Operative Dictations in Ophthalmology

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Editors
Eric D. Rosenberg Alanna S. Nattis
Ophthalmology Resident Cornea and Refractive Surgery Fellow
Department of Ophthalmology Ophthalmic Consultants of Long Island
New York Medical College Rockville Centre, NY, USA
Valhalla, NY, USA

Richard J. Nattis
Chief of Ophthalmology
and Clinical Professor
Department of Ophthalmology
Good Samaritan Hospital
West Islip, NY, USA

ISBN 978-3-319-45494-8    ISBN 978-3-319-45495-5 (eBook)

DOI 10.1007/978-3-319-45495-5

Library of Congress Control Number: 2017932292

© Springer International Publishing Switzerland 2017

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Introduction

1. All dictations will consist of a standard template specific to the state or institu-
tion. In an attempt to limit repetition, we have only included the sample dicta-
tion. It will pay dividends later to get a familiarity with your institution’s dictation
practice, which often includes:
Preoperative Diagnosis
Procedure
Postoperative Diagnosis
Surgeon
Assistant(s)
Anesthesia
Anesthesiologist
Specimens
Implants
Estimated Blood Loss
Complications
2. Dictations differ amongst attending surgeons, geography, institutions, etc. So
long as there are cats, there will be multiple ways to skin them. Italics, ____, and
(/) have been installed to help guide and prepare you for the variability that may
exist.
3. Out-of-date procedures have been included. Although most may feel that these
procedures would be better relegated to the history books, we strongly believe in
the importance of understanding surgical evolution.
4. The timing of “time-out” procedures varies. Be mindful of when they take place
in your OR.

v
Preface

Great things are not done by impulse, but by a series of small

things brought together.
—Vincent van Gogh (Letter to Theo, October 1882)

I began writing this book while I was a categorical general surgery resident.
Encouraged to pursue what deeply riveted me by my wife, family, and friends, I
made the bold leap into a truly inspiring field, Ophthalmology. After becoming
friendly with the OR staff, it always made me smile when they asked something to
the effect of “why are you leaving surgery, you know, real surgery?” Instead of
countering with “Ophthalmology is real surgery,” I simply answered that general
surgery was not for me—and that was the truth. Instead, I was entering a field
reserved for the select elite. Not only are we surgeons, clinicians, medical and surgi-
cal diagnosticians, and solo comprehensive practitioners, but we are enigmatic, fur-
tive, perfectionists. If someone cannot figure out why this field is the quintessence
of medicine, then what else can you do but smile.
We would like to take this special opportunity to thank our friends, colleagues,
and mentors who helped make this script a reality and dedicate it to those of you
who may have taken the nontraditional route. Learn as much as you can, acquire
patience, and develop precision, because it is you who will be the only real surgeon
that ever maintains and reserves the privilege to operate on the eye.

Valhalla, NY, USA Eric D. Rosenberg

Rockville Centre, NY, USA  Alanna S. Nattis
West Islip, NY, USA Richard J. Nattis

vii
Contents

Part I Anterior Segment

Conjunctiva
1 Pterygium Excision with Conjunctival Autograft................................. 3
Alanna S. Nattis and Eric D. Rosenberg
2 Pterygium Excision with Conjunctival Pedicle Graft........................... 7
Alanna S. Nattis and Eric D. Rosenberg
3 Pterygium Excision with Amniotic Membrane Graft.......................... 11
Alanna S. Nattis and Eric D. Rosenberg
4 Sealing the Gap with Amniotic Membrane Transplantation
for Primary and Recurrent Pterygium.................................................. 15
Anny M.S. Cheng and Scheffer C.G. Tseng
5 Repair of Conjunctivochalasis................................................................ 21
Laurence Sperber
6 Restoration of Fornix Tear Reservoir by Amniotic Membrane
Transplantation in Conjunctivochalasis................................................ 25
Anny M.S. Cheng and Scheffer C.G. Tseng
7 Amniotic Membrane Transplantation in Stevens–Johnson
Syndrome.................................................................................................. 31
Hajirah N. Saeed, Iason S. Mantagos, and James Chodosh
8 Gundersen’s Conjunctival Flap.............................................................. 35
Marguerite McDonald
Cornea
9 EDTA Chelation for Calcific Band Keratopathy.................................. 39
Alanna S. Nattis and Richard J. Nattis
10 Penetrating Keratoplasty (PKP)............................................................. 41
Alanna S. Nattis and Gerald Zaidman
ix
x Contents

