Presentation on theme: "DEPARTMENT OF INPATIENT"— Presentation transcript:
1 DEPARTMENT OF INPATIENT POST OPERATIVE COMPLICATION
2 AIM The MLOP shall identify the early post operative complications in the ward and shallhelp in the effective management of the same.
3 Objectives The MLOP shall Develop wide range of basic knowledge of immediate post surgical complicationsIn early identification of post operative complicationsHelping doctors in prompt remedial measuresIn explaining and reassuring patients in a proper way about their complications.
4 TheoryThe ocular post surgical complications can broadly be divided intoAnterior segment complicationsPosterior segment complicationsEarly post operative complicationsLate post operative complications
5 Early Post - Operative Anterior segment complications Lid Oedema; ptosisConjunctiva - Chemosis, Subconjunctival haemorrhageCornea Oedema, Striate Keratopathy,Epi. defectAnt. Chamber - Shallow, Cortex, Hyphaema, HypopyonCont…
15 Descemets Membrane Stripping The stroma and thus allowing easy separation from stromaCauses:Entry in to the globeFaulty instrumentationFluid is injected between the descemet’s membrane and stromaIf small – Air Bubble left in anterior chamberIf larger – Needs surgical repair
16 Epithelial defect Epithelial defect Rupture of epithelium Predisposing Factors :Injury (Instrument, Pad / Cotton )During anaesthesia eye is openTreatment :Only antibiotic ointmentpad / bandage.
18 Wound leak : Treatment : Size of the section is larger than the normal Loose suture wound gapeTraumaInadequate and improper suturing of the woundTreatment :Pressure pad / bandage / mydriaticIf AC does not form within 24 – 48 hrsNeeds AC reforming / resuturing
19 Pupilary Block Causes : AC IOL without PI Severe Iritis – 360 deg PS Vitreous touching the PUPILIOL captureTreatment :Inj. mannitol 20%Tab. diamox1st Laser PI.If not possible Needs surgical PI.
20 Fibrin Membrane Appear as a dense fibrin net in pupillary area Causes: Prolonged Irrigation with balance – salt solutionUnsterile IOLTreatment:Antibiotic drops hourlySteriods drops hourlyCycloplegic drops TDSIf needed oral steriods to be given (1mg /1kg)
21 Cortex Residual cortex Predisposing Conditions : Treatment : Small pupilPseudo exfoliationDiabetic mellitusPositive pressure during surgeryPC rentTreatment :Small piece of loose cortex will get absorbed – steroids E/DLarge clumps of cortex not getting absorbed – needs AC wash.
22 Bed rest, bandage both eyes. Treatment :Bed rest, bandage both eyes.Steroid eye drops.Cycloplegic eye drops.Timolol eye drops.Tab. Diamox.Tab. Vit C.Observation for 2 days. If not responding needs AC wash.