Cataract Surgery

CATARACT SURGERY

Q. 1

In Cataract, spectacles are advised after following number of weeks after operation

 A

6 weeks

 B

10 weeks

 C

12 weeks

 D

14 weeks

Q. 1

In Cataract, spectacles are advised after following number of weeks after operation

 A

6 weeks

 B

10 weeks

 C

12 weeks

 D

14 weeks

Ans. A

Explanation:

A i.e. 6 weeks


Q. 2

Leaving the capsule behind in cataract surgery is advantageous because it:

 A

Prevents cystoid macular edema

 B

Decreases endothelial damage

 C

Progressively improves vision

 D

a and b

Q. 2

Leaving the capsule behind in cataract surgery is advantageous because it:

 A

Prevents cystoid macular edema

 B

Decreases endothelial damage

 C

Progressively improves vision

 D

a and b

Ans. D

Explanation:

A i.e. Prevents cystoid macular oedema; B i.e. Decreases endothelial damage

In ECCE (extra capsular cataract extraction) central part of anterior capsule is removed along with nucleus & cortex of lens. The posterior capsule & equatorial and peripheral part of anterior capsule are being left inside. 


Q. 3

Advantages of extracapsular cataract extraction (ECCE):

 A

Less chance of vitreous h’ge & RD

 B

Decreased chances of CME (cystoid macular edema) 

 C

Can be used is traumatic lens dislocation

 D

a and b

Q. 3

Advantages of extracapsular cataract extraction (ECCE):

 A

Less chance of vitreous h’ge & RD

 B

Decreased chances of CME (cystoid macular edema) 

 C

Can be used is traumatic lens dislocation

 D

a and b

Ans. D

Explanation:

A i.e. Less chances of vitreous h’ge & RD; B i.e. Decreased chances of CME 

Quiz In Between


Q. 4

Laser used in cutting out cataract capsule is

 A

Nd : YAG laser

 B

Argon laser

 C

DYE laser

 D

Diode

Q. 4

Laser used in cutting out cataract capsule is

 A

Nd : YAG laser

 B

Argon laser

 C

DYE laser

 D

Diode

Ans. A

Explanation:

A i.e. Nd:YAG Laser


Q. 5

In posterior capsular cataract, treatment is

 A

Krypton Laser

 B

Nd-YAG Laser

 C

Argon Laser

 D

CO2 Laser

Q. 5

In posterior capsular cataract, treatment is

 A

Krypton Laser

 B

Nd-YAG Laser

 C

Argon Laser

 D

CO2 Laser

Ans. B

Explanation:

B i.e. Nd-YAG laser

Nd. YAG (Neodymium-Yttrium-Aluminium-Garnet) laser is used for posterior capsulotomy in after cataract.Q After cataract/ Secondary cataract/ Posterior Capsular Opacification (PCO)

– It is the opacity which persists or develops after ECCE

–  It may present as thickened posterior capsule or dense membranous after cataract or Soemmering’s ringQ (thick ring of after cataract formed behind the iris, enclosed between the two layers of capsule) or Elschnig’s pearlsQ (vacuolated subcapsular epithelial cells are clustered like soap bubbles along the posterior capsule)

–  It is treated by Nd-YAG-laser posterior capsulotomyQ (Neodymium-Yttrium-Aluminium-Garnet laser) or surgical membranectomy

 

Laser

Wavelength

(nm)

Clinical Application of LASERS in Ophthalmology

Nd: YAG

1064Q

Posterior capsulotomy Q, iridotomy, vitreolysis.

Femtosecond laser

1053

Refractory surgery, lamellar corneal surgery.