11 Manual Deep Anterior Lamellar Keratoplasty (Manual DALK)....... 45

Alanna S. Nattis and Eric D. Rosenberg
12 IntraLase-Enabled Deep Anterior Lamellar Keratoplasty
(IEDALK)................................................................................................. 49
Winston Chamberlain and Eric D. Rosenberg
13 Descemet’s Stripping Automated Endothelial Keratoplasty
(DSAEK)................................................................................................... 53
Eric Donnenfeld and Alanna S. Nattis
14 Keratoprosthesis....................................................................................... 57
James V. Aquavella
15 Simple Limbal Conjunctival Autograft................................................. 65
Marwan Atallah and Guillermo Amescua
16 Removal of Salzmann’s Nodule and Amniotic Membrane
Placement.................................................................................................. 71
Anny M.S. Cheng and Scheffer C.G. Tseng
17 Insertion of Intrastromal Corneal Ring Segments (ICRS),
Femtosecond Laser Assisted................................................................... 75
Jorge L. Alió and Antonio Renna
Iris
18 Iris Repair (Iridoplasty) Using the Siepser Sliding Knot..................... 79
Steven B. Siepser

Part II Refractive and Cataract Surgery

19 Cataract Extraction, with Intraocular Lens Implant........................... 85
Alanna S. Nattis and Richard J. Nattis
20 Cataract Extraction, Extracapsular (ECCE)........................................ 89
Marwan Atallah and Guillermo Amescua
21 Cataract Extraction, the Use of Iris Hooks for Intraoperative
Floppy Iris Syndrome (IFIS)................................................................... 93
Reginald Camillo and Alanna S. Nattis
22 Cataract Extraction, Malyugin Ring...................................................... 97
Marguerite McDonald
23 Cataract Extraction Requiring Vitrectomy due to Violation
of the Posterior Capsule with Lens Implantation (Optic Capture,
in the Bag, Sulcus, and ACIOL)............................................................. 101
Shakeel Shareef and Lisa B. Arbisser
Contents xi

24 Cataract Extraction, Femtosecond Laser Assisted............................... 111

Eric Donnenfeld and Eric D. Rosenberg
25 Cataract Extraction, Endocyclophotocoagulation,
and Goniosynechialysis............................................................................ 115
Ike K. Ahmed and Matthew B. Schlenker
26 Cataract Extraction with Gold Metal Shunt (GMS) Implant............. 119
Ike K. Ahmed and Matthew B. Schlenker
27 Glued Intrascleral Haptic Fixation of an Intraocular Lens................. 123
Eric Donnenfeld and Alanna S. Nattis
28 Intraocular Lens Exchange..................................................................... 127
Eric Donnenfeld and David Alevi
29 Iris-Enclavated Intraocular Lens Implantation.................................... 131
Ike K. Ahmed and Matthew B. Schlenker
30 IOL Explantation with Iris-Enclavated Intraocular
Lens Implantation.................................................................................... 135
Ike K. Ahmed and Matthew B. Schlenker
31 Repair and Centration of Dislocated IOL Using McCannel
Suture Technique..................................................................................... 139
Alanna S. Nattis, Jennifer Yong, and Gerald Zaidman
32 Scleral Suturing and Fixation of a Dislocated Intraocular Lens......... 143
Ike K. Ahmed and Matthew B. Schlenker
33 Phakic IOL Removal and Cataract Extraction..................................... 147
David Alevi and Eric Donnenfeld
34 Astigmatic Keratotomy............................................................................ 151
Marguerite McDonald
35 Limbal Relaxing Incision........................................................................ 153
Alanna S. Nattis and Eric D. Rosenberg

Part III Filtering and Glaucoma

36 Laser Table............................................................................................... 157
Nathan Radcliffe and Tarika Thareja
37 Cyclocryotherapy..................................................................................... 159
Thaddeus Wandel and Alanna S. Nattis
38 Transscleral Diode Laser Cyclophotocoagulation (CPC).................... 161
Shakeel Shareef
39 Micropulse Trans-scleral Cyclophotocoagulation (mTSCPC)............ 169
Nathan Radcliffe and Tarika Thareja
xii Contents

