Ophthalmology Surgery

Question 1

What is the best operation in terms of QOLYs?

Answer 1

Cataract surgery

Question 2

What operation is most commonly done for cataracts in the UK?

Answer 2

Extracapsular lens extraction and phacoemulsification

Question 3

What anaesthesia is used for cataract surgery?

Answer 3

Local injected or anaesthetic eye drops

Question 4

What post-operative care is needed for a pt after cataract surgery?

Answer 4

Topical abx, topical steroids, avoid strenuous activity.

Question 5

What is phacoemulsifiaction?

Answer 5

Liquification of hard lens by ultrasonic probe which is extracted, then soft lens fibre is removed by aspiration

Question 6

Are sutures needed for cataract surgery?

Answer 6

No - for standard cataract surgery the hole is small enough to heal without sutures.

Question 7

What kind of cataract surgery does use sutures?

Answer 7

Intracapsular extraction - plastic lens is stitched into place at the sulcus.

Question 8

What are the complications associated with cataract surgery?

Answer 8

They are all rare and minor:

• Inadequate correction of refractive error
• Posterior capsule rupture
• Endophthalmitis
• Anterior chamber/vitreous/choroidal haemorrhage
• Posterior capsule opacification

Question 9

What is the prognosis for cataracts treated with surgery?

Answer 9

95% will have 6/12 best corrected vision

Question 10

What are the steps to local injections in the eye?

Answer 10

• 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

Question 11

What complications may occur from local injections into the eye?

Answer 11

Red eye or small conjunctival haemorrhage which should begin to resolve soon.

Question 12

Why might eyelid surgery be needed?

Answer 12

Skin around eye loses elasticity and muscles slacken which affects the function of the eyelid.

Question 13

What is blepharoplasty?

Answer 13

Eyelid reduction which removes surplus skin and protruding fat

Question 14

Is a blepharoplasty performed under local or general anaesthetic?

Answer 14

Either

Question 15

Where are the incisions made for blepharoplasty?

Answer 15

Along the natural lines of the eyelids

Question 16

What are the complications of eyelid surgery?

Answer 16

• Haematoma
• Infection
• Blindness (very very very very rare)

Question 17

What is the basis of refractive error correction surgery?

Answer 17

Modifying the shape of the cornea or inserting a lens to perform the correction.

Question 18

What types of surgery can be used to correct refractive errors?

Answer 18

• Keratotomies (incisions made in cornea to change shape)
• Implant of new lens
• Laser surgery

Question 19

How common is re-treatment for refractive error correction surgery?

Answer 19

10% as a result of under or over-correction of error.

Question 20

How long should be left between original surgery and second treatment for refractive errors?

Answer 20

At least 3 months for cornea to heal and refraction to stabilise.

Question 21

What are the complications associated with surgery to correct refractive errors?

Answer 21

• Astigmatism
• Anisometropia
• Presbyopia
• Glare or halo
• Reduced corneal sensitivity
• Dry eyes

Question 22

What surgical interventions can be performed for thyroid eye disease?

Answer 22

• Orbital decompression
• Strabismus surgery
• Lid-lengthening surgery
• Blepharoplasty

Question 23

Why does orbital decompression often need to be performed in thyroid eye disease?

Answer 23

Extraocular muscles and orbital fat expands secondary to autoimmune hyperthyroidism (Grave’s disease) attacking the tissues and causing inflammation.