DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Cyst of iris and ciliary body, right eye, rule out neoplastic component.
POSTOPERATIVE DIAGNOSIS: Cyst of iris and ciliary body, right eye, rule out neoplastic component.
OPERATION PERFORMED:
1. Aspiration of iridociliary cyst, right eye.
2. Transscleral cryotherapy of partially collapsed cyst of iris and ciliary body, right eye.
SURGEON: John Doe, MD
ANESTHESIA: General.
DESCRIPTION OF OPERATION: The patient was brought to the operating room and was positioned on the operating table. Cardiac and blood pressure monitoring devices were applied. General inhalational anesthesia was induced without complications. The patient was prepped and draped in the usual fashion for a procedure of the right eye.
A lid speculum was inserted between the lids of the eye to expose the eye. A curved conjunctival incision was created from a position at the limbus in the 9 o’clock meridian, curving toward the fornix in the superotemporal quadrant and returning to the limbus in the 12 o’clock meridian. The subconjunctival connective tissues were dissected from this conjunctival incision toward the limbus in the superotemporal quadrant until the entire limbal region had been uncovered. Transcorneal transillumination was then performed to cast a glow on the sclera corresponding to transillumination defects in the eye wall caused by the iris cyst. The position of the cyst was marked on the sclera with a sterile marking pen.
Using a 27 gauge needle attached to an aspirating syringe, the sclera was punctured near the posterior margin of the cyst, and the tip of the needle was directed into the central aspect of the cyst under direct visualization. The cyst was slowly aspirated until no additional fluid could be removed. The needle was withdrawn. The aspirate was submitted to pathology for cytopathologic study. Transscleral cryotherapy was then performed to the entire region of the iris cyst as marked on the sclera, including the portion that extended into the peripheral iris. The treatment was repeated as a double freeze-thaw cycle at every site, and multiple overlapping sites were treated until the entire lesion had been double frozen.
The conjunctiva was then re-placed in its normal position. It was secured with a running suture of 7-0 Vicryl. The lid speculum was removed. Bacitracin/polymyxin ointment was applied to the surface of the eye. The lids were patched with a sterile eye pad dressing. The patient tolerated the procedure well. He was transferred to postanesthesia recovery in satisfactory condition.