40 Laser Peripheral Iridotomy.................................................................... 173

Nathan Radcliffe and Tarika Thareja
41 Laser Peripheral Iridoplasty................................................................... 177
Shakeel Shareef
42 Laser Trabeculoplasty............................................................................. 181
Nathan Radcliffe and Tarika Thareja
43 Goniosynechialysis................................................................................... 185
Daniel Lee and Jonathan S. Myers
44 Trabectome (Trabeculectomy Ab Interno)............................................ 189
Nisha Chadha
45 Goniotomy and Exam Under Anesthesia (EUA)................................... 193
Shani S. Reich and Janet B. Serle
46 Trabeculotomy and Exam Under Anesthesia (EUA)............................ 197
Janet B. Serle and Shani S. Reich
47 Trabeculectomy........................................................................................ 203
Thaddeus Wandel and Alanna S. Nattis
48 Target Placement of Multiple iStents..................................................... 207
Shakeel Shareef and Sansar Sharma
49 Target Placement of iStent Combined with Phacoemulsification........ 215
Shakeel Shareef and Sansar Sharma
50 Baerveldt Drainage Shunt with Scleral Patch Graft............................ 225
Ike K. Ahmed and Matthew B. Schlenker
51 Baerveldt Drainage Shunt with Scleral Patch Graft
and Cataract Extraction.......................................................................... 229
Ike K. Ahmed and Matthew B. Schlenker
52 Glaucoma Drainage Device (Ahmed Valve FP-7)................................. 235
Reginald Camillo and Eric D. Rosenberg
53 Ahmed Glaucoma Valve with Scleral Patch Graft
and Cataract Extraction.......................................................................... 239
Ike K. Ahmed and Matthew B. Schlenker
54 Viscocanalostomy..................................................................................... 243
Ike K. Ahmed and Matthew B. Schlenker
55 Canaloplasty............................................................................................. 247
Ike K. Ahmed and Matthew B. Schlenker
56 Canaloplasty and Cataract Extraction.................................................. 251
Ike K. Ahmed and Matthew B. Schlenker
57 Deep Sclerectomy with Collagen Implant.............................................. 257
Ike K. Ahmed and Matthew B. Schlenker
Contents xiii

58 Gold Metal Shunt (GMS) Implant......................................................... 261

Ike K. Ahmed and Matthew B. Schlenker

Part IV Retina and Vitreous

59 Panretinal Photocoagulation (PRP)....................................................... 267
Jessica Lee and Richard Rosen
60 Focal Macular Laser................................................................................ 271
Jessica Lee and Richard Rosen
61 Pneumatic Retinopexy 1.......................................................................... 273
Stephen Huddleston and Steve Charles
62 Pneumatic Retinopexy 2.......................................................................... 277
Paymohn Mahdavi and Paul E. Tornambe
63 Laser Retinopexy..................................................................................... 281
Jessica Lee and Richard Rosen
64 Repair of Macular Hole........................................................................... 285
Stephen Huddleston and Steve Charles
65 Internal Limiting Membrane Peel.......................................................... 289
Paymohn Mahdavi and Paul E. Tornambe
66 Removal of Epiretinal Membrane (ERM Peel)..................................... 293
Jessica Lee and Richard Rosen
67 Pars Plana Vitrectomy............................................................................. 297
Paymohn Mahdavi and Paul E. Tornambe
68 Evacuation of Vitreous Hemorrhage via Pars Plana Vitrectomy........ 301
Stephen Huddleston and Steve Charles
69 Scleral Buckling for Primary Retinal Detachment 1............................ 305
Stephen Huddleston and Steve Charles
70 Scleral Buckling for Primary Retinal Detachment 2............................ 309
Edward Marcus
71 Scleral Buckling for Rhegmatogenous Retinal Detachment................ 313
Quraish Ghadiali and Michael Engelbert
72 Scleral Buckle with Vitrectomy.............................................................. 317
Edward Marcus
73 Repair of Retinal Detachment via Pars Plana Vitrectomy
(C3F8/SF6/Oil)......................................................................................... 321
Stephen Huddleston and Steve Charles
74 Removal of Silicone Oil Following PPV and Retinal
Detachment Repair.................................................................................. 325
Stephen Huddleston and Steve Charles
xiv Contents

