COT Surgical Assisting Procedures 3 — Questions and Answers
Question 1: In the sterile surgical field, if the ophthalmic technician suspects an instrument has been contaminated, what is the correct action?
- Remove it from the field and replace it with a sterile instrument (Correct answer)
- Wipe it with a sterile gauze and continue use
- Notify the surgeon only if the procedure is nearly complete
- Submerge it in the BSS irrigation bowl on the field
Correct answer: Remove it from the field and replace it with a sterile instrument
Any instrument suspected of contamination must be removed immediately and replaced to maintain sterile field integrity and prevent infection.
Question 2: Which viscoelastic agent is classified as a cohesive OVD and is preferred for maintaining anterior chamber space during IOL implantation?
- Healon (sodium hyaluronate) (Correct answer)
- Viscoat (chondroitin sulfate/hyaluronate)
- BSS Plus
- Carbachol (Miostat)
Correct answer: Healon (sodium hyaluronate)
Healon is a cohesive OVD that forms a single mass, making it easy to maintain space and to remove completely after IOL placement.
Question 3: During a vitrectomy procedure, the technician must ensure the infusion line is connected before the surgeon begins. What is the primary reason for this safety step?
- To maintain intraocular pressure and prevent globe collapse (Correct answer)
- To irrigate the corneal surface continuously
- To deliver antibiotic prophylaxis intraoperatively
- To lubricate the vitreous cutter instrument
Correct answer: To maintain intraocular pressure and prevent globe collapse
The infusion line replaces vitreous volume as it is removed, maintaining IOP and preventing hypotony and retinal detachment.
Question 4: What is the purpose of performing a Seidel test intraoperatively after corneal wound closure?
- To detect aqueous humor leakage through the wound (Correct answer)
- To measure intraocular pressure after suturing
- To assess endothelial cell density post-closure
- To verify pupil dilation adequacy
Correct answer: To detect aqueous humor leakage through the wound
The Seidel test uses fluorescein dye to identify aqueous leakage; a streaming green fluorescence indicates a wound leak requiring additional sutures.
Question 5: When assisting during LASIK, which instrument is used to create the corneal flap in a microkeratome-based procedure?
- Microkeratome with oscillating blade (Correct answer)
- Femtosecond laser
- Diamond knife
- Crescent blade
Correct answer: Microkeratome with oscillating blade
In traditional LASIK, a microkeratome with an oscillating metal blade creates the hinged corneal flap prior to excimer laser stromal ablation.
Question 6: A patient is scheduled for Ahmed glaucoma valve implantation. The surgical technician should prepare which type of suture to secure the plate to the sclera?
- 9-0 nylon or 9-0 polypropylene (Correct answer)
- 6-0 vicryl absorbable suture
- 4-0 silk suture
- 10-0 nylon suture
Correct answer: 9-0 nylon or 9-0 polypropylene
9-0 nylon or polypropylene nonabsorbable sutures are used to anchor the glaucoma drainage device plate permanently to the sclera.
Question 7: During pterygium excision with conjunctival autograft, the technician should have bare sclera measurements ready because the graft must be:
- Sized to match the excised conjunctival defect (Correct answer)
- Larger than the corneal involvement area
- Taken from the inferior fornix only
- Sutured with absorbable suture exclusively
Correct answer: Sized to match the excised conjunctival defect
The conjunctival autograft must precisely match the defect left after pterygium removal to ensure adequate coverage and reduce recurrence.
COT Surgical Assisting Procedures 3
In the sterile surgical field, if the ophthalmic technician suspects an instrument has been contaminated, what is the correct action?