Quarterly QuestionsSample Question
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Sample QuestionHow would you answer this?Remember, you have 60 seconds to select from the choices listed.
A patient presenting for cataract surgery is ontamulosin. Which of the following intraoperative maneuvers is most likely to decrease the effects of intraoperative floppy iris syndrome?Enlarging the corneal incisionPlacing incremental atropineCreating iris sphincterotomiesReducing the aspiration flow rate
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A patient presenting for cataract surgery is ontamulosin. Which of the following intraoperative maneuvers is most likely to decrease the effects of intraoperative floppy iris syndrome?Enlarging the corneal incisionPlacing incremental atropineCreating iris sphincterotomiesReducing the aspiration flow rateYour answer isCORRECT.
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The platform also provides detailed feedback.Thekey pointaddresses the subject matter knowledge necessary to answer the question correctly.
Key Point:Intraoperative maneuvers to help reduce the effects of floppy iris syndrome include reducing the aspiration flow rate and vacuum, use of mechanical iris expansion devices, placement of intracameral epinephrine, use of highly retentive viscoelastic, and avoiding an incision that is too large or too posterior (to reduce risk of iris prolapse).
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Thecritique(discussion) explains why the correct answer is the best choice, followed by reasons the other choices are not appropriate.
Critique:Intraoperative floppy iris syndrome is a characterized by the triad of 1) progressive pupil constriction during surgery, 2) billowing of the iris, and 3) tendency for iris prolapse into the phacoemulsification and side port incisions during surgery. This triad may or may not be associated with a poorly dilated pupil before surgery…
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Clickablereferencesto further information about the content of the question are available.
References:Chang, DF,OsherRH, Wang L, Koch DD.Prospective multicenter evaluation of cataract surgery in patients takingtamsulosin(Flomax). Ophthalmology 2007;114:957-964.Flach, A.Intraoperative floppy iris syndrome: Pathophysiology, Prevention and Treatment. Trans AmOphthalmolSoc2009;107:234-39.
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