Diode laser

800

Retinal photocoagulation*

Krypton laser

714

Retinal photocoagulation*

Frequency doubled Nd: YAG

532

Retinal photocoagulation*, cyclophoto-coagulation

Argon green

514

Retinal photocoagulation*, trabeculoplasty,

iridoplasty, pupillo-mydriasis

Excimer (Argon-fluoride)

193

Photorefractive keratectomy (PRK),

phototherapeutic keratectomy (PTK), LASIK,

LASEK

Retinal photocoagulation includes treatment for diabetic retinopathy, other causes of retinal neovascularization or oedema, retinal breaks, central serous retinochoroidopathy, subretinal neovascular membranes, small retinal tumors, angiomas. Argon green laser is m.c. used for this.


Q. 6

For revised NPCB cataract surgeries are approaches followed except:

 A

Uniform distribution

 B

Regular follow up

 C

Fixed place surgery treatment

 D

Mobile surgery camps

Q. 6

For revised NPCB cataract surgeries are approaches followed except:

 A

Uniform distribution

 B

Regular follow up

 C

Fixed place surgery treatment

 D

Mobile surgery camps

Ans. D

Explanation:

D i.e. Mobile surgery camps

Revised strtegies regarding catarct surgeries under NPCB

  • Follow up of operated casesQ
  • To shift from eye camp approach to fixed facility surgical approachQ
  • To shift from conventional surgery to IOL implantation
  • To improve infrastructure i.e. operation theatres, equipments
  • To train surgeons in modern techniques
  • To strenghthen participation of NGOs
  • To target under-served areas

Quiz In Between


Q. 7

Complete unilateral congenital cataract should preferably be operated:

 A

Within a few weeks of birth

 B

At the age of 6 months

 C

At the age of 2 years

 D

At the age of 5 years

Q. 7

Complete unilateral congenital cataract should preferably be operated:

 A

Within a few weeks of birth

 B

At the age of 6 months

 C

At the age of 2 years

 D

At the age of 5 years

Ans. A

Explanation:

Ans. Within a few weeks of birth


Q. 8

The early changes in corticosteroid-induced cataract are in the form of:

 A

Central posterior subcapsular lens changes

 B

Anterior cortical lens changes

 C

Nuclear changes

 D

Diffuse lens changes

Q. 8

The early changes in corticosteroid-induced cataract are in the form of:

 A

Central posterior subcapsular lens changes

 B

Anterior cortical lens changes

 C

Nuclear changes

 D

Diffuse lens changes

Ans. A

Explanation:

Ans. Central posterior subcapsular lens changes


Q. 9

In a patient with senile cataract the macular functions can be tested by all except:

 A

Two-light discrimination test

 B

Swinging flash light test

 C

Maddox rod test

 D

Laser interferometry

Q. 9

In a patient with senile cataract the macular functions can be tested by all except:

 A

Two-light discrimination test

 B

Swinging flash light test

 C

Maddox rod test

 D

Laser interferometry

Ans. B

Explanation:

Ans. Swinging flash light test

Quiz In Between


Q. 10

A mature uniocular cataract in a 3-year-old child:

 A

Will require refraction

 B

May be absorbed

 C

Should be removed

 D

Should he left as such

Q. 10

A mature uniocular cataract in a 3-year-old child:

 A

Will require refraction

 B

May be absorbed

 C

Should be removed

 D

Should he left as such

Ans. C

Explanation:

Ans. Should be removed


Q. 11

All are the advantages of leaving the capsule behind in cataract surgery except:

 A

Prevents cystoid macular edema

 B

Decreases endothelial damage

 C

Progressively improves vision

 D

Decreases chance of retinal detachment

Q. 11

All are the advantages of leaving the capsule behind in cataract surgery except:

 A

Prevents cystoid macular edema

 B

Decreases endothelial damage

 C

Progressively improves vision

 D

Decreases chance of retinal detachment

Ans. C

Explanation:

Ans. Progressively improves vision


Q. 12

In preoperative assessment of cataract patient following is to be done:

 A

Axial length of cornea

 B

Corneal thickness

 C

Thickness of the lens

 D

Corneal curvature

Q. 12

In preoperative assessment of cataract patient following is to be done:

 A

Axial length of cornea

 B

Corneal thickness

 C

Thickness of the lens

 D

Corneal curvature

Ans. D

Explanation:

