Ecce dictation report

 

Informed consent was found to be complete and on the chart.  The patient was taken to the OR and given a retrobulbar block consisting of Marcaine 6cc 0.75%, 2cc Lidocaine 1% and 1cc Wydase 150 units.  An Atkinson block was also performed.  The patient was then prepped and draped in the usual sterile fashion, and a wire lid speculum was placed.

 

A 4-0 silk bridal suture was then place under the SR tendon for better exposure.  Next, a conjunctival peritomy from 10:00 to 2:00 was performed, and any remaining conjunctival and Tenons tissue was removed.  The sclera was then cauterized with the bipolar for hemostasis.

 

Next, a 10.5mm incision from 2:00 to 10:00 was made in the sclera ½ depth 1mm posterior to the blue line using a 69 blade.  The 69 blade was then used to tunnel through the incision into the cornea.  Then, a 75 blade was used to make an incision into A/C and extended 3mm.  Viscoelastic was then injected to fill the A/C.

 

A 360 degree can opener capsulotomy using a cystotome was performed.  The wound was then fully opened using corneoscleral scissors.  The nucleus was rotated into the A/C and expressed using an irrigating lens loop.  Any remaining cortex was removed with the Simcoe.  Next, the capsular bag and A/C were filled with viscoelastic.  A 23.0D MC71CM PMMA posterior intraocular lens (SN 600623.012) was placed into the bag, and dialed into position.

 

A corneal light shield was placed, and 5 10-0 nylon sutures were placed to close the scleral wound.  Any remaining viscoelastic was then removed using the Simcoe.  An air bubble was placed, and miostat injected for miosis.  The wound was checked and found to be water tight.

 

The 4-0 silk bridal suture was removed, and the conjunctiva was closed with cautery.  A subconjunctival injection of 20 mg gentamicin and 4 mg of dexamethasone was applied.  At the end of the case, the pupil was noted to be round, the corneal clear, and the lens to be centered.  The lid speculum was removed, tobradex ointment was applied to the eye, and a light patch and fox shield was applied.  The patient was then transferred to recovery in stable condition.  The attending was scrubbed and present for the entire case.