Assisting with Interventions & Procedures Flashcards

When assisting with a corneal transplant (penetrating keratoplasty), the donor cornea is stored in which medium prior to surgery?

Answer: Optisol-GS or similar corneal preservation medium at 4°C

Donor corneas are stored in Optisol-GS or similar hypothermic preservation medium at 4°C to maintain endothelial cell viability until transplantation.

Following a retrobulbar injection for eye surgery, the assistant should monitor the patient for which potentially serious complication?

Answer: Brainstem anesthesia or retrobulbar hemorrhage with proptosis and increased IOP

Brainstem anesthesia (from inadvertent subarachnoid injection) and retrobulbar hemorrhage (presenting with proptosis and rising IOP) are serious, potentially vision- or life-threatening complications after retrobulbar block.

During the setup for an anterior segment optical coherence tomography (AS-OCT) scan, the assistant should instruct the patient to:

Answer: Fixate on the internal fixation target and blink normally between acquisitions

The patient should fixate on the internal fixation target and blink between image acquisitions to maintain tear film quality and reduce motion artifact during AS-OCT imaging.

A surgeon requests a corneal trephine for a biopsy. The assistant should know that the trephine size selected will determine:

Answer: The diameter of the tissue sample or keratoplasty button excised

A corneal trephine is a circular cutting device; its size (measured in millimeters) determines the diameter of the corneal button or biopsy specimen obtained.

When assisting with a selective laser trabeculoplasty (SLT), compared to argon laser trabeculoplasty (ALT), the key difference the assistant should understand is:

Answer: SLT selectively targets pigmented trabecular meshwork cells without causing coagulative damage, and can be repeated

SLT uses a Q-switched Nd:YAG laser to selectively target melanin-containing cells in the trabecular meshwork with minimal thermal damage, allowing the procedure to be repeated if needed.

When the physician performs a forced duction test intraoperatively, the assistant should provide:

Answer: Toothed or non-toothed forceps to grasp the conjunctiva or sclera near the limbus

A forced duction test requires forceps to grasp the conjunctival or episcleral tissue so the surgeon can mechanically rotate the globe and assess whether restriction is mechanical or paralytic.

After a patient receives a subconjunctival injection of antibiotic at the conclusion of surgery, what immediate response should the assistant anticipate and inform the patient about?

Answer: Temporary chemosis (conjunctival swelling) and a small bleb visible under the conjunctiva

A subconjunctival injection creates a visible bleb (fluid blister) under the conjunctiva and may cause temporary chemosis, which resolves as the medication is absorbed.