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Eye Surgery


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Table of Contents

The Paradox of High Success.- Tactics in Ophthalmic Surgery.- 1 Spatial Tactics.- 1.1 Pressure Systems for Regulating Chamber Volume.- 1.1.1 No-Outflow Systems.- 1.1.2 Controlled-Outflow Systems.- 1.1.3 Uncontrolled-Outflow Systems.- 1.1.4 Effect of External Forces on Regulating Systems.- 1.1.5 Basic Safety Strategy for Spatial Tactics.- 1.2 Space-Tactical Instruments.- 1.2.1 Watery Fluids.- 1.2.2 Viscous and Viscoelastic Materials.- 1.2.3 "Membranous" Implants (Bubbles).- 1.3 The Field of Spatial Tactics.- 1.3.1 The Pressure Chamber of the Globe.- 1.3.2 The Pressure Chamber of the Vitreous.- 1.3.3 Effect of Deforming Forces on the Pressure Chambers of the Eye.- 1.3.4 Deformations Caused by External Forces.- 1.3.5 Deformation by Hinge Folds.- 1.3.6 Margin of Deformation.- 1.3.7 Summary of Safety Strategy for External Forces.- 2 Tissue Tactics.- 2.1 The Application of Mechanical Energy.- 2.1.1 Handles.- 2.1.2 Grasping.- 2.1.3 The Division of Tissues.- 2.1.4 Uniting of Tissues.- 2.2 Application of Heat.- 2.2.1 Heat from an External Source.- 2.2.2 Heat Generation in Tissues.- 2.2.3 Application of Cold.- 2.3 Application of Light.- 2.4 The Utilization of Chemical Effects (Electrolysis).- 3 Preparation of the Operating Field.- 3.1 Lowering the Pressure in the Intraocular Chambers.- 3.2 Anesthesia.- 3.2.1 Instillation Anesthesia.- 3.2.2 Injection Anesthesia.- 3.2.3 Akinesia of the Orbicularis Muscle.- 3.2.4 Retrobulbar Anesthesia.- 3.3 Maintaining Separation of the Lids.- 3.3.1 Methods of Opening the Lids.- 3.3.2 Instruments for Maintaining Lid Separation.- 3.4 Fixation of the Globe.- 3.5 Traction Sutures for Orienting the Globe.- 3.6 Sutured-On Stabilizing Rings.- 3.7 Placement of Transconjunctival Muscle Sutures.- 3.8 Final Check of Preparations.- 4 Operations on the Conjunctiva.- 4.1 General Problems of Surgical Technique.- 4.2 Episcleral Dissection ("Deep Dissection").- 4.3 Subepithelial Dissection ("Superficial Dissection").- 4.4 Suturing the Conjunctiva.- 5 Operations on the Cornea and Sclera.- 5.1 General Problems of Surgical Technique.- 5.2 Dissection Technique.- 5.3 Planning the Approach to the Eye Interior.- 5.3.1 Anatomic Factors in Opening the Globe.- 5.3.2 Geometric Factors in Opening the Globe.- 5.3.3 Comparison of Different Incision Profiles.- 5.4 Methods of Opening the Anterior Chamber.- 5.4.1 Keratome Section.- 5.4.2 Cataract Knife Section.- 5.4.3 Cutting with a "Point" Cutting Edge.- 5.4.4 Scissor Section.- 5.4.5 Two-Plane Stepped Incision.- 5.4.6 Three-Plane Stepped Incision.- 5.4.7 Trephine Incisions.- 5.5 Suturing the Cornea and Sclera.- 5.5.1 Suture Technique.- 5.5.2 Special Types of Suture.- 6 Operations on the Ciliary Body.- 6.1 Cyclodialysis.- 6.2 Cyclopexy.- 7 Operations on the Iris.- 7.1 Iris Displacement and Reposition.- 7.2 Grasping and Cutting.- 7.3 Iridectomies.- 7.4 Synechiolysis.- 7.5 Surgical Enlargement of the Pupil.- 7.6 Repair of Iris Defects.- 7.7 Suturing the Iris.- 7.8 Reposition of a Disinserted Iris.- 8 Operations on the Lens.- 8.1 General Problems of Surgical Technique.- 8.2 Intracapsular Lens Delivery.- 8.2.1 Mobilization (Zonulolysis).- 8.2.2 Aligning the Lens for Delivery.- 8.2.3 Locomotion.- 8.2.4 Instruments for Lens Delivery.- 8.2.5 The Phases of a Lens Delivery.- 8.2.6 Completing the Intracapsular Delivery after Inadvertent Capsule Rupture.- 8.3 Extracapsular Cataract Operation.- 8.3.1 Anterior Capsulotomy.- 8.3.2 Delivery of the Nucleus.- 8.3.3 Phacoemulsification.- 8.3.4 Delivery of the Cortex.- 8.3.5 Operations on the Posterior Lens Capsule.- 9 Anterior Vitrectomy.- 9.1 General Problems of Surgical Technique.- 9.2 Strategic Decision-Making Criteria in Vitreous Prolapse.- 9.3 Anterior Vitrectomy for Vitreous Prolapse Caused by External Factors.- 9.4 Management of Vitreous Prolapse Caused by Internal Hemorrhage.- 10 Future Trends.

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