Surgical Consent
|
General Anesthesia Consent
|
Surgical Header
|
|
Preoperative Diagnosis OD
• • •
|
Preoperative Diagnosis OS
• • •
|
Postoperative Diagnosis
• • •
|
Procedure
• • •
|
Subtenon’s block
|
Retrobulbar Anesthesia
|
General Anesthesia
|
|
Anesthesiologist
|
Complications
• • •
|
Specimens
• • •
|
Report Header
|
Eye
|
|
Retrobulbar Anesthesia
|
General Anesthesia
|
Prep
|
Subtenon’s block
|
Scleral Loops
|
Scleral Buckle Revision
|
Corneal Epi Debridement
|
Susvimo
|
Vitrectomy Phakic
|
Vitrectomy Pseudophakic
|
Vitrectomy Phakic 25g
|
Vitrectomy Pseudophakic 25g
|
Posterior capsulotomy
|
|
Chandelier
|
PVD
|
Prior Vitrectomy
|
Kenalog
|
Vitrector Lensectomy
|
Phacofragmatome
|
TRD Repair
|
Hemostasis
|
Silicone Oil Removal
|
BBG
|
ICG
|
Membrane Peel
|
PVR Peel
|
Retinectomy
|
Degrees of Retinectomy
|
Subretinal Bands
|
Retinotomy
|
Perfluoron
|
AFE
|
SRF Drainage
|
Old IOL removed - SFIOL
|
Corneal Incision in Aphakic
|
Old IOL removed - ACIOL
|
|
Peritomy for Scleral Fixation
|
Trocars for Scleral Fixation
|
Lens Power
|
Lens Type
|
Fixation/Closure
|
Scleral Fixation of Old Lens
|
ACIOL
|
Free Text
|
Focal
|
PRP
|
Laser Retinopexy
|
360 Laser
|
Endophotocoagulation
|
Cryopexy
• • •
|
Scleral Band
|
Buckle Suturing
|
External Drainage
|
Additional buckle components
|
Vitreous Substitute
|
Trocar removal with suture
|
Trocar removal without suture
|
Buckle Closure
|
Peritomy Closure
|
|
Sutures-less
|
Comments
|
IOP/Optic Nerve
|
Close
|
Retinal Diagram OD
|
Retinal Diagram OS
|
Eye Diagram
|
|