This report is to be used for one or two cases per week as assigned by the instructor. These forms are filled out following the procedure using textbooks, Medcom, information from patient chart, doctor preference information sheets, and recalled activities. This is a report that concerns itself with the case as performed. It requires information according to the expectations of The Core Curriculum for Surgical Technology and asks for a report in the general style of a surgeon’s postoperative report. 1st Scrub_X___2nd Scrub _____Asst. Circulate_____Observe__ __ Procedure__Cataract Extraction with IOL implant _.
Surgeon___ Curly Howard_________________ First Assistant__ Moe Howard______________ Staff CST__ Larry Fine____________________ Circulator_ Larry Fine_____________________ Other__________________________________ Grade: Instructor’s Feedback: 1. Discuss the relevant anatomy. * The lens, a strong, elastic capsule filled with viscous material, is biconvex and avascular. It is suspended behind the iris by ligaments called zonules. The zonules also attach to the ciliary body. Contraction and relaxation of the ciliary body is transmitted to the lens through the zonules, thereby adjusting lens focus.
The lens helps to focus light rays on the retina. When the lens becomes sufficiently opaque, it is removed. | Top of Form Bottom of Form 2. a. Preoperative Diagnosis: Cataract b. Postoperative Diagnosis: Cataract 3. List any preoperative diagnostic procedures/tests. Eye Exam 4. Discuss any special preoperative preparation procedures. N/A 5. Identify the names and uses of special instruments, supplies and drugs. * Cataract Set – contains all instruments needed for the case 6. Identify the names and uses of special equipment. * Phaco machine 7. a. Describe the anatomical boundaries of the prep area on the patient.
* Prep close to the eye with cotton tipped prep applicators. Dip one applicator into prep solution and use to cleanse the upper lid margin (lash line) moving from the inner canthus to the outer canthus of the eye, then use another applicator on the lower lid margin. Repeat the above to clean the area just adjacent to the first pass on both upper and lower lid margins. Next, use the 4X4’s dipped in prep solution, squeeze any excess prep solution, and cleanse the rest of the lids, cheek, brow and forehead area to the hairline, moving from nasal side outward. b.
Describe the patient’s position and list any special positioning aids. * Place patient in a supine position. Padding should be placed under the head, elbows, and heels. A small pillow is placed under the knee to give support for the patients with low back pain or arthritis in their knees. The pressure areas on the posterior side should be assessed and padded as necessary. 8. Describe the surgical procedure as performed * Eye speculum is placed under the eyelids * Create a partial depth corneal scleral groove. * Provide hemostasis * Penetrate the anterior chamber * Inject viscoelastic material to deepen anterior chamber.
* open the lens capsule. (anterior) * extend the limbal incision. * loosen the lens capsule. * emulsify nucleus. (Phacoemulsification) * place stay sutures. * irrigate and aspirate (Phacoemulsification)(break up the lens). * polish the posterior lens. * fill (reform) the anterior chamber * implant the lens. * position the lens. * constrict the pupil. * close the incision. * Antibiotic injections also are usually given. 9. Discuss the purpose and expected outcomes of the surgery. * The purpose of surgery is To remove the opaque lens (cataract) and restore vision by implanting an artificial IOL.
10. Discuss the immediate postoperative care and possible complications. Possible complications include: * Blurred vision * Infection A. Upon dismissal from the surgical room, the patient was: _x_alert ___awake __asleep _intubated _x_ extubated B. Dressings and/or Drains used were: Bacitracin, Eye pads, Eye shield, and dressing tape C. Patient remained in post-anesthesia care unit for __1__ hours D. PACU reported the patient’s dismissal condition as (Critical/Stable/Fair/Satisfactory): Satisfactory ONE THING I LEARNED FROM THIS CASE THAT WILL HELP ME AS A SURGICAL TECHNOLOGIST IS: