Ocular Procedures

A procedure to remove the patient's eye lens and in most cases, replace it with an artificial intraocular lens (IOL);
Most common operation
Usually takes 30- 45 mins under local anaesthetic; tetracaine hydrochloride 0.5% w/v eye drops.

First IOLs were made of PMMA;
However PMMA is rigid and requires a relatively large incision of ~7mm to enable implantation.
Modern IOLs produced from soft polymers based on silicon or acrylic polymers, allowing lens to be folded and inserted through a much smaller incision of <3mm

· Infection;
· postoperative inflammation;
· Posterior capsule opacification;
· Secondary cataracts caused by epithelial cell adhesion and proliferation in the posterior lens capsule.
Drug-eluting intraocular lenses: potential for postoperative delivery of antibiotics and anti-inflammatory medication

OcuSeal™ Liquid Ocular Bandage
Provides a protective hydrogel film barrier while stabilizing ocular wounds;
Designed to promote healing by protecting the corneal incision from eyelid trauma.

An ocular degenerative condition that affects the cornea. Gradually weakens, progressively, thins and becomes irregular in shape. Results in high levels of astigmatism and blurred vision

This procedure requires removal of the corneal epithelium (epithelial debridement) in a 6-7mm diameter central zone;
Application of a 0.1% riboflavin solution
Irradiation with ultraviolet-A light at 370 nm. This activates riboflavin generating reactive oxygen species that induce covalent bonds between collagen fibrils in the corneal stroma.

Performed by an ophthalmologist who uses a laser or microkeratome to reshape cornea to improve visual acuity
For most, LASIK provides a permanent alternative to eyeglasses or contact lenses
For those near-sighted, LASIK is used to flatten a cornea that is too steep.
Far-sighted people (presbyopia) have LASIK to achieve a steeper cornea.
·Also corrects astigmatism by shaping an irregular cornea into a more normal shape.

1. eye numbed with a topical anaesthetic.
2. Eyelid holder placed between the eyelids to keep them open.
3. Suction ring placed on the eye lifts and flattens the cornea and helps keep the eye from moving.
4. Once cornea is flattened, a hinged flap of corneal tissue is created using an automated microsurgical device, either a laser or blade. This corneal flap is lifted and folded back.
5. The excimer laser pre-programmed with patient's unique eye measurements is centred above the eye.
6. Patient looks at a special pinpoint light,( called fixation or target light), while the excimer laser sculpts the corneal tissue;
7. Surgeon places flap back into position and smoothes the edges.
8. Corneal flap sticks to underlying corneal tissue within 2-5 mins. Stitches aren't needed.

Infection and inflammation.
Small chance vision won't be as good after surgery as before, even with glasses or contact lenses.
Side effects
· Hazy or blurry vision.
· Difficulty with night vision and/or driving at night; scratchiness, dryness and other symptoms of "dry eye".
· Glare.
· Halos or starbursts around lights.
· Light sensitivity.
· Discomfort or pain.
· Small pink or red patches on the sclera.
In small minority of patients, some of these effects are permanent.

Povidone-Iodine 5% w/v eye drops
A chemical complex of poly-N-vinylpyrrolidone (povidone, PVP) and elemental iodine.
Iodophore with a broad spectrum antiseptic activities for topical applications

Acular®
Ketorolac trometamol 5 mg/mL -API (NSAIDs)
Excipients:
· Sodium chloride
· Benzalkonium chloride
· Disodium edetate
· Octoxinol 40
· 1N Sodium hydroxide or 1N Hydrochloric acid, to adjust pH
· Purified water

Azyter® eye drops (azithromycin) - UK/EU
Medium-chain triglycerides, (oil)
AzaSite® (azithromycin ophthalmic solution) 1% - USA
Polycarbophil (polyacrylic acid) - in situ gelling agent
Edetate disodium - chelating agent enhances permeability
Sodium chloride - adjustment of tonicity.