Procedures Flashcards
AC lens placement
LPI at 12
LPI at 6 - when
DSEK/DMEK, silicone oil
ALT - parameters
0.1s duration. 50 micron spot. 300-1000 mW power
Gonioscopy - what distinguishes
appositional vs synechial vs plateau angle closure
Which lens can be used to measure the optic disc diameter with a slit beam by directly reading off the slit-lamp scale?
Volk Super 66
Which structure is the most tolerated in terms of touching the endothelium?
Iris
Goldmann aplanation after scleral buckle - higher, lower or the same
inaccurately low (reduced ocular rigidity)
Goldmann aplanation ain scleral scar - higher, lower or the same
inaccurately high
Goldmann aplanation in corneal edema - higher, lower or the same
inaccurately low
Goldmann aplanation in soft contact lens - higher, lower or the same
inaccurately low
What is the threshold pupil diameter below which generalized depression artifacts may occur?
2.5mm
Which location is associated with the highest frequency of bleb-related infections after trabeculectomy?
inferior
size 0 target - area
1/16mm2
size I target - area
1/4mm2
size II target - area
1mm2
size III target - area
4mm2
size IV target - area
16mm2
size V target - area
64mm2
Conditions with high likelihood of trabeculectomy failure
younger age, uveitic glaucoma, neovascular glaucoma, aphakic galucoma, chemical burns, scarred conjuctiva
TSCPC - settings
17-19 applications. 270 degrees. power 1.5-2.0 W. duration 2 seconds
Indirect gonio lenses
Goldmann, Posner, Zeiss
Direct gonio lenses
Koeppe
Laser trabeculoplasty - effectiveness at 1 year and 10 years
80%, 30%
How to better visualize the nerve fiber later
red-free filter on the direct ophthalmoscope
narrow in Van Herick
distance between anterior iris and posterior cornea is 1/4 or less of the corneal thickness
Argon laser iridoplasty - parameters
0.1-0.5s. duration; 200-500 micron spot size; 200-500 mW power
YAG LPI - parameters
start with 1.0 mJ
Selective laser trabeculoplasty - parameters
3 ns duration; 400 micron spot size; 0.4-1.0 mJ power
Humphrey 30-2 and 24-2 programs - points how many degrees apart
6 degrees
What measures absolute RNFL thickness
HRT, OCT
What measures relative RNFL thickness
scanning laser polarimetry (GDx)
HRT =
confocal scanning laser ophthalmoscopy
GDx =
scanning laser polarimetry
Which method takes advantage of the nerve fiber layer’s natural birefringence?
scanning laser polarimetry (GDx)
antifibrotic agents are effective in…
filtering procedures (NOT effective in drainage implants)
antifibrotic agents increase risk of…
blebitis/endophthalmitis, hypotony maculopathy
Fornix-based trabeculectomy
at the limbus, technically easier, risk of wound leak. lower, more diffuse blebs, fluid posterior
Limbal-based trabeculectomy
incision 8-10mm posterior to the limbus (fornix), technically more difficult. bleb more focal and elevated. less prone to leaks
What is the most common complication after trabeculectomy?
cataract
Valved shunts
Krupin, Ahmed
Non-Valved shunts
BMW: Baerveldt, Molteno, Wthout valve
Glaucoma after scleral buckle - features
may choroidal effusion and anterior rotation of the ciliary body. flattening of peripheral iris with relatively deep central AC. blood in Schlemm’s canal (increased EVP), LPI not effective –> adjust or release tension of the scleral buckle
Glaucoma after panretinal photocoagulation (PRP) - mechanism
ciliary body become thickened and rotated anteriorly
unique complication of ECP compared to TSCPC
endophthalmitis, sympathetic ophtalmia
SLT in PEX
effective, less power needed, shorter effect, more post laser IOP spikes