Ans. Corneal curvature

Quiz In Between


Q. 13

A child has got a congenital cataract involving the visual axis which was detected by the parents right at birth. This child should be operated:

 A

Immediately

 B

At 2 months of age

 C

At 1 year of age when the globe becomes normal sized

 D

After 4 years when entire ocular and orbital growth becomes normal

Q. 13

A child has got a congenital cataract involving the visual axis which was detected by the parents right at birth. This child should be operated:

 A

Immediately

 B

At 2 months of age

 C

At 1 year of age when the globe becomes normal sized

 D

After 4 years when entire ocular and orbital growth becomes normal

Ans. A

Explanation:

Ans. Immediately


Q. 14

In Cataract, spectacles are advised for following number of weeks after operation:

 A

6 weeks

 B

10 weeks

 C

12 weeks

 D

14 weeks

Q. 14

In Cataract, spectacles are advised for following number of weeks after operation:

 A

6 weeks

 B

10 weeks

 C

12 weeks

 D

14 weeks

Ans. A

Explanation:

Ans. 6 weeks


Q. 15

Which of the following is the most important factor in the prevention of the endophthalmitis in cataract surgery?

 A

Preoperative preparation with povidone iodine

 B

One week antibiotic therapy prior to surgery

 C

Trimming of eyelashes

 D

Use of intravitreal antibiotics

Q. 15

Which of the following is the most important factor in the prevention of the endophthalmitis in cataract surgery?

 A

Preoperative preparation with povidone iodine

 B

One week antibiotic therapy prior to surgery

 C

Trimming of eyelashes

 D

Use of intravitreal antibiotics

Ans. A

Explanation:

Ans. Preoperative preparation with povidone iodine

Quiz In Between


Q. 16

In extra-capsular cataract surgery [ECCE], which part of the lens is excised: 

September 2008

 A

Anterior capsule

 B

Posterior capsule

 C

Nucleus

 D

Whole lens

Q. 16

In extra-capsular cataract surgery [ECCE], which part of the lens is excised: 

September 2008

 A

Anterior capsule

 B

Posterior capsule

 C

Nucleus

 D

Whole lens

Ans. C

Explanation:

Ans. C: Nucleus

Extracapsular cataract extraction (ECCE) is a category of eye surgery in which the nucleus of the lens of the eye is removed andcortical content washed out, while the elastic capsule that covers the lens is left partially intact to allow implantation of an intraocular lens (104

This approach is contrasted with intracapsular cataract extraction (ICCE), an older procedure in which the complete lens is removed with its capsule and left the eye aphakic (without a lens).


Q. 17

Which laser is used in the management of after cataracts:               

March 2011

 A

Argon

 B

Krypton

 C

Nd-YAG

 D

Excimer

Q. 17

Which laser is used in the management of after cataracts:               

March 2011

 A

Argon

 B

Krypton

 C

Nd-YAG

 D

Excimer

Ans. C

Explanation:

Ans. C: Nd-YAG

‘After’ cataracts, if thin, can be cleared centrally by a YAG laser capsulotomy

Nd:YAG/ Neodymium-doped yttrium aluminium garnet/ Nd:Y3A15O12

  • It is a crystal that is used as a lasing medium for solid-state lasers.
  • The dopant, triply ionized neodymium, typically replaces yttrium in the crystal structure of the yttrium aluminium garnet (YAG), since they are of similar size.
  • Generally the crystalline host is doped with around 1% neodymium by atomic percent.
  • Nd:YAG lasers are optically pumped using a flashtube or laser diodes.
  • Nd:YAG lasers typically emit light with a wavelength of 1064 nm, in the infrared.
  • However, there are also transitions near 940,1120,1320, and 1440 nm.
  • Nd:YAG lasers operate in both pulsed and continuous mode.
  • Pulsed Nd:YAG lasers are typically operated in the so called Q-switching mode:
  • Nd:YAG absorbs mostly in the bands between 730-760 nm and 790-820 nm.
  • At low current densities krypton flashlamps have higher output in those bands than do the more common xenon lamps, which produce more light at around 900 nm.
  • The former are therefore more efficient for pumping Nd:YAG lasers

