0.5% tetracaine is dropped into the eyes twice for topical anesthesia, while 2% lidocaine is used for retrobulbar anesthesia and infiltration anesthesia of the orbicularis oculi muscle and subconjunctiva.

Looking at Tang Lou's calm movements on the screen, Shen Jun was a little dissatisfied, but he still sat down quietly.

"Director Shen, let's take a look. It is said that newborn calves are not afraid of tigers."

Cheng Jian also didn't expect Tanglou to be so confident. The key was that there were no problems with his steps.

Huo Tong was also a little puzzled. Is this Tanglou really an intern?

When he was young, the first time he used lidocaine was half a year later. Looking at the tenement building in the operating room, his appreciation for talent was once again aroused.

He was very dissatisfied and looked at Liu Tong aside.

Liu Tong felt as if he had fallen into an ice cave. He avoided Director Huo's gaze and looked at the operating room with some surprise: "I don't believe you can perform a complete iris suturing operation."

"It's just anesthesia before surgery. Will it open the eyelids?"

Liu Tong asked himself that he was considered a talented player in surgery, and it took him several years to encounter such an unsophisticated operation like eyelid opening for the first time.

"...the eyelid opener is ready..."

Tanglou devoted himself wholeheartedly to the operation. The working principle of the eyelid opener was similar to the retractor, an essential tool in surgery.

Or more intuitively, it can be understood as, when you are sleepy, use matches to open your upper and lower eyelids!

The instrument nurse brought up the eyelid opener, and Tang Lou carefully opened and fixed the patient's upper and lower eyelids. The entire eyeball seemed to have a special effect of opening a big eye.

Of course, this was not sufficient. Tanglou continued to sew the patient's inferior rectus muscle with traction sutures to fully expose the surgical field.

Seeing Tanglou's unhurried completion of the technique, several big guys in the observation room nodded frequently.

"At least up to this point, Xiao Tang has done a very good job. You interns who have not been on the operating table should study hard. Don't panic when things happen, and have a calm mind."

Shen Jun's voice echoed in the observation room.

"Awesome, worthy of being the Great God of the Tang Dynasty."

Bai Hao and Li Lin gathered behind them, feeling both envy and admiration.

"I have never used such a thing as an eyelid opener."

"Isn't that right? Kneel down before the Great God!"

Liu Tong looked gloomy: "Lucky for you, the difficulty of suturing the iris lies in the precise search for the corneoscleral edge and the formation of the anterior chamber. If you have not experienced this kind of thing, it is impossible to master it well."

As the director of surgery, Huo Tong naturally understood the difficulty of this surgery. He took the microphone and directed: "Xiao Tang, the next step is the key incision of the corneoscleral limbus. The location is..."

But before Huo Tong could say anything, Tang Lou's hand had already moved.

The corneoscleral limbus is in the transition zone between the cornea and the sclera, with a width of about 1.5~2.0mm. Since the opaque cornea is embedded in the opaque sclera, it gradually presents a transitional state, so there is no clear dividing line on the surface of the eyeball.

If you have never done this before, or have personally dissected an eyeball for the first time, you will not dare to do it easily.

However, Tanglou controlled the scalpel and accurately cut it at 12 o'clock, incising exactly 5mm, fully exposing the cornea and sclera edge to the screen.

"this..."

Huo Tong's heart shuddered as he recalled Tanglou's sharp and decisive blow.

So accurate!

Cheng Jian was also stunned and couldn't help but cheered: "Beautiful!"

Seeing this, Shen Jun was very happy and explained the length and entry point of the incision to the surgical novice in the observation room.

Only then did everyone realize that there were so many technical details contained in Tanglou's seemingly arbitrary sword stroke.

"Everyone, please note that you cannot sew immediately after incision. You also need to stop bleeding."

Huo Tong continued, and when he finished speaking, Tang Lou in the operating room was holding a toothbrush-like cauterizing hemostatic device with a round head at the front, and a needle at the front of the round head, which was tilted, a bit like the one in a manual class.

Soldering iron.

"The next step is to form the anterior chamber. Who of you knows what the anterior chamber is."

