Senile nuclear cataract, right eye
PREOPERATIVE DIAGNOSIS: Senile nuclear cataract, right eye
INDICATIONS: Dennis presents today for cataract surgery of the right eye. We discussed any and all risks and I have answered his questions concerning the procedure and he wishes to proceed at this time.
POSTOPERATIVE DIAGNOSIS: Same.
PROCEDURE PERFORMED: Cataract extraction by phacoemulsification, right eye
ANESTHESIA: Topical
ESTIMATED BLOOD LOSS: Minimal
COMPLICATIONS: None
PROCEDURE: Once the patient was in the operating room, a drop of lidocaine 4%-MPF was applied to the right eye. The patient was prepped and draped in the usual sterile fashion for an intraocular procedure of the right eye. A lid speculum was placed. A Weck-cel soaked with lidocaine 4%-MPF was placed at the limbus both in the area of the planned phaco incision and planned side-port incision. A keratome was used to enter the chamber at the arcade. A small amount of preservative-free lidocaine 1% was injected into the anterior chamber. The aqueous was exchanged with viscoelastic material and a side-port incision was made with a 15 degree angle blade. A continuous tear capsulotomy was made with a 15 degree angle blade. A continuous tear capsulotomy was made with a bent needle and the Utrata forceps. The nucleus was hydrodissected. Phacoemulsification was used to remove the nucleus using an ultrasound time of 2 minutes, 22 seconds, and effective phaco time 5.93 seconds. Irrigation and aspiration was used to remove the remaining cortical material. The capsule was polished and vacuumed as indicated. A small additional amount of non-preserved lidocaine 1% was again injected into the anterior chamber. The chamber was deepened with viscoelastic and the posterior chamber intraocular lens was injected into the capsule bag and dialed into position. The remaining viscoelastic material was removed with irrigation and aspiration. The globe was pressurized and the cornea was hydrated to ensure a good seal. The wound was tested and found to be watertight. Zymar and Pred Forte 1% drops were placed on the surface of the eye. The patient left the operating room in stable condition without complications having tolerated the procedure well.
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