Attending Clinics

General Tips for All Cases

Discuss with the scrub + circulator what you will need during turnover so they can pull it
Usual drape is U shape drape – do nasal down the bridge then make a 90 bend and cover forehead + brow, then do same for temporal. Work on making a trough to put the towel.
Use the steri strip from the medium tegaderm (cut in half), place each tegaderm side upper then lower. Make sure to put down into the nasal side to prevent fogging
Lid speculum -> BSS -> endocoat

Machine: 23g Alcon
Anesthesia: Prefers general
Drape: Usual - Timeout before draping, must be in the room
Kenalog: 1:4
Forceps: Your preference
Suture: 7-0 vicryl
Additional information: Print last relevant note from each patient, table in OR for laptop, make sure the screen is visible and connected, diamox always with gas

Machine: 25g DORC (23g if TRD or oil going to be used)
Anesthesia: Prefers MAC (you do block)
Drape: NO WRIST REST, usual drape (do nasal first then temporal), make sure to use clamps to hold it up
Kenalog: 1:4 on 25g needle
Forceps: 25g ultrapeel
Suture: 7-0 vicryl
Additional information:
- Prefers Shiraga instead of soft tip
- Gas is done with 2 x 3cc syringes and stop cock with pure gas
  - Be able to calculate on the fly how much pure gas you need to get a desired concentration
- Generally do a peripheral vitrectomy (wide) first, prefer to start on the infusion side to clear it

Machine: 23g Alcon
Anesthesia: Prefers GA
Drape: Usual
Kenalog: 1:4
Forceps: 25g ILM for peels, 23g serrated for TRD
Suture: 7-0 vicryl
Additional information:
- His pedals are switched (scope on left), have a tano scraper on standby for ILM peel, soft tip cut ½ way
- Patients with multiple surgeries he rotates trocar 90 degrees (so wound is circumferential)
Scleral Buckles: Isolate MR, IR, LR, then SR. Mersilene suture, forceps over cornea, suture with band in place unless using tire; then preplace.

Machine: 23g Alcon
Anesthesia: Prefers MAC (often does own blocks)
Drape: Usual but leave as much skin exposed (incl brow) to be covered by tegaderm
Kenalog: 1:4
Forceps: 25g asymmetric for peels, sometimes serrated for TRD
Suture: 7-0 vicryl
Additional information:
- Do not cut soft tip
- For core, trace the arcades clockwise then CCW

Machine: 25g DORC
Anesthesia: MAC with Subtenon
Drape: U-drape then do the cataract type (can use steri strips to open lids or cotton tip), then put the suction down
Kenalog: 1:2 on 25g needle
Forceps: 25g ILM for peel
Suture: 6-0 gut, polyglactin OK
Additional information:
- Generally prefers gas
- For scleral buckles:
  - Initial RRD Cases: Measure 110mm band, then at the end when trimming, its tight enough when tip to tip is 40mm
  - Subsequent RRD Cases: 110mm length does not apply.
  - All Combo SB/PPV: Prefers 41/70, belt loops, 3mm posterior to insertion. Isolate MR, LR, IR, then SR.

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