75 Pars Plana Vitrectomy and Pars Plana Lensectomy

for Retained Lens Fragments................................................................. 329
Quraish Ghadiali and Michael Engelbert
76 Intravitreal Injection............................................................................... 333
Jessica Lee and Richard Rosen

Part V Pediatrics and Strabismus

77 Nasolacrimal Duct Probing..................................................................... 337
Dawn Rush and Eric D. Rosenberg
78 Lacrimal Intubation................................................................................ 341
Dawn Rush and Alanna S. Nattis
79 Bilateral Lateral Rectus Recession (BLR)............................................. 343
Dawn Rush, Amro Ali, and Eric D. Rosenberg
80 Recession and Resection (R&R)............................................................. 347
Dawn Rush and Alanna S. Nattis
81 Bilateral Medial Rectus Recession (BMR)............................................ 351
Dawn Rush, Amro Ali, and Eric D. Rosenberg
82 Bilateral Inferior Oblique and Lateral Rectus Recession.................... 355
Dawn Rush and Alanna S. Nattis
83 Vertical and Horizontal Muscle Recessions With
and Without Adjustable Suture.............................................................. 359
Vivek Patel
84 Hummelsheim Transposition for Complete Paralytic
Sixth Nerve Palsy..................................................................................... 365
Vivek Patel
85 Surgical Optical Iridectomy.................................................................... 371
Alanna S. Nattis and Gerald Zaidman
86 Surgical Posterior Capsulotomy with Anterior Vitrectomy................ 373
Alanna S. Nattis and Gerald Zaidman

Part VI Occuloplastics and Orbit

Orbit
87 Orbit: One-Wall (Medial) Decompression............................................. 379
Cameron B. Nabavi and Craig N. Czyz
88 Orbit: Two-Wall (Medial and Floor) Decompression........................... 383
Cameron B. Nabavi and Craig N. Czyz
89 Orbit: Three-Wall (Medial, Floor, and Lateral) Decompression......... 387
Cameron B. Nabavi and Craig N. Czyz
Contents xv

  90 Orbit: Canthal Advancement and Balanced

Orbital Decompression............................................................................ 393
Jill A. Foster, Craig N. Czyz, and Cameron B. Nabavi
  91 Orbit: Dermis Fat Graft (DFG) for Orbital Volume
Augmentation........................................................................................... 401
Daniel Straka and Craig N. Czyz
  92 Orbit: Lacrimal Gland Biopsy................................................................ 405
Daniel Straka and Craig N. Czyz
  93 Orbit: Lacrimal Gland Resuspension.................................................... 409
Craig N. Czyz
  94 Orbit: Percutaneous Sclerotherapy........................................................ 413
Daniel Straka and Craig N. Czyz
  95 Orbit: Eye Socket Reconstruction with Mucous
Membrane Graft...................................................................................... 417
Larissa Ghadiali and Bryan Winn
 96 Orbit: Enucleation................................................................................... 421
Mehdi Tavakoli, Benjamin Erickson, and Wendy W. Lee
 97 Orbit: Evisceration.................................................................................. 425
Andrew Rong, Benjamin Erickson, and Wendy W. Lee
  98 Orbit: Orbital Exenteration with Split-­Thickness Skin Graft............ 429
Mehdi Tavakoli, Benjamin Erickson, and Wendy W. Lee
  99 Orbit: Orbital Exenteration (Subtotal/Total/Extended)...................... 433
Cameron B. Nabavi and Craig N. Czyz
Eyelid
100 Eyelid: Blepharoplasty, Upper Lid......................................................... 437
Andrew Rong, Benjamin Erickson, and Wendy W. Lee
101 Eyelid: Levator Resection....................................................................... 441
Daniel Straka and Craig N. Czyz
102 Eyelid: External Levator Resection........................................................ 445
Mehdi Tavakoli, Benjamin Erickson, and Wendy W. Lee
103 Eyelid: Levator Advancement................................................................ 449
Kimberly D. Tran, Benjamin Erickson, and Wendy W. Lee
104 Eyelid: Conjunctival Müllerectomy....................................................... 453
Craig N. Czyz
105 Eyelid: Conjunctival Müller’s Muscle Resection (CMMR)................. 457
Andrew Rong, Benjamin Erickson, and Wendy W. Lee
xvi Contents