Uses

  • Nd:YAG lasers are used in ophthalmology to correct posterior capsular opacification, a condition that may occur after cataract surgery, and for peripheral iridotomy in patients with acute angle-closure glaucoma, where it has superseded surgical iridectomy.
  • Frequency-doubled Nd:YAG lasers (wavelength 532 nm) are used for pan-retinal photocoagulation in patients with diabetic retinopathy.
  • In oncology, Nd:YAG lasers can be used to remove skin cancers.
  • These lasers are also used extensively in the field of cosmetic medicine for laser hair removal and the treatment of minor vascular defects such as spider veins on the face and legs.
  • Using hysteroscopy the Nd:YAG laser has been used for removal of uterine septa within the inside of the uterus.
  • In podiatry, the Nd:YAG laser is being used to treat onychomycosis, which is fungus infection of the toenail.

Q. 18

Laser used to manage after cataract:

March 2005, September 2009

 A

Excimer laser

 B

Argon green laser

 C

Diode laser

 D

Nd:YAG laser

Q. 18

Laser used to manage after cataract:

March 2005, September 2009

 A

Excimer laser

 B

Argon green laser

 C

Diode laser

 D

Nd:YAG laser

Ans. D

Explanation:

Ans. D: Nd:YAG laser

The Nd:YAG laser is a solid state laser that uses a neodymium-doped yttrium-aluminum-garnet crystal as the lasing medium. It is optically pumped with a lamp or diode and most commonly emits infrared light at 1064nm. It can be used in either a pulsed or continuous mode. Pulsed YAG lasers are typically Q-switched to achieve high-intensity pulses, which can be frequency doubled to emit light at 532nm.

There are numerous ophthalmic applications for Nd:YAG lasers.

  • They are most commonly used to treat posterior capsular opacification after cataract surgery
  • To create a peripheral iridotomy in patients with narrow angles or angle-closure glaucoma.
  • YAG lasers can also be used to cut the anterior capsule for capsular block syndrome and capsular phimosis
  • To cut vitreous strands in the anterior chamber.
  • In malignant glaucoma, disruption of the anterior hyaloid face is performed with the YAG laser
  • In refractory glaucomas, these lasers can be used for cyclophotoablation of the ciliary body.
  • They have also been helpful for draining premacular subhyaloid hemorrhages in patients with Valsalva retinopathy.
  • Panretinal photocoagulation can be performed with frequency-doubled Nd:YAG lasers.

Other applications include the treatment of recurrent corneal erosions and vitreous floaters.

Excimer (Argon fluoride) laser is used in photorefractive keratectomy (PRK), phototherapeutic keratectomy (PTK), LASIK, LASEK

Argon green laser is used in trabeculoplasty, iridoplasty, pupillomydriasis and retinal photocoagulation Diode laser is used in retinal photocoagulation

Quiz In Between


Q. 19

Surgery of choice for congenital cataract ‑

 A

Lens aspiration

 B

Lensectomy

 C

Posterior capsulectomy

 D

ICCE

Q. 19

Surgery of choice for congenital cataract ‑

 A

Lens aspiration

 B

Lensectomy

 C

Posterior capsulectomy

 D

ICCE

Ans. C

Explanation:

Ans. is ‘c’ i.e., Posterior capsulectomy

Surgery for congenital or developmental cataract

  • Cataract surgery is the treatment of choice for congenital and developmental cataract.
  • Extracapsular cataract extraction (extracapsular removal of the cataractous lens) is the surgery of choice.This is done by phacoemulsification.
  • Intracapsular cataract extraction (ICCE) in children is contraindicated because of vitreous traction and loss at the wieger capsulohyaloid ligament
  • Method for extracapsular cataract extration are :-
  1. Posterior capsulectomy and anterior vitrectomy (Procedure of choice). This can be done via limbal or pars plana approach.
  2. Lens aspiration
  3. Lensectony
  • The traditional treatment of needling or discission of congenital cataract are obsolete now.
  • After removal of cataractous lens, the resultant aphakia in children is treated by : –
  1. If child is < 2 years → Contact lens
  2. If child is > 2 years → Intraocular lens implantation

