Ординатура / Офтальмология / Английские материалы / Basic Principles of Ophthalmic Surgery_Arnold_2006

232

skin preparation,101 wrong-site surgery,88-89

Ophthaine. SeeProparacaine

Ophthalmic anesthesiaSee.Anesthesia

Ophthetic. SeeProparacaine

Orbital surgery,215-216,220

Oval eye pads,203

"Oxygen tent," 93

p

Pain management,217

Parabulbarblock, 125,126f

Patient(s)

comfort of, 15 draping of, 106,108f expectationsof, 3-4

postoperativeinstructions, 212-213 preparation of

informed consent.SeeInformed consent medical clearance,13

in office, 11-13

in operating room, 13-15 safetyissuesand concernsfor. SeeSafety

Issues selectionof, 7-8

surgeonmeeting with, 14,19-20 treatment-relateddecisionmaking by, 7

Patientpositioning

children, 34

chin-down position, 32[, 32-33

chin-up position, 32f description of, 15

"eye parallel to floor" position, 31[, 31-32,34

on head rest,31[,33 head rotation, 33 infants, 34

local anestheticblocks, 15 for microscope,15,31-34 problems in, 33-34

reverseTrendelenburgposition, 33-34, 34f

Perfluorooctane,177

Peribulbar block

complications of, 218-219 technique for, 123-125,124f

index

Phacochopper,70[

Phacoemulsihcationcataractextraction

clearcorneal incisions, 150-151,

155-157,156[ description of, 147-148

scleral tunnel incision, 154,155[

Photocoagulation,175-176

Pigtail probe, 60[

Plateletderived groWth factor, 187

Polyestersutures,79, 79t

Polyglactin sutures,78, 78t, 194,195t Polypropylene sutures,76, 79, 79t, 195t

Polysorb sutures,78, 78t

Pontocaine.SeeTetracaine

Positioning

of bed,38,39[ of hands,46-47

of patient. SeePatientpositioning of surgeon,35-38

Posteriorcapsulepolishers,70[

Postoperativecare

anterior segmentsurgery,214,216 examinations,216-217

eyelid surgery,215-216 lasersurgery,215,217 orbital surgery,215-216 pain management,217

retinovitreous surgery,215,217 strabismussurgery,214-216 timing of, 213-214

Postoperativeinstructions, 212-213

Postoperativemanagement,211-221

Povidone-iodine, 101-102

Preoperativediscussions,12-13

Pressuredressings,207-208

Probes,60[

Procedure.Seea/sospecificprocedure

discussionabout, 12 informed consentabout, 12

surgeon'sfamiliarization and understanding of, 20

Proparacaine,115,lISt

Propofol,114

Proteases,186

Proteoglycan, 190

Pulmonary disease,6

index

Punches,69[

Punctatekeratopathy, 114-115

Pupil distance,50

Q

Quickertlacrimalprobe,60[

R

Red reflex, 29-30, 218

Re-epithelialization,188-189

Refractive keratotomy, 191

Regional anesthesia

adjuvant agentsfor, 118-119 advantagesof, 121,121t agentsfor

bupivacaine,116t,117 description of, 116-117

etidocaine,116t,117-118 lidocaine, 117 mepivacaine,116t, 117

centralnervous systemspreadof, 130 complications of, 130

description of, 121 disadvantagesof, 121,121t epinephrine for, 118,118t hyaluronidase for, 118,118t parabulbarblock, 125,126[ patient selectionfor, 121

peribulbar block, 123-125,124[,218-219 retrobulbar block. SeeRetrobulbar block sodium bicarbonate for, 118t, 119

Rehabilitation, 12

Remodeling of wound, 189

Residentin training, 7-8

Retinovitreous surgery,215,217,220 Retractors,58,58[

Retrobulbar block complications of, 218-219

description of, 122,123[, 125 Retrobulbar hemorrhage,129 Reversecutting needles,81,82[

ReverseTrendelenburgposition, 33-34,34[, 173 Ruedemanlacrimal dilator, 61[

Running horizontal mattresssutUre,168,168[ Running subcuticular sutUres,169[,169-170

Running sutUre,167[-168[, 167-168

233

S

Safetyissues anesthesia,114 bulletins for, 87

intraocular lens placementerrors, 89-90 medication errors, 91-93, 93t operating room fires

cautery units, 94,95[

combustible substancesfor, 94-96,95[ elementsnecessaryfor, 93-94 oxygen-enrichedenvironment and,

93-94

patient preparationsto prevent, 96 wrong-site surgery,88-89

Scissors,61,61[-62[

Sclera

perforation of, 129-130 wound healingof, 193-194

Scleralblades,72[-73[

Scleraltunnel incision, 154,155[

Screw-type speculums,59[

Scrubbing of hands,22-23, 103-105,104[ Scrubtechnician,105

Secondintention, wound healing by, 184,184[

Sedation,113-114

Seeleyflat-shapedhydrodissection

cannula,69[

Sheathhematoma,218

Shouldermuscles

hand stabilization and,40-42

"shrugging" of, 41,42[ Silicone oil, 177

Silk sutures,77-79, 79t,195t

Simplecontinuous (running) suture, 167[- 168/, 167-168

Simpleinterrupted suture, 164,165[

Simplesquareknot, 159-162,161[

Sinskeyhook, 65[

Skin preparation, 101-102

Sleepdeprivation, 21

Sodium bicarbonate,118t, 119

Sodium hyaluronate, 177

Spatulaneedles,81-83,82[

Spatulas,67,67[

Speculums,58,58[-59[

Stabknife blades,71f