106 Eyelid: Frontalis Suspension................................................................... 461

Daniel Straka and Craig N. Czyz
107 Eyelid: Transverse Everting Sutures (Quickert Sutures,
Three-Suture Technique)......................................................................... 465
Larissa Ghadiali and Bryan Winn
108 Eyelid: Entropion Repair (Internal)...................................................... 469
Craig N. Czyz
109 Eyelid: Entropion Repair (External)...................................................... 473
Craig N. Czyz
110 Eyelid: Ectropion Repair FTSG (Cicatricial)....................................... 477
Craig N. Czyz
111 Eyelid: Ectropion Repair, Tarsal Strip (Involutional).......................... 481
Craig N. Czyz
112 Eyelid: Medial Ectropion Repair............................................................ 485
Craig N. Czyz
113 Eyelid: Lateral Tarsal Strip with Medial Spindle
for Ectropion Repair with Punctal Eversion......................................... 489
Larissa Ghadiali and Bryan Winn
114 Eyelid: Lateral Canthotomy................................................................... 493
Ashley Crane, Benjamin Erickson, and Wendy W. Lee
115 Eyelid: Lateral Canthopexy.................................................................... 497
Craig N. Czyz
116 Eyelid: Floppy Eyelid Syndrome Repair (Wedge Resection)............... 501
Craig N. Czyz and Kenneth V. Cahill
117 Eyelid: Chalazion Incision and Drainage (I&D)................................... 505
Daniel Straka and Craig N. Czyz
118 Eyelid: Wedge Resection for Eyelid Lesion........................................... 509
Craig N. Czyz
119 Eyelid: Temporary Tarsorrhaphy.......................................................... 513
Nimesh Patel, Benjamin Erickson, and Wendy W. Lee
120 Eyelid: Gold Weight Implantation......................................................... 517
Kimberly D. Tran, Benjamin Erickson, and Wendy W. Lee
121 Levator Recession.................................................................................... 521
Daniel Straka and Craig N. Czyz
122 Hard Palate Graft for Lower Eyelid Retraction Repair...................... 525
Larissa Ghadiali and Bryan Winn
Contents xvii

Brow
123 Browpexy.................................................................................................. 529
Craig N. Czyz
124 Direct Brow Lift....................................................................................... 533
Ashley Crane, Benjamin Erickson, and Wendy W. Lee
125 Coronal Brow Lift.................................................................................... 537
Kelly R. Everman and Craig N. Czyz
126 Internal Lateral Browpexy...................................................................... 541
Larissa Ghadiali and Bryan Winn
Facial and Miscellaneous
127 Temporal Artery Biopsy.......................................................................... 545
Daniel Straka and Craig N. Czyz
128 Botulinum Toxin Treatment of Benign Essential Blepharospasm
(BEB) and Hemifacial Spasm................................................................. 549
Craig N. Czyz
129 Optic Nerve Sheath Fenestration............................................................ 553
Scott Forman and Eric D. Rosenberg
Reconstructive
130 Hughes Tarsoconjunctival Flap 1........................................................... 557
Ashley Crane, Benjamin Erickson, and Wendy W. Lee
131 Hughes Tarsoconjunctival Flap 2........................................................... 561
Craig N. Czyz
132 Free Tarsal Graft...................................................................................... 565
Craig N. Czyz
133 Anterior Lamellar Repositioning........................................................... 569
Alanna S. Nattis
134 Tenzel Semicircular Flap......................................................................... 573
Ashley Crane, Benjamin Erickson, and Wendy W. Lee
135 O-to-Z Plasty............................................................................................ 577
Larissa Ghadiali and Bryan Winn
136 Glabellar Flap.......................................................................................... 581
Larissa Ghadiali and Bryan Winn
Lacrimal
137 Punctoplasty............................................................................................. 585
Ashley Crane, Benjamin Erickson, and Wendy W. Lee
xviii Contents