"The cavity in the eyeball between the cornea, iris, and lens."

Leng Yunze shouted back. Although he had not personally dissected the structure of the eye, he still had some understanding of it.

Huo Tong nodded with satisfaction: "Yes, in order to have a better operating space, enough anterior chamber must be formed. Do you know how to form it?"

Leng Yunze was stunned for a moment, trying to remember, but his mind went blank.

Huo Tong was a little disappointed when Leng Yunze avoided his gaze, and then looked around at the others, all of whom lowered their heads in shame.

"It's normal not to know. You need to undergo surgery to understand this. Then let me tell you. You must remember it!"

Huo Tong took the microphone over at the same time.

But before he could shout out, he heard Tanglou's salty voice in the operating room:

"...Viscoelastic..."

"Dr. Xiao Tang, I...I won't..." the little nurse said in an embarrassed and timid voice.

"...a colorless, transparent gel-like solution composed of high-purity sodium hyaluronate and physiological buffered balanced salts..."

Tanglou’s voice without any pride echoed throughout the operating room.

Huo Tong: "..."

The other people in the observation room also had beeping expressions.

"I am also an intern. I can't stand this grievance. What the hell is this!"

"Tch, what's wrong with the intern? I'm still a resident. I..."

The observation room suddenly became quiet, and everyone shed tears of ignorance in their hearts.

Sitting in the first row, Leng Yunze was on pins and needles: "I have always been someone else's child! What kind of monster is this tenement building!"

Cheng Jian's eyes also lit up, and he began to think about how he would take Tanglou to the city hospital. How could such a powerful intern end up in the county hospital?

Tanglou didn't care at all about the situation in the observation room. After completing the suturing preparations, he began to adjust the surgical microscope.

Accurately align the position of the iris break.

"...Micro blunt intraocular forceps...10-0 polypropylene wire backup..."

Under the microscope, Tang Lou used micro blunt intraocular forceps to pull the severed iris root edge to the corneoscleral limbal incision.

Use the interrupted suture method through the circular needle to start suturing, quickly puncture and knot in a very small operating space...

After suturing is complete, return the pupil to its center.

"...double cannula suction needle...BSS..."

Huo Tong held the microphone for a long time. Whenever he wanted to give guidance, Tanglou had already completed the corresponding operation.

"It's so hard for me."

It was the first time for Huo Tong to be given guidance and it was so frustrating. Not only did the intern do it accurately, but he also did it very quickly.

"Use a double-cannula injection needle to infuse BSS and remove the viscoelastic agent in the anterior chamber."

Huo Tong finally accepted his fate, he might as well do the commentary.

Sure enough, Tanglou's operation was too fast, and the rookies in the observation room were completely unable to understand the knowledge points under these simple instructions.

After his explanation, the interns suddenly realized that Huo Tong finally had some sense of accomplishment, but he always felt a little aggrieved.

After completing the removal of the viscoelastic agent, Tang Lou began to suture the corneoscleral limbal incision, and the sutures were quickly formed into a perfect shape.

The next step is to suture the conjunctiva. Tanglou used continuous sutures and made a V-Y suture at the larger wound edge.

Neat and crisp!

"...Brumycin, dexamethasone and a small amount of 2% lidocaine were injected under the bulbar conjunctiva..."

Tanglou continued to order the next steps, and recovery after surgery was naturally extremely important.

"...antibiotic eye drops and antibiotic eye ointments, 0.5% tropicamide eye drops...single eye pads, bandages..."

The final bandage is completed.

"Change the dressing every other day, and remove the iris suture 5 days after surgery."

Tanglou’s final postoperative arrangements.

In the observation room, Huo Tong finally became a little happier and caught the mistake: "Xiao Tang, there is something wrong with your post-operative arrangement. Changing the dressing every other day is theoretically feasible, but in practice it is better to change it once a day, otherwise it may

Infection will occur, although the probability of infection is more than 10%. As for the suture removal time, according to my experience, no matter how well the procedure is done, it will still take at least 7 days, and five days is too short."
Chapter completed!