4

Question 1

What should be done when removing a pterygium to the firing conjuncgiva below it

Answer 1

Cut a square out and rotate it and suture it back on.

Treat the area with MMC and then rinse away before rotating the flaps Put a CL on at the end

Question 2

Post-op for pterygium (5)

Answer 2

BSCL

Antibiotics QID

Slide BSCL to check epi beneath it

If healed, ABX BID until BSCL removed

Steroid QID tapered one dose per week

Question 3

Treatment for pterygium

Answer 3

If not painful, not noticeable not affecting vision LEAVE IT ALONE

Question 4

Pterygium and cataract surgery

Answer 4

If planning custom cataract surgery,remove the pterygium, even if its not bothersome

Question 5

What is the most important thing to consider in treating Salzmanns nodules and pterygia?

Answer 5

Both should be resected beforethey reach the corneal optical zone

Question 6

Emergency paracentesis

-indications (4)

Answer 6

Emergent IOP

Formed/flat AC

Have equipment and meds

Call surgeon first

Question 7

Emergency paracentesis technique

-prep

Answer 7

Put them at ease/reassuring tone
Topical anaesthesia
Topical betadine and antibiotic
Lid speculum
Extra drop betadine

Question 8

Emergency paracentesis technique

-procedure and recovery

Answer 8

Open-ended, sterile, 30 gauge needle***
Horizontally thru limball cornea, inferior to pupil, parallel to iris
May turn at slightly upward angle to avoid needle being plunged in further by Bell’s phenomenon

Self-sealing wound
Often takes 10-20sec
Betadine chaser and antibiotics

Question 9

Transcleral cyclophotocoagulation (TS-ECP)
-micropulse vs G-probe

Answer 9

Micropulse (new) is similar to SLT, but doesn’t sit in one area too long/is continually moving, no popping sound
-less decr than old, but also less inflammation

G-probe (old) lots of complications, including inflammation, pthisis bulbi (over-respond)

Question 10

Transcleral cyclophotocoagulation (TS-ECP)
-post-op

Answer 10

Pred forte QID tapered weekly

Question 11

iStent

• about (3)
• complications (3)

Answer 11

Smallest FDA approved device
Titanium (safe for MRI)
L-shaped stent bypasses TM

Cataract, hypema, inflammation

Question 12

iStent

• post-op
• efficacy

Answer 12

Ct meds and prior glaucoma meds

Just under 1gtt (4.5%) with 50% stopping drops

Question 13

Fistulizing surgery

-post-op considerations

Answer 13

Post-op meds can help prevent scarring of blebs