is phacoemulsifiaction?
Liquification of hard lens by ultrasonic probe which is extracted, then soft lens fibre is removed by aspiration
Are sutures needed for cataract surgery?
No - for standard cataract surgery the hole is small enough to heal without sutures.
What kind of cataract surgery does use sutures?
Intracapsular extraction - plastic lens is stitched into place at the sulcus.
What are the complications associated with cataract surgery?
They are all rare and minor:
- Inadequate correction of refractive error
- Posterior capsule rupture
- Endophthalmitis
- Anterior chamber/vitreous/choroidal haemorrhage
- Posterior capsule opacification
What is the prognosis for cataracts treated with surgery?
95% will have 6/12 best corrected vision
What are the steps to local injections in the eye?
- Anaesthetic drop administered
- Eye lids held open with a small spring (painless)
- Small incision made (painless)
- Injection performed
- Spring removed and pad placed over the eye
What complications may occur from local injections into the eye?
Red eye or small conjunctival haemorrhage which should begin to resolve soon.
Why might eyelid surgery be needed?
Skin around eye loses elasticity and muscles slacken which affects the function of the eyelid.
What is blepharoplasty?
Eyelid reduction which removes surplus skin and protruding fat
Is a blepharoplasty performed under local or general anaesthetic?
Either
Where are the incisions made for blepharoplasty?
Along the natural lines of the eyelids
What are the complications of eyelid surgery?
- Haematoma
- Infection
- Blindness (very very very very rare)
What is the basis of refractive error correction surgery?
Modifying the shape of the cornea or inserting a lens to perform the correction.
What types of surgery can be used to correct refractive errors?
- Keratotomies (incisions made in cornea to change shape)
- Implant of new lens
- Laser surgery
How common is re-treatment for refractive error correction surgery?
10% as a result of under or over-correction of error.
How long should be left between original surgery and second treatment for refractive errors?
At least 3 months for cornea to heal and refraction to stabilise.
What are the complications associated with surgery to correct refractive errors?
- Astigmatism
- Anisometropia
- Presbyopia
- Glare or halo
- Reduced corneal sensitivity
- Dry eyes
What surgical interventions can be performed for thyroid eye disease?
- Orbital decompression
- Strabismus surgery
- Lid-lengthening surgery
- Blepharoplasty
Why does orbital decompression often need to be performed in thyroid eye disease?
Extraocular muscles and orbital fat expands secondary to autoimmune hyperthyroidism (Grave’s disease) attacking the tissues and causing inflammation.
