DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS:
Chronic retinal detachment, left eye.
POSTOPERATIVE DIAGNOSIS:
Chronic retinal detachment, left eye.
PROCEDURE PERFORMED:
Scleral buckle cryoretinopexy, left eye.
SURGEON: John Doe, MD
ASSISTANT: None.
ANESTHESIA: General.
DESCRIPTION OF OPERATION: The patient was brought into the operating room and placed in the supine position on the operating table. Blood pressure and cardiac monitors were placed on the patient. The patient was then administered gentle IV sedation and was then administered left-sided inferior lid approach retrobulbar injection of 5 mL of solution containing a 1:1 mixture of 2% lidocaine without epinephrine and 0.75% Marcaine and 1 mL of hyaluronidase added. There was noted to be good akinesia and anesthesia of the eye after the block. The patient was then administered gentle IV sedation. The patient was then placed on general anesthesia.
The left eye was prepped and draped in the usual sterile fashion, trimmed the lashes. A heavy wire lid speculum was inserted to maintain the left eye in open fashion. Conjunctival peritomy was performed for 360 degrees 1 mm posterior to the limbus. The four recti muscles were retracted nicely using 4-0 black silk suture. A 240 band was placed underneath each of the rectus muscles with a joint in the inferior nasal quadrant. A single 5-0 nylon suture was used to secure the buckling element in place. There was one suture per quadrant. The fundus was inspected with indirect ophthalmoscope and 20 diopter lens. Atrophic holes associated with area of chronic detachment were noted to be present primarily anterior to the buckle. These were treated with cryoretinopexy with excellent effect. The detachment was very low lying over the buckle, and therefore, no drainage was performed. Anterior chamber paracentesis was performed. This was performed with a 27 gauge needle to the limbus at the 3 o’clock position. A 240 band was tightened and trimmed at the joint. The fundus was inspected with indirect ophthalmoscope and 20 diopter lens. There was normal ophthalmodynamometry.
The intraocular pressure was within normal limits to palpation. The bridle sutures were removed. Neosporin ophthalmic solution was applied to the ocular surface. Conjunctiva was closed with 8-0 Vicryl suture. Subconjunctival injections of 100 mg of cefazolin, 20 mg of gentamicin, and 2 mg of dexamethasone were applied to the inferior subconjunctival space. Speculum and drapes were removed. A patch was applied to the patient’s eye. The patient left the operating room in stable condition.
