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December 1965

Scleral Buckling ProceduresVIII. Preoperative Complications

Author Affiliations

From the Retina Service, Massachusetts Eye and Ear Infirmary; The Department of Clinical Eye Research of the Retina Foundation; and Harvard Medical School.

Arch Ophthalmol. 1965;74(6):792-798. doi:10.1001/archopht.1965.00970040794010

In our first paper the preoperative management for an uncomplicated retinal detachment was discussed.1 In many instances, however, patients with retinal detachment present additional problems which may modify the preoperative care of the patient. The most important of these problems are interference with satisfactory ophthalmoscopy, glaucoma, uveitis, choroidal detachment, external infections, medical disorders, and emotional instability. In this paper the management of patients showing these difficulties will be discussed.

Interference With Ophthalmoscopy  Corneal haziness may develop during the course of ophthalmoscopy. This is due to epithelial edema following drying of the corneal epithelium. The use of local anesthetic agents, such as 0.5% tetracaine hydrochloride, aggravates this type of corneal edema; therefore, local anesthetics should be used only when absolutely necessary, and, if possible, near the end of the examination. Proparacaine hydrochloride 0.5% has been found to cause the least disturbance of the corneal epithelium. In addition, to minimize corneal

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