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Lanjutan ke -2, ANESTHESIA FOR CATARACT SURGERY

VII. SPECIAL CONSIDERATIONS REGARDING ANTITHROMBOTICS The concern that patients taking antithrombotics before surgery might be at higher risk or perioperative bleeding must be balanced against the risk of stopping these drugs and increasing the risk of a life-threatening clotting complication (eg, stroke, myocardial infarction, pulmonary embolism or deep vein thrombosis). There have been several recent articles addressing this issue for…

Lanjutan ke -1, ANESTHESIA FOR CATARACT SURGERY

IV. EXTRACONAL BLOCK (SOMETIMES CALLED PERIBULBAR BLOCK) Several decades ago, when anesthesiologists began performing eye blocks more commonly, a technique was reported for placing local anesthetic purposely outside the EOM cone.Proponents of extraconal block suggest that it would be safer to routinely keep the tip of the needle further from the globe and intraconal components. These blocks were called “peribulbar”…

ANESTHESIA FOR CATARACT SURGERY

I. INTRODUCTION There are several commonly used techniques for providing analgesia, sedation, and anesthesia for patients undergoing cataract surgery. Anesthetists and ophthalmologists caring for these patients should be familiar with the benefits, risks, and technical considerations of these techniques. II. TOPICAL ANESTHESIA Topical anesthesia involves placing a local anesthetic eyedrop(s) on the cornea and conjunctiva, thereby…

Lanjutan ke -1, PREOPERATIVE EYEDROPS AND OTHER MEDICATIONS

IV. DILATING DROPS Adequate dilation of the pupil prior to cataract surgery is critical in providing the surgeon a good red reflex, the opportunity to create an adequately sized capsulorrhexis, and safer phacoemulsification. While a number of different dilating drops can be used, a typical regimen consists of a moderately long-acting anticholinergic agent (eg, cyclopentolate 1%…

PREOPERATIVE EYEDROPS AND OTHER MEDICATIONS

I. INTRODUCTION Appropriate use of preoperative eyedrops is essential in providing a well-dilated pupil prior to cataract surgery and in minimizing the risk of endophthalmitis. Residents should develop a consistent approach to their preoperative regimen based on fundamental principles and the specific characteristics of a given procedure. Most cases of endophthalmitis following cataract surgery result…

Lanjutan ke – 5, CATARACT SURGERY: PREOPERATIVE EVALUATION

VI. SPECIAL CONSIDERATION FOR LASER CATARACT SURGERY As of this writing refractive laser-assisted cataract surgery (ReLACS) is just entering the marketplace. Although much is yet to be learned, the authors have significant early experience with ReLACS and can share some preoperative evaluative thoughts. The biggest difference using ReLACS is docking the patient interface to the eye with suction. Although,…

Lanjutan ke – 4, CATARACT SURGERY: PREOPERATIVE EVALUATION

V. SPECIAL CONSIDERATION FOR SPECTACLE INDEPENDENCE Recent advances in multifocal and accommodative IOL design have led to a tremendous increase in patient satisfaction with spectacle independence. However, the most critical part of ensuring success with these lenses is the preoperative evaluation. Appropriately identifying patient’s visual goals is always the first step to choosing the best IOL. However, the…

Lanjutan ke – 3, CATARACT SURGERY PREOPERATIVE EVALUATION

IV. PATIENT EXPECTATIONS As discussed throughout this chapter, individualized surgical planning must occur for each patient. Patients have varying visual requirements and expectations regarding cataract surgery. The most important conversation between the patient and the surgeon is to adequately address patient expectations. Key issues to address include postoperative visual expectations, visual potential, uncorrected visual goal and…

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