medical road high rise

Chapter 471 The First Eye Surgery

Chapter 473 The First Eye Surgery

Qin Feng discussed the surgical plan with the orthopedic surgeon and finally decided on it.

First, clean up the broken glass shards, necrotic eyeball tissue, cornea, etc. from the patient's eye area. After simple eye debridement, there is no need to transplant the cornea immediately, but to directly repair the fracture. Race against time.

Because after the cleaning of the eye area is completed, there is no need to worry about cornea transplantation. There is no difference between early transplantation and late transplantation. The main reason is that the residue in the eye area will affect the internal environment of the eye.

The patient's fracture was a comminuted fracture. In the narrow and deformed driver's seat, the patient's leg was squeezed and injured, and multiple leg bones were deformed and broken.

After entering the operating room, Qin Feng began the operation, and the debridement of the eye was completed quickly, and he went directly to the fracture repair.

The orthopedic doctor took the patient's radiograph and said, "Doctor Qin, I'm afraid you can't do bone grafting directly. The patient's bones have already been inserted into the blood vessels, and some are even still in the muscle tissue. The only option is amputation."

The main reason is that the difficulty of bone setting is too high, not only to fix and repair the fractured bones, but also to suture nerves, repair blood vessels, and suture muscle tissue. If there is a little carelessness, amputation cannot be saved.

"It's still bone grafting, ready for surgery." Qin Feng said without doubt.

The orthopedic doctor sighed, but still brought over the instruments one after another.

Qin Feng started the operation, fixed the patient's lower limbs at 45°, and then used the HENRY incision to gradually separate the muscle tissue, and used the Kirschner wire to gradually build up the patient's skeleton from the blood and flesh, at least it looked like a leg bone.

Then there are the two most difficult steps in bone surgery, which are blood vessel repair and nerve anastomosis. Compared with these two, bone repair is the easiest.

Broken blood vessel repair requires electrocoagulation, and ligation can also be used, but for this patient, electrocoagulation is the best.

Because the patient has many broken blood vessels, ligation will increase the amount of surgery, and excessive ligation will also affect postoperative recovery.

The burnt smell came from inside, and it lasted for an hour and a half before Qin Feng put down the equipment in his hand.

The whole bone setting operation is considered complete, and the next step is corneal transplantation.

Because of Qin Feng's arrangement, the patient's wife's cornea has been removed, and it is well preserved and ready for transplantation at any time.

"Ready to transplant."

Corneal transplant surgery is mainly to replace the patient's existing diseased cornea with a normal cornea, so that the patient can regain vision or control corneal disease, so as to improve vision or treat certain corneal diseases.

Some corneal diseases that cause severe visual impairment or even blindness can restore sight through corneal transplantation. Corneal transplantation is not difficult. Compared with other allogeneic organ transplants, corneal transplantation is successful. The rate is ranked number one.

Because the cornea does not contain blood vessels, it is much simpler to transplant, and there will be no rejection, and the success rate is greatly improved.

There are two types of corneal surgery.

One is full-thickness keratoplasty, which replaces the full-thickness turbid cornea with a full-thickness transparent cornea. Indications include central leukoplakia, corneal degeneration, keratoconus, and intractable keratitis.

Since full-thickness keratoplasty requires endothelial cells to have good activity, it is best to harvest the eyeball within a few hours after death.

The operation principle is to select the appropriate caliber corneal trephine according to the extent of the lesion, and perform corneal resection on the operated eye and the donor eye respectively.

The second type is lamellar keratoplasty, which removes the superficial corneal disease tissue, leaving a certain thickness of cornea as a transplant, and then fixes it with sutures using a lamellar graft of the same size and thickness.

This operation is suitable for corneal spots or malnutrition cloudy, progressive keratitis or ulcers, corneal fistula and so on.

One advantage of lamellar keratoplasty is that it does not penetrate the eyeball, so it is safer and has fewer complications than full-thickness keratoplasty.

But there are also disadvantages, that is, the optical effect is not as good as full-thickness keratoplasty, and the visual effect obtained is not as good as full-thickness keratoplasty.

Qin Feng thought about it and chose the first option.

If you were any other doctor, you would definitely choose the second option. Choosing a surgery with a higher success rate is better than choosing a better visual effect. They are not willing to be tortured by patients and their families in the later stage.

But for Qin Feng, the success rates of the two surgeries are similar, so it is understandable for him to choose the surgeries that are better for the patients.

"Face opener."

Qin Feng took over the equipment, opened the eyelids of the patient lying on the operating bed, and directly fixed the upper and lower self-muscles with sutures to prevent the patient from closing his eyes. The surgery was all for nothing.

"7mm trephine." Qin Feng continued.

The choice of trephine is generally 0.25mm smaller than the graft, so there is no difficulty in judging it.

Use a trephine to drill through the straight bed, carefully cut off the cornea damaged by glass slag, then Qin Feng covers the gauze with his left hand from the epithelial surface, wraps the donor eye with the cornea upward, and puts the trephine in the right hand vertically into the center of the donor cornea .

After drilling through, Qin Feng cut off the corneal graft again, and placed the corneal scissors on the patient's wrist. Qin Feng then took material from the endothelial surface, and then put the corneal graft on the cutting pillow with the endothelial side facing up, and used a sharp trephine The corneal graft was removed.

"Fix the implant."

Qin Feng placed the graft on the transplant hole, and took the stapler from the nurse.

"10-gauge nylon thread."

Qin Feng performed interrupted sutures at holes 3, 6, 9, and 12. The reason for choosing interrupted sutures is that it is easy to adjust the sutures after surgery and reduce eyeball astigmatism.

Moreover, this method is less irritating to the eyeballs, and the wound seal is relatively tight.

Qin Feng then reconstructed the anterior chamber and performed astigmatism examination.

The steps were carried out in an orderly manner, and the orthopedic surgeon at the side was a little surprised to see the patient's eyeballs being slowly built up.

Although he is not a doctor at Ruijin Hospital, the news in the hospital is shared. Qin Feng has never had eye surgery.

Moreover, he still chose the most difficult full-layer transplantation, and it was so successful that he doubted whether Qin Feng had changed from a monster.

From hand surgery to oncology and interventional surgery, there is no surgery that Qin Feng can't do. Even the orthopedic surgery that he is good at is not worth mentioning in front of Qin Feng.

For some surgeries, you can tell whether they are performed well just by looking at the details.

After a while, the door to the operation opened, and the ophthalmologist from Shanghai No. [-] Hospital walked in. He also came here temporarily, and looked at the orthopedic doctor when he saw this scene.

"Doctor Qin, he has already done all the orthopedic and ophthalmic surgeries."

"So fast?"

(End of this chapter)