Ophthalmology

Cataract Right Eye

PREOPERATIVE DIAGNOSIS:  Cataract right eye.

POSTOPERATIVE DIAGNOSIS:  Same.

PROCEDURE PERFORMED:  Kelman phacoemulsification posterior chamber intraocular lens implantation right eye.

SURGEON:  J.  G., MD.

ASSISTANT SURGEON:  D.

ANESTHESIA:  Monitored anesthesia care with local.

COMPLICATIONS:  None.

INDICATIONS:  Visually significant cataract right eye, interfering with activities daily living.

DESCRIPTION OF THE PROCEDURE:  The patient was brought to the holding area, where under monitoring intravenous sedation, the patient received a peribulbar block, consisting of 10 cc of the following mixture:  50 percent 2 percent lidocaine without epinephrine, 50 percent 3/4 percent bupivacaine, with 150 units of Wydase.  Digital pressure was applied to the eye, and a Honan balloon was placed over the eye.  The patient was then transferred to the Operating Room, where he was prepped and draped in the typical sterile fashion.  Lid speculum was placed into the eye.  Using an MVR blade, paracentesis were created at the 12 and 6 o’clock position, Vitrax was injected into the anterior chamber.  Next a 2.8 mm keratome was used to fashion a limbal corneal incision at the 9 o’clock hour.  Cystotome and Utrata forceps were used to fashion continuous anterior line capsulorrhexis.  Hydrodissection was performed with BSS 27 gauge cannula.  Next lens nuclear and cortical materials were removed using the Phaco-emulsification instrument.  Residual cortical material was removed using bimanual automated irrigation, and aspiration.  Capsular bag was filled with Amvisc plus, and the posterior chamber intraocular lens Bausch & Lomb model number LI61U 15.0 diopter, serial number 71LA08, was placed into the posterior capsule bag using the import Unfolder. The lens was rotated in place using Sinskey’s hook.  Residual viscoelastic was removed using irrigation aspiration.  The corneal wounds were rehydrated with BSS.  The anterior chamber is reformed with BSS.  Wounds were checked for integrity and found to be water tight.  A subconjunctival injection of 50 mg of Kefzol and 2 mg Decadron was given inferiorly.  Maxitrol ointment was instilled into the eye.  The eye was patched.  A shield was placed over the eye.  The patient was transferred to the Recovery Room after having tolerated the procedure without difficulties.

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