Presentation on theme: "ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute."— Presentation transcript:
ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF INPATIENT POST OPERATIVE COMPLICATION
The MLOP shall identify the early post operative complications in the ward and shall help in the effective management of the same. AIM
The MLOP shall Develop wide range of basic knowledge of immediate post surgical complicationsDevelop wide range of basic knowledge of immediate post surgical complications In early identification of post operative complicationsIn early identification of post operative complications Helping doctors in prompt remedial measuresHelping doctors in prompt remedial measures In explaining and reassuring patients in a proper way about their complications.In explaining and reassuring patients in a proper way about their complications. Objectives
Theory The ocular post surgical complications can broadly be divided into Anterior segment complicationsAnterior segment complications Posterior segment complicationsPosterior segment complications Early post operative complicationsEarly post operative complications Late post operative complicationsLate post operative complications
Lid edema Swelling of the Lid Swelling of the Lid Causes : Injury with instruments Inflammation ( Iritis) Allergy to medications Treatment : Anti - Inflammatory drugs Steroids Anti histamines in case of allergy
Chemosis Congestion and collection of fluid Causes : Allergy Subconjunctival Injections Iritis Endophthalmitis Treatment : Observation Anti Inflammatory drug
Descemets Membrane Stripping Descemets Membrane Stripping The stroma and thus allowing easy separation from stroma Causes: Entry in to the globe Faulty instrumentation Fluid is injected between the descemet’s membrane and stroma If small – Air Bubble left in anterior chamber If larger – Needs surgical repair
Epithelial defect Rupture of epithelium Predisposing Factors : Injury (Instrument, Pad / Cotton ) During anaesthesia eye is open Treatment : Only antibiotic ointment pad / bandage. pad / bandage.
Wound leak : Size of the section is larger than the normal Loose suture wound gape Trauma Inadequate and improper suturing of the wound Treatment : Pressure pad / bandage / mydriatic If AC does not form within 24 – 48 hrs Needs AC reforming / resuturing
Pupilary Block Causes : AC IOL without PI Severe Iritis – 360 deg PS Vitreous touching the PUPIL IOL capture Treatment : Inj. mannitol 20% Tab. diamox 1st Laser PI. If not possible Needs surgical PI.
Fibrin Membrane Appear as a dense fibrin net in pupillary area Causes: Prolonged Irrigation with balance – salt solution Unsterile IOL Treatment: Antibiotic drops hourly Steriods drops hourly Cycloplegic drops TDS If needed oral steriods to be given (1mg /1kg)
Cortex Residual cortex Predisposing Conditions : Small pupil Pseudo exfoliation Diabetic mellitus Positive pressure during surgery PC rent Treatment : Small piece of loose cortex will get absorbed – steroids E/D Large clumps of cortex not getting absorbed – needs AC wash.
Treatment : Bed rest, bandage both eyes. Bed rest, bandage both eyes. Steroid eye drops. Steroid eye drops. Cycloplegic eye drops. Cycloplegic eye drops. Timolol eye drops. Timolol eye drops. Tab. Diamox. Tab. Diamox. Tab. Vit C. Tab. Vit C. Observation for 2 days. If not responding needs AC wash. Observation for 2 days. If not responding needs AC wash.
SYMPTOMS Pain, Redness, Defective vision. Lid edema, conjunctival chemosisLid edema, conjunctival chemosis Corneal edema, corneal InfiltrationCorneal edema, corneal Infiltration AC cells, HypopyonAC cells, Hypopyon Infiltrate in suture / sectionInfiltrate in suture / section Wound gape or weak wound.Wound gape or weak wound.
TREATMENT: No steroids Topical antibiotics AC tap. Vit-tap Intravitreal antibiotics
IRITIS Inflammation of the iris.Inflammation of the iris. Flare and cellsFlare and cells Fibrin membrane.Fibrin membrane. Treatment :Treatment : Antibiotic drops hourly Antibiotic drops hourly Steroids drops hourly Steroids drops hourly Cycloplegic drops TDS Cycloplegic drops TDS If needed oral steroids to be given (1mg/1kg) If needed oral steroids to be given (1mg/1kg)