Ocular surgery

the surgery of the eye , also known under the name of ophthalmologic surgery or ocular surgery , is the Chirurgie carried out on the eye and its appendices, generally by a Ophtalmologue. Although the majority of surgical operations on the eye can be carried out by any experienced ophtalmologist, the most complex procedures are usually given to qualified and recognized doctors.

Preparation and precautions

The eye is a sensitive body, which requires front care extremely demanding, during and after surgical operation. The ophtalmologist who intervenes must thus take all his responsabilities and identify the good ways of proceeding in order to carry out his operation without risk. Many university programs in the United States make it possible patients to indicate if they agree to be operated by a Intern or then if they refuse explicitly and want to really deal with qualified doctor.

The anesthesia is a need for any surgery of eye. The Local anesthesia in general is employed. Techniques of injection and infiltration of product anaesthetizing on the level Sous-cortical are employed to immobilize the muscles extra eyepiece and to eliminate the feeling from pain. The local anesthesia often employs gel containing Lidocaïne which is preferred for the fast operations. For the local anesthesia, the co-operation of the patient is the best thing for a procedure proceeding carefully. The General anesthesia as for it, is recommended for the children, traumatic lesions of the eye, most of the orbitotomies and for the patients having apprehension. A cardiovascular monitoring is preferable during the Local anesthesia and is obligatory for the General anesthesia. Precautions appropriate to the level of sterility are taken to prepare the zone which will undergo the operation, including by the use of disinfectants like the Bétadine. To be vêtus blouses, and sterile gloves is of course obligatory. A plastic pocket with a receptacle helps to recover the fluids during the Phacoémulsification. A blépharostat, kind of Spéculum adapted for the eyes is inserted in the conjunctival culs-de-sac to maintain the eyelids open.

Laser surgery and refractive surgery

Although the terms of laser surgery and refractive surgery are generally employed as if they were interchangeable, it is indeed not the case. The laser can be used to treat affections nonrefractive (for example to seal a retinal tear), while the radiate Kératotomie is an example of refractive surgery without use of a laser.

Surgery of the cataract

The Cataracte is the opacification of the crystalline lens, This opacification is responsible for a progressive fall of the sight, at the beginning accompanied by embarrassment with the light (photophobia). This fall of the vision can be fast (a few hours) because of a traumatism. If the loss of sight is significant, surgical operation can be justified, the loss of sight can be recovered by the change of the Cristallin by an artificial crystalline lens (implant intraoculaire). This operation is one of most common in the surgery of the eye. An Indian surgeon, Govindappa Venkataswamy, even made his speciality of it by developing a model of hospital looking after the Indian patients. While designing a new more productive model of interventions, without harming the quality of the operations, it manages today to look after very great numbers of patients, rich person or poor. Its model is exemplary by its capacity to cause the solidarity of the easiest patients who pay so that poorest can profit from the operation free.

Surgery of the glaucomes

The Glaucome is a group of disease affecting the Optical nerve having for results the loss of the vision, this affection is frequently characterized by an increase in the Pression intraoculaire. It is possible several to treat the glaucomes by the surgery, various combinations or variations on the surgical act making it possible to evacuate the aqueous humors of the eye in order to cause a drop in this pressure intraoculaire. For example the Trabéculectomie is regularly practiced.

Refractive surgery

  • the refractive Chirurgie aims at correcting the errors of refraction of the eye, reducing or eliminating the need for the wearing of corrective lenses. One finds there various operations of which:
    • Keratomileusis
    • Automated lamellar keratoplasty (ALK)
    • Laser assisted in-situ keratomileusis (LASIK)
    • Laser LASEK for assisted sub-epithelial keratomileusis
    • Keratectomie photorefractive
    • thermal Kératoplastie with the laser''' or thermal TLK for Laser keratoplasty
    • Kératoplastie conductive which uses radio frequencies to narrow the collagen of the cornea. Method used for corrected the Hypermétropie
    • LRI for Limbal relaxing incisions
    • astigmatic Kératotomie
    • radiate Kératotomie
    • Kératotomie hexagonal
    • Epikeratophakie
    • Anneau will intra corneal
    • plantable Contact lenses
  • Inversion of the Presbytie
    • Sclérotomie ciliaire former
      • Inversion of presbyopia to the laser

Surgery of the cornea

  • the surgery of the cornea includes the majority of the operations of refractive surgery which follow:

    • surgical Transplantation of the cornea , is employed to remove an opaque cornea and to replace it with a clear cornea.

      • Kératoplastie penetrating
    • photo-therapeutic Kératectomie
    • Excision of a Pterygium

Vitréo-retinal surgery

  • vitréo-retinal surgery included following operations:
    • Vitrectomie
      • former vitrectomy used in certain cases of Cataract and Glaucome
      • Pars planed vitrectomy (statement), is a process to remove opacities of the vitreous membranes by an incision of leave planed. It is often combined with other processes will intra ocular, procedures for the treatment of the retinas.
    • retinal Photo-coagulation side it is a treatment by Photo-coagulation used in particular for the treatment of the Rétinopathie diabetic
    • Detachment of retina
      • Ignipuncture is an obsolete process which implies a Cautérisation retina by a very hot instrument pointed.
      • laser Photocoagulation, it is the use of a laser in order to seal a retinal tear.
      • pneumatic Retinopexie
      • Cryopexie retinal , or cryothérapie retinal , is a process which uses an intense cold to induce a chorio-retinal scar and to destroy retinal fabrics or Choroïde.
    • Réparation of the hole Mackled lamellate anger
    • Sclerouvectomie partial
    • Sclérotomie posterior
    • radiate optical Neurotomie
    • macular Translocation
      • by a retinotomy of 360 degree
      • by a technique of overlap sclérale

Surgery of the muscles of the eyes

  • the surgery of the muscles of the eyes is especially used to correct defects of Strabisme share the following operations:
    • Procedure of relaxation of the muscles
      • the recession implies to move the insertion of the posterior muscle towards its origin.
      • Myectomie
      • Myotomie
      • Tenectomie
      • Tenotomie
    • Procedure of reinforcement of the muscles
      • Résection
      • Retraction
      • Advance of the muscles, consists in moving forwards the fastener of a muscle previously located more backwards on the ocular sphere
    • Transposition/procedure of repositioning:

Oculoplastic surgery

  • the oculoplastic surgery or Oculoplastie, is a speciality of the ophthalmology which deals with the repairing and plastic surgery of the eye and its appendices. The surgeons in oculoplastie carry out procedures such as the repair of the eyelids, the removal of obstructions from tear duct, the repair of the orbital ruptures, the exérèse of the tumors in (and around) of the eyes, and the procedures of renovation (blépharoplastie, canthoplastie, botulinic toxin).

See too

Internal bonds

External bonds

  • “A little more on… the Surgery of the cataract, by an intern of Saint-Etienne”
  • “A little more on… the refractive surgery”
  • Site of association LASIK of France

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