COST Anesthesia and Medications in Ophthalmic Surgery Flashcards

Which dye is injected intravenously during fluorescein angiography to visualize retinal and choroidal vasculature?

Answer: Sodium fluorescein

Sodium fluorescein is injected IV and fluoresces under blue light, allowing dynamic imaging of retinal blood vessel integrity and leakage patterns.

Trypan blue 0.06% is used during cataract surgery for which specific purpose?

Answer: To stain the anterior lens capsule for continuous curvilinear capsulorhexis

Trypan blue selectively stains the anterior lens capsule, improving visualization for the capsulorhexis step — especially helpful in mature cataracts where the red reflex is poor.

Sub-Tenon's anesthesia provides which advantage over retrobulbar block?

Answer: No risk of globe perforation and reduced risk of optic nerve injury

Sub-Tenon's block delivers anesthetic beneath Tenon's capsule using a blunt cannula, eliminating the needle-related risks of globe perforation and optic nerve injury associated with sharp-needle retrobulbar blocks.

Which agent is used as a surgical adjunct during vitreoretinal surgery to create a posterior vitreous detachment (PVD) pharmacologically?

Answer: Ocriplasmin (vitreolysis)

Ocriplasmin (a recombinant truncated plasmin) is injected intravitreally to cleave fibronectin and laminin at the vitreoretinal interface, inducing pharmacologic vitreolysis and PVD.

When preparing povidone-iodine 5% for conjunctival antisepsis before ophthalmic surgery, the surgical technologist should be aware that the primary contraindication is:

Answer: Known iodine or shellfish allergy

Povidone-iodine is contraindicated in patients with documented iodine hypersensitivity; an iodine allergy requires an alternative antiseptic such as aqueous chlorhexidine.

Balanced salt solution (BSS) is used as an irrigation fluid during intraocular surgery because it:

Answer: Is isotonic and pH-balanced to minimize endothelial cell damage

BSS is formulated to match the ionic composition and pH of aqueous humor, making it safe for intraocular irrigation without causing osmotic damage to the delicate corneal endothelium or other intraocular tissues.