d. Lighting. Illumination for eye surgery may be furnished by a number of
(1) One method is the use of the standard overhead light. The circulator
may be responsible for adjusting the light during surgery. If this need occurs, he should
pay particular attention to not contaminating the sterile field and scrubbed personnel.
(2) A second source is the use of an electric head lamp. This lamp is
strapped to the surgeon's head and is used in the same manner as a coal miner's
helmet. The surgeon may redirect the light during surgery.
(3) The third method is the use of the operating microscope. This is a
device used to magnify the site of surgery and enable the surgeon to do very delicate
work with excellent illumination. This device is draped with sterile material before the
procedure is started, and the surgeon may make any adjustments. The microscope is
being used more and more for eye and other delicate surgery.
e. Medications. As many as 5 or 6 solutions may be kept within the sterile field
for use during eye procedures; examples of these are saline (for dampening the
eyeball), local anesthetic agents, and epinephrine. If these are not prepackaged and
sterilized in individually labeled doses, the specialist should label medicine glasses to
show the name and the strength of each solution. During preparation for an operation,
the circulator should pour the solutions needed into the medicine glasses, making sure
that the solution he is pouring matches the label on the glass. Great care should be
taken to assure that ophthalmic solutions of the desired drugs are used.
f. Sterile Setup. If both of the patient's eyes are to be operated on for
correction of defects requiring muscle surgery or other extraocular procedures, only one
Mayo table needs to be up. However, if intraocular surgery is to be performed on both
eyes, the specialist sets up two tables--one for each eye. When the procedure on the
first eye is completed, the surgeon and specialist change only their gloves in
preparation for the second eye.
A large percentage of intraocular surgery does not require double setups.
Advancement in techniques and equipment makes the practice ineffective
PREPARATION OF THE PATIENT
a. Preoperative Prep. For a successful operation, the physical, spiritual, and
emotional needs of the person must be considered. Each member of the staff should
endeavor to meet the needs of each patient and help him to cope with his specific