Surgery intraocular

Surgery Topical When a short-acting mydriaticis needed for wide dilatation of the pupil before intraocular surgery, phenylephrine HCl 2.5% (or the 10%) maybe applied topically from 30 to 60 minutes before the operation. 

Ointments may be used immediately after intraocular surgery under a conjunctival flap or in corneal incisions with excellent wound approximation, because the risk of entrapment of ointment is minimal. Ointments should not be used, however, in any surgical wound in which there is a question of wound integrity, such as when difficulty is experienced maintaining the anterior chamber at surgery. In such cases ointment application should be delayed for several days. 

Hyaluronate sodium is also combined with sodium chondroitin sulfate (in Viscoat) as a corneal transplant preservation medium. Sodium chondroitin sulfate and other viscoelastic substances protect the corneal endothelium during intraocular surgery. 

Taylor TH, Mulcahy M, Nightingale DA. Suxamethonium chloride in intraocular surgery. Br J Anaesth 1968 40(2) 113-18. 

Intraocular surgery within last 2 mos or capsulotomy within last month in study eye... 

As discussed previously, corticosteroids downregulate VEGF production in experimental models and possibly reduce breakdown of the blood retinal barrier (15,16). Similarly, corticosteroids have antiangiogenic properties possibly due to attenuation of the effects of VEGF (20,21). These properties of steroids are commonly used. Clinically, triamcinolone acetonide is used locally as a periocular injection to treat cystoid macular edema secondary to uveitis or as a result of intraocular surgery (22,23). In animal studies, intravitreal triamcinolone acetonide has been used to prevent proliferative vitreoretinopathy and retinal neovascularization (24—27). Intravitreal triamcinolone acetonide has been used clinically to treat proliferative vitreoretinopathy and choroidal neovascularization (28-31). 

Kattan HM, Flynn HW Jr, Pflugfelder SC, Robertson C, Forster RK. Nonsocomial endophthalmitis survey current incidence of infection after intraocular surgery. Ophthalmology 1991 98 227-238. 

Maintaining a deep anterior chamber can be considered the conditio sine qua non for successful anterior segment intraocular surgery. There are diverse pre- and intraoperative precautionary measures available to achieve this oculopression, addition of adrenalin and hyaluronidase to retrobulbar anesthesia, hyperventilation and blood pressure reduction during anesthesia, closed system operation as made possible by phacoemulsification (lens nucleus disintegration via ultrasound), or by intravenous infusion of hyperosmolar substances (Voros-marthy, 1967 Kelman, 1967). 

Sodium hyaluronate solution, as well as any other fluid used in intraocular surgery, should evoke a low inflammatory reaction to the vitreous body, similar to that of physiological buffer solution, under like test conditions. 

Buckley RJ. Healthy corneal endothelium and the effects of intraocular surgery. Trans Ophthalmol Soc UK 1985 104 801-826... 

Despite the recent development of microsurgical techniques, intraocular surgery can still fail because of postoperative complications, such as fibrin formation and proliferative vitreoretinopathy (PVR). Fibrin formation tends to be more severe in eyes with increased vascular permeability after vitrectomy in endophthalmitis, proliferative diabetic retinopathy... 

Haritoglou, C. Xadayoni, R. May, C. A. Gass, C. A. Freyer, W. Priglinger, S. G. Kampik, A. Short-term in vivo evaluation of novel vital dyes for intraocular surgery. Retina 2006, 26, 673-678. 

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