Q. 20

According to Vision 2020, the recommendations for secondary care services including cataract surgery is:

 A

1 service center for 5000 population

 B

1 service center for 50,000 population

 C

1 service center for 5,00,000 population

 D

1 service center for 50,00,000 population

Q. 20

According to Vision 2020, the recommendations for secondary care services including cataract surgery is:

 A

1 service center for 5000 population

 B

1 service center for 50,000 population

 C

1 service center for 5,00,000 population

 D

1 service center for 50,00,000 population

Ans. C

Explanation:

Ans. c. 1 service center for 5,00,000 population


Q. 21

Best way to prevent infection after cataract surgery is‑

 A

Antibiotics

 B

Yebrows shaving

 C

Through irrigation 

 D

None of the above

Q. 21

Best way to prevent infection after cataract surgery is‑

 A

Antibiotics

 B

Yebrows shaving

 C

Through irrigation 

 D

None of the above

Ans. A

Explanation:

Ans. is ‘a’ i.e., Antibiotics 

Perioperative measures toprevent infection

  • The most important source of potential infectious organisms is the patient’s own natural conjunctival and skin flora. So, prophylactic antibiotic should adequately cover these organisms. The pre- operative topical antibi­otic should be started 3 days prior to surgery. Preferred antibiotics are fourth generation fluoroquinolones (gatifloxacin, moxifloxacin). Other antibiotics are aminoglycosides, traditional fluoroquinolones (ciprofloxacin, levofloxacin) and gramicidin- neomycin – polymyxin B combination.
  • Never the less, complete conjunctival sterility is not usually possible with the use of preoperative antibiotics alone. The topical antiseptic povidone iodine 5% instilled as a single drop 10- 30 minutes before surgery is one of the most effective measure to decrease this bacterial flora.
  • Intraoperatively, a large portion of surgeons (66.4%) also use subconjunctival antibiotic. Intracameral antibiotic at the end of surgery showed significant benefit in reducing the rate of bacterial endophthalmitis. 
  • Post- operatively topical antibiotics (eye drops) are given along with steroids for 10 -14 days.

Q. 22

Surgery of choice for congenital cataract

 A

ECCE

 B

ICCE

 C

Needling

 D

Discission

Q. 22

Surgery of choice for congenital cataract

 A

ECCE

 B

ICCE

 C

Needling

 D

Discission

Ans. A

Explanation:

Ans. is ‘a’ i.e., ECCE 

Surgery for congenital or developmental cataract

  • Cataract surgery is the treatment of choice for congenital and developmental cataract.
  • Extracapsular cataract extraction (extracapsular removal of the cataractous lens) is the surgery of choice.This is done by phacoemulsification.
  • Intracapsular cataract extraction (ICCE) in children is contraindicated because of vitreous traction and loss at the wieger capsulohyaloid ligament

Method for extracapsular cataract extration are :-

  1. Posterior capsulectomy and anterior vitrectomy (Procedure of choice). This can be done via limbal or pars plana approach.
  2. Lens aspiration
  3. Lensectony
  • The traditional treatment of needling or discission of congenital cataract are obsolete now.
  • After removal of cataractous lens, the resultant aphakia in children is treated by : –
  1. If child is < 2 years → Contact lens
  2. If child is > 2 years  →Intraocular lens implantation

Quiz In Between



Leave a Reply

Free Mini Course on Stomach

Mini Course – Stomach

22 High Yield Topics in Stomach

in Just 2 Hours

Submission received, thank you!

Close Window
%d bloggers like this:
Malcare WordPress Security