Advances in Eye Surgery by Patricio A. Pacheco

By Patricio A. Pacheco

It is a finished, useful guidebook that gives a transparent evaluate and replace of present smooth concepts of ocular surgical procedure. The chapters may be of curiosity to a large viewers. The chapters are written via specialists with detailed curiosity and huge scientific adventure within the issues.

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The ophthalmol‐ ogist will need a good dose of empathy and psychology skills to explain to the patient that the planned surgery is the only and best option. The oculoplastic surgeon must be ready to hear that some patients will wish to ask for a second opinion. This may annoy the doctor in charge of the patient, but despite of this, it is advisable to help the patient look for a second opinion with other colleagues. When dealing with these kinds of patients, it is crucial to take your time 26 Advances in Eye Surgery to explain with detail the surgical technique, the time the patient is expected to stay in the hospital, the need for frequent bandage changes in the hospital clinic, the possible complica‐ tions of the socket, and a long recovery period before a prosthesis can be fitted in.

Complete a 360° keratectomy with Westcott scissors and toothed forceps (Figure 14). 7. Once the cornea is removed, use an evisceration spoon to dissect the sclera from the choroid. If complete dissection is possible, remove the intraocular contents en bloc. It is common to find active bleeding from the central retinal artery and other perforant arteries that branch from long anterior ciliary arteries. We recommend to use suction and a monopolar or bipolar cautery to stop the bleeding. Should the intraocular contents break while dissecting the choroid from the sclera, we recommend to remove them with a suction device in order to minimize the exposure of the content of the eye to the socket, thus reducing the low risk of sympathetic ophthalmia (Figure 15).

Sometimes Tenon’s tissue is dragged as you introduce the implant. We recommend that the surgical assistant retracts Tenon’s anteriorly so as to avoid its displacement with nontoothed forceps while placing the implant. 22. Once correctly positioned in the orbit, we press the implant deep in the orbit with a finger to make sure it is correctly fitted. Make sure that Tenon’s layer is not trapped under the implant and that it covers the implant needing no excessive traction with nontoothed forceps.

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