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O P H T H A L M O L O G Y
not to mention the adhesive labels and temporary tattoos that can
serve as adjunct reminders. "Most places have adopted a series of
checks and balances," says Dr. Cunningham. "It should be standard."
A more pressing problem, he notes, is the potential risk of implanting the wrong intraocular lens. From a dizzying array of powers and
types, a patient's IOL (identified by a serial number) is pulled by hand
for 1 case in a schedule full of them. The lens sheet and calculation
sheet have been worked up manually. "It would be easy if you
weren't paying attention to put the incorrect lens in someone's eye,"
he says. It's not common, but it can happen. The risk is increased if,
for instance, the patient has cataracts in both eyes, each of which is
going to be removed during different surgeries; or charts are confused between husband-and-wife patients, or patients with the same
last name.
An intraoperative aberrometer, which connects to the scope and
measures the eye and degree of astigmatism in real time, can eliminate any confusion in the power and placement of an IOL. "It would
be very difficult to use that machine and not put the right lens in,"
says Dr. Cunningham.
As an additional safeguard, Dr. Yeh says she only allows 1 lens in the
OR at a time. "You can't always rely on your assistants to know which
lens to hand you," she notes. Even if each patient's packaged lens is
placed on top of their chart, they can still be moved and mixed up
with other lenses.
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