Who's folding the lens during the cataract surgery? I was disappointed today when I was assisting in cataract operation. As a scrub nurse we normally fold the IOL. The surgeon was in a hurry while I was folding the lens. When he inserted it the haptic was broken. He then cut the lens and it took a lot of manipulation on the eye of the patient, he then removed the lens and put another IOL. Is anybody having the same experience like this?
What is your policy and procedure for cataract operation under local anesthesia? In our hospital.... a nurse is holding the hand of the patient and let the patient squeez the nurse hand to know if the patient is in pain or uncomportable etc.... Our patient are on ECG, BP, SAt monitoring throughout procedure. No versed for topical drops unless otherwise the patient wants sedation or Peribulbar/ subtenon block.
Sep 8, '06
The scrub nurse folds the IOL and puts it in the foam tip injector where i work. We also have differnet kinds of lenes that don't require the foam tip injector.
Sep 9, '06
Usually the person scrubbed with the doc does the lens at our hospital
Sep 10, '06
Our scrub nurses do the IOL folding.
We do use basicly, two types of lenses. One folded, the other not.
Occasionally we do break a haptic, or get one out of the box broken.
We just dept. req. those, send them back and get credit.
We almost always have at least two of each size on hand, mostly the middle, more often used sizes.
We always have an anesthesiologist in the room on cataracts.
We do LOCAL/Mac's. Topical or blocks, we have a doc there, watching vitals, etc. Saved us more than once in my experience! Mike
Sep 10, '06
Thanks for all your reply. If we have all topical cataracts or local ophthalmic surgery. we don't have any anesthesiologist around only nurses holding the hand of the patient and watching the vital signs. we had one incident of a patient for pterygium, had subtenon in anesthetic room then after subtenon, PR went down and the patient almost passed out. we just called the anesthesiologist on call etc. and postponed the surgery. I think the patient was not properly pre-assessed. All our patient for cataract are pre-assessed by pre-assessment nurse but we always have an incident of cancellation due to high blood pressure.
I feel that ophthalmic surgery is so boring.
Sep 10, '06
I feel the same way. I learned how to scrub and set those cases up, but man, it's like watching grass grow.
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