138 Probing of the Nasolacrimal Duct.......................................................... 589

Andrew Rong, Nathan Blessing, and Wendy W. Lee
139 Lacrimal System Intubation (Bicanalicular)......................................... 591
Kenneth V. Cahill and Craig N. Czyz
140 Lacrimal System Intubation (Monocanalicular)................................... 595
Craig N. Czyz
141 Balloon Dacryocystoplasty...................................................................... 599
Maan Alkharashi and Deborah VanderVeen
142 Conjunctivodacryocystorhinostomy (CDCR)....................................... 603
Kenneth V. Cahill and Craig N. Czyz
143 External Dacryocystorhinostomy 1 (DCR)............................................ 607
Mehdi Tavakoli, Benjamin Erickson, and Wendy W. Lee
144 External Dacryocystorhinostomy 2 (DCR)............................................ 611
Cameron B. Nabavi and Craig N. Czyz
145 Endoscopic Dacryocystorhinostomy (DCR).......................................... 615
Maan Alkharashi and Deborah VanderVeen

Part VII Cosmetic Surgery

146 Facelift: Deep Plane................................................................................. 621
Craig N. Czyz
147 Facelift, Plication...................................................................................... 627
Craig N. Czyz and Jill A. Foster
148 Endoscopic Brow Lift.............................................................................. 631
Craig N. Czyz and Jill A. Foster
149 Ablative Laser Resurfacing (CO2).......................................................... 635
Craig N. Czyz
150 Cosmetic Botulinum Toxin Treatment................................................... 637
Craig N. Czyz
151 Cosmetic Tissue Filler Treatment........................................................... 641
Craig N. Czyz
152 Dermis Fat Graft (DFG) for Superior Sulcus Volumetric
Rejuvenation............................................................................................. 645
Craig N. Czyz and Jill A. Foster

Part VIII Trauma

153 Eyelid Laceration Repair, Superficial and Deep................................... 651
Alanna S. Nattis
Contents xix

154 Repair of Marginal Laceration............................................................... 655

Alanna S. Nattis
155 Repair of Canalicular Laceration........................................................... 657
Kenneth V. Cahill and Kelly R. Everman
156 Full-Thickness Eyelid Laceration Repair.............................................. 661
Craig N. Czyz and Kelly R. Everman
157 Orbital Floor Fracture Repair................................................................ 665
Craig N. Czyz
158 Orbital Compartment Syndrome: Canthotomy/Cantholysis/
Canthal Cutdown..................................................................................... 669
Craig N. Czyz
159 Zygomaticomaxillary Complex (ZMC) Fracture Repair..................... 673
Kelly R. Everman and Craig N. Czyz
160 Ruptured Globe Repair........................................................................... 677
Craig N. Czyz

Index.................................................................................................................. 681
Contributors

Ike K. Ahmed Department of Ophthalmology and Vision Sciences, University of

Toronto, Toronto, ON, Canada
David Alevi Department of Ophthalmology, Ophthalmic Consultants of Long
Island, Rockville Center, NY, USA
Amro Ali Department of Ophthalmology, New York Medical College, Valhalla,
NY, USA
Jorge L. Alió Division of Ophthalmology, Vissum Corporation, Universidad
Miguel Hernandez, Alicante, Spain
Maan Alkharashi Department of Ophthalmology, Boston Children’s Hospital,
Harvard Medical School, Boston, MA, USA
Guillermo Amescua Department of Ophthalmology, Bascom Palmer Eye Institute,
University of Miami Miller School of Medicine, Miami, FL, USA
James V. Aquavella Department of Ophthalmology, Flaum Eye Institute,
University of Rochester Medical Center, Rochester, NY, USA
Lisa B. Arbisser Department of Ophthalmology, John A. Moran Eye Center,
University of Utah, Salt Lake City, UT, USA
Marwan Atallah Department of Ophthalmology, Bascom Plamer Eye Institute,
University of Miami Miller School of Medicine, Miami, FL, USA
Nathan Blessing Department of Ophthalmology, Bascom Plamer Eye Institute,
University of Miami Miller School of Medicine, Miami, FL, USA
Kenneth V. Cahill Department of Ophthalmology, Grant Medical Center,
Columbus, OH, USA
Department of Ophthalmology, The Ohio State University, Columbus, OH, USA
Reginald Camillo Department of Ophthalmology, Metropolitan Hospital, New
York, NY, USA

xxi