COT Surgical Assisting Procedures 2 — Questions and Answers
Question 1: When setting up a cataract surgery instrument tray, which item is used to hold the eyelid open during the procedure?
- Lid speculum (Correct answer)
- Iris hook
- Capsulorrhexis forceps
- Corneal spoon
Correct answer: Lid speculum
A lid speculum is placed between the eyelids to keep the eye open and maintain exposure throughout cataract surgery.
Question 2: During phacoemulsification, the ophthalmic surgical technician should anticipate handing the surgeon which instrument immediately after the capsulorhexis is completed?
- Hydrodissection cannula (Correct answer)
- Phaco handpiece
- IOL injector
- Vitrector
Correct answer: Hydrodissection cannula
After capsulorhexis, hydrodissection separates the lens nucleus from the capsule, requiring the hydrodissection cannula next.
Question 3: What is the correct technique for handling ophthalmic microsurgical instruments to prevent damage?
- Hold by the shaft and avoid touching the tips (Correct answer)
- Clean tips with dry gauze between passes
- Store tips down in a cup between uses
- Autoclave after every instrument pass
Correct answer: Hold by the shaft and avoid touching the tips
Microsurgical instrument tips are delicate and must never contact hard surfaces; handling by the shaft protects their precision alignment.
Question 4: Which balanced salt solution (BSS) characteristic is most critical when irrigating the anterior chamber during surgery?
- Isotonic and buffered to physiologic pH (Correct answer)
- Hypotonic to prevent corneal swelling
- Hypertonic to reduce intraocular pressure
- Contains preservatives to prevent contamination
Correct answer: Isotonic and buffered to physiologic pH
Anterior chamber irrigation requires isotonic, pH-balanced BSS to protect corneal endothelial cells and maintain ocular integrity.
Question 5: A surgeon requests a 10-0 nylon suture during corneal repair. Which needle type is most appropriate for this suture?
- Spatula needle (Correct answer)
- Cutting needle
- Taper needle
- Reverse cutting needle
Correct answer: Spatula needle
Spatula needles are designed for lamellar tissue like the cornea, passing between layers without perforating them inadvertently.
Question 6: During a trabeculectomy, the surgical technician should have which medication ready to apply to the scleral flap to reduce scarring?
- Mitomycin C (Correct answer)
- Atropine
- Pilocarpine
- Timolol
Correct answer: Mitomycin C
Mitomycin C is an antimetabolite applied intraoperatively during trabeculectomy to inhibit fibroblast proliferation and prevent bleb scarring.
Question 7: When assisting with strabismus surgery, the ophthalmic technician should recognize that the recession procedure involves which action?
- Detaching the muscle and reattaching it further from the limbus (Correct answer)
- Shortening the muscle by removing a segment
- Advancing the muscle closer to the limbus
- Splitting the muscle into two separate slips
Correct answer: Detaching the muscle and reattaching it further from the limbus
Recession weakens an extraocular muscle by detaching it from the globe and reattaching it at a more posterior position.
COT Surgical Assisting Procedures 2
When setting up a cataract surgery instrument tray, which item is used to hold the eyelid open during the procedure?