Ординатура / Офтальмология / Английские материалы / Basic Principles of Ophthalmic Surgery_Arnold_2006
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basic |
principles |
of ophthalmic |
surgery |
Strabismus Surgery
Complications of strabismussurgeryinclude
~Overand under-corrections (documentation,observationfor stability, prisms, possible reoperation)
~Scleralperforations (evaluationfor retinal tear or detachment,retinovitreous surgeryif necessary)
~Lost or torn muscles(surgicalexploration and repair)
~Anterior segmentischemia(anti-inflammatory therapy)
Eyelid and Orbital Surgery
Complications of eyelid and orbital surgeryinclude
-+ Orbital hemorrhage(emergentcantholysis,possible orbital exploration) -+ Optic nervedamageafter orbital surgery (neuroimagingto assessfor
bone fragments,intrasheathhemorrhage,possiblereoperation for optic nerve sheathdecompression)
-+ Orbital cellulitis (neuroimagingto assessfor abscess,systemicantibiot-
ics,possible surgicaldrainage)
-+ Eyelid hematoma(ice) or infection (systemicantibiotics)
-+ Lagophthalmosand exposurekeratitis (intensivelubricants, possible surgicalrepositioning)
Retinovitreous Surgery
Complications of retinovitreous surgeryinclude
-+ Failure to achieveretinal reattachmentor closure of holes or tears
(observe,possible reoperation)
-+ Intraocular hemorrhage(observe,possiblereoperation) -+ New retinal tears (re-treatment)
-+ Intraocular pressureelevation,particularly when long-acting gasesare used(pressure-loweringagents)
1 |
Chapter 5 |
1. d |
1. b, c |
2. Cardiac disease,systemic |
2. a,b, d |
hypertension, pulmonary |
3. b, d |
disease,diabetesmellitus, |
4. b.c.d |
altered mentalstatus |
|
3. a,b, c |
6 |
|
|
2 |
1. a,b |
2. a,b, d |
|
1. b |
3. a,c |
2. d |
4. a,c,d |
3. f |
|
Chapter 3 |
Chapter 7 |
1. a,b, c,d |
|
1. b, c,d |
2. b, c |
2. Exercise,sleepdeprivation |
3. a,b, d, e |
3. True |
4. a,b,c,d |
4. a,b |
|
Chapter 4 |
Chapter 8 |
1. a,b |
|
1. d |
2. b,d |
2. a,d |
3. b |
3. a,c,e,f |
4. a,c |
4. a,d |
5. d |
223
Chapter
Index
Pagenumbersfollowed byf denotefigures; thosefollowed by t denotetables.
A
Absorbable sutures,77-78, 78t
Accommodation, 52
Acetylcholine, 141
Adjuvant agents,118-119
Advertising,8
AkTaine.SeeProparacaine
Ak- T-Caine. SeeTetracaine
Alcaine. SeeProparacaine
Alcohol, 102
Altered mental status,7
Alternatives to surgery,12
American Heart Association, 13
Aminoglycosides,143
Amphotericin, 142
Anaphylatoxins,186
Anesthesia
brainstem, 130
central nervous systemspreadof, 130 complications of
centralnervous systemspreadof anesthesia,130
extraocularmuscle trauma,218 injection into eye,218 injection into optic nerve,218 malignanthyperthermia, 131 oculocardiac reflex, 131 retrobulbar hemorrhage,129 scleralperforation, 129-130 strabismus,130
general,109,125-127,127t hypotensive, 173
intracameral,142
local. SeeLocal anesthesia overview of, 113 patient'sunderstanding of, 12 regional. SeeRegionalanesthesia safetyduring, 114 specialrequirements or concerns,14 topical. SeeTopical anesthesia
Anesthetic blocks administration of, 15 parabulbar,125,1261 patientpositioning and, 15
peribulbar
complications of, 218-219 technique for, 123-125,1241
retrobulbar
complications of, 218-219 technique for, 122,123[, 125
Anethaine.SeeTetracaine
Angiogenesis,187-188
Anterior chamber,viscoelasticinjection into, 137
Anterior chamberirrigating cannula,681 Anterior segmentsurgery.SeealsoCataract
surgery complications of, 219
examinationafter,216 postoperativecarefor, 214
Antibiotics, 142-143
Antifungals,142-143
Anti-inflammatories, 196 Antiproliferative agents,196-197 Antiseptic agents
application of, 102,1031 types of, 101-102
Anti-transforming groWth factor-B2, 197 A-scan ultrasonography,119
Aseptic techniques draping, 106,1081 gloving, 105-106,1071 gowning, 105-106
hand scrubbing,22-23, 103-105,1041 history of, 101
Atkinson's needle,122,124
B
Barraquercilia forceps,63[
Barraqueriris spatula,67[
Barraquerneedleholder,68[
Barraquerwire, 58[
Basementmembrane,188
225
228 |
index |
Epithelial cells description of, 185 wound healingof, 191
Epithelial growth factor, 188
Epithelialization, 188
Ethical considerations,7-8
Etidocaine, 116t,117-118
Exercise,21
Extracapsularcataractextraction description of, 147-148 incisions for, 150,153f
wound construction, 152-153,153f Extracellular matrix, 187,189,196 Extraocular muscletrauma, 218
Eyelid clamp,59f
Eyelid surgery,215-216,220
"Eye parallel to floor" position, 31[, 31-32, 34
Eye shields description of, 204
nonpressuredressingwith, 205f-207[, 205-207
placementof, 206f-207f
Flat-shapedhydrodissection cannula,69[ Fl\!id-gas exchange,177
5-Fluorouracil,196 Forceps,63,63[-65[, 75
Forearm scrubbing, 104
Frown incision, 151,151[
G
Gauze,204
Generalanesthesia,109,125-127,127t
Glaucoma surgery,214,219
Globe puncture, 218
Gloving, 105-106,107f
Glutathione, 140
Gowning, 105-106
Granulation tissue
formation of, 187-188 illustration of, 184,184f
Growth factors, 187-188,197 Guidelinefor Preventionof SurgicalSite
Infection, 101
Gut suture,77, 77t, 195t
F
Facial nerveblocks description of, 127
Nadbath-Ellis block, 128f, 129
O'Brien block, 128,128f
Van Lint block, 127-128,128f
Family members,12
Fibrin, 190-191
Fibrin degradationproducts, 186
Fibrinogen, 176
Fibroblast, 185,187,191
Fibroblast growth factor, 197
Fibroin, 78
Fibronectin,190-191
Field of view, 54
Fire in operating room cautery units, 94,95f
combustible substancesfor, 94-96,95f elementsnecessaryfor, 93-94 oxygen-enriched environment and,93-94 patient preparations to prevent, 96
First intention, wound healing by,
183-184,184f
H
Hand(s)
poor positioning of, 46--47 scrubbing of, 22-23, 103-105,104f stabilization processfor
large arm muscles,40-42 raisedelbows and,42
relaxation of smallhand muscles,44-45 shoulder muscles,40-42 stepsinvolved in, 40-41
at wrist, 43-44,44f Hand grip, 44,45f Hand lifting, 46
Hand tremor caffeineand,22
counter touch with nondominant hand to
reduce,45,46f
hand stabilization to minimize. See Hand(s), stabilization processfor
"Hang back" technique, 194 Head rest, 31[,33
Head rotation, 33
Healing of wound. SeeWound healing
