Cataract and Lens Flashcards
7 cards from real ABO practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cataract and Lens flashcards as text
During phacoemulsification, the iris billows, prolapses through the incisions, and the pupil progressively constricts. Which medication history is most strongly associated with this?
Answer: Tamsulosin
Intraoperative floppy iris syndrome is most strongly linked to tamsulosin, a selective alpha-1A antagonist that affects iris dilator muscle tone.
During phacoemulsification, the posterior capsule ruptures and a large nuclear fragment sinks into the vitreous. What is the most appropriate management?
Answer: Perform anterior vitrectomy, place an IOL if support allows, and refer for pars plana vitrectomy
Dropped nuclear fragments should not be chased from the front; clean up vitreous anteriorly, place an IOL if possible, and arrange timely pars plana vitrectomy.
During cataract surgery, the eye suddenly becomes firm, the anterior chamber shallows, and a dark mass appears behind the pupil with loss of red reflex. What is the immediate priority?
Answer: Rapidly close all incisions to tamponade the globe
Suspected suprachoroidal hemorrhage requires immediate wound closure to restore pressure and limit expulsive extension.
On postoperative day 1, a patient has an unexpected myopic shift, a deep anterior chamber, and a clear fluid space between the IOL optic and posterior capsule. What is the most likely diagnosis?
Answer: Capsular block syndrome
Capsular block syndrome occurs when viscoelastic is trapped behind the IOL by a small capsulorhexis, pushing the optic forward and causing myopic shift.
During surgery, a 3-clock-hour zonular dialysis is noted with otherwise intact capsule. Which device is most commonly used to stabilize the capsular bag?
Answer: Capsular tension ring
A capsular tension ring redistributes forces evenly across remaining zonules, stabilizing the bag for in-the-bag IOL placement.
Which preoperative finding is most associated with poor pupil dilation, zonular weakness, and higher risk of vitreous loss during cataract surgery?
Answer: Pseudoexfoliation syndrome
Pseudoexfoliation causes weak zonules and poor mydriasis, significantly increasing the risk of complications such as capsular rupture and lens dislocation.
A patient has a large Descemet membrane detachment noted at the end of cataract surgery with localized corneal edema. What is the most appropriate initial treatment?
Answer: Intracameral air or gas tamponade (descemetopexy)
Large Descemet detachments are repaired by injecting air or SF6/C3F8 gas into the anterior chamber to reattach the membrane.