Check list
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Check
list/consent ...use this to help you remember
to look for all conditions that increase the risk of surgery. Many
of the risks can be reduced if the issues are addressed.
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Fuchs
corneal dystrophy & cataract surgery
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This condition is explained starting here.
Cataract surgery is more risky in this condition, as Fuchs dystrophy
and the surgery can combine to damage the cornea permanently. New
research suggests what surgery with care and the latest techniques
and viscoelastics on eyes with corneal thickness <640um is safe, without
a corneal transplant. See hypermetropia
risk.
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Measurement
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- for the most accurate measurement, stop soft lens
2 weeks and hard lenses 3 weeks before the keratometry
- measurement may need to be repeated in eyes <22mm, >26mm,
if there is a >1mm difference, mature cataract, lamellar hole. IOL
master needs a good tear film. D no dilate as this changes the AC depth.
Formulae ...<22, Hoffer; 22-26, Holliday; >26 SRK?/Holliday. If
AC depth not equal, look for iridodonesis & # zonules.
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In angle closure
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normal |
angle closure |
| axial length |
23 |
<22 |
| anterior chamber depth |
2.8 |
1.8 |
| lens thickness |
4.5 |
5.1 |
| lens thickness/axial length |
2.27 |
1.9 |
| corneal diameter |
11.8 |
10.8 |
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PXF
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- PXF..sensioneural deafness
- high homocycsteine
- pupils don't dilate etc see
- may get
iris ischaemia
- IV methyl prednisolone (500mg) at time of surgery,
or intravitreal triamcinolone at time of surgery, are recommmended
by various experts
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