OPHTHALMIC SURGERY INSTRUMENTS – APPLICATIONS AND MECHANICS

Dr Sanjoy SanyalProfessor and Surgeon

Who Will Need This? Ophthalmic Residents in Training

Ophthalmic Surgery Technicians

Ophthalmic Operating Theater Assistants

Ophthalmic Surgery Nurses

Medical Students with interest in Ophthalmology

Foreword

No specific order has been followed while describing the instruments

Cataract being very common, most instruments are related to Cataract surgery

Instruments were obtained from an Ophthalmologist’s clinic and pictures were taken with the author’s Low-Res camera

This is not a comprehensive list, not by a long shot! More such presentations will follow in due course

Artery (Mosquito/Halsted) Forceps Basic instrument

for any surgery

Numerous sizes exist

Straight / Curved Jaws

Small (4") Straight / Curved are a.k.a. Mosquito / Halsted's Forceps(after William Stewart Halsted)

Straight is for holding Stay-sutures or Tissues

Curved is for catching / crushing small bleeders; a.k.a. 'Hemostat Forceps'

Simcoe Irrigation-Aspiration Cannula

Two Cannulae merged together, in Ophthalmic Surgery

One Hub is to introduce fluid in Anterior Chamber (AC)

Other Hub is to extract Lens matter, Blood etc from AC

Universal Eye Speculum

Separates Eyelids during Ophthalmic Procedures

Universal: Can be used on either Eye

Unguarded: Eyelashes can project into operating field

Adjustable: Screw-Handle controls separation of Eyelids

Screw-Handle is always on Temporal Side of Orbit

Barraquer Wire Speculum – Adult Separates

Eyelids

Used on either eye

Unguarded: Eyelashes can project into operating field

Non-Adjustable: Fixed 22-25 mm separation of Eyelids

Springy light-wire InstrumentAdult-size is 14 mm (length of Eyelids)

Strabismus / Squint / Muscle Hook To lift up

muscle during Strabismus (Squint) surgery

Double-curved end for hooking up Muscle

Sideways flattened tip for ease of insertion under Muscle near its insertion

Distinguish from Lens Expressor(blue inset picture), used to force out Lens in Cataract Extraction

Superior Rectus-Holding Forceps

Special double-curve to go inside Orbit and over Eyeball

Toothed tips for firmly grasping Superior Rectus Muscle

Suture-Tying Forceps (Straight) Fine-limbed

Non-toothed forceps to hold fine sutures (8-0)

Inner surface of Tip is faintly ridged, flat and slightly roughened to hold the fine suture

Straight Suture-Tying Forceps are held in Left Hand, for holding one end of the Suture

Suture-Tying Forceps (Curved)

Curved Suture-Tying Forceps are held in Right Hand, for holding other end of the Suture and tying the knot

de' Wecker's Iris Scissors Small,

Slender spring-open Scissors

Slightly larger than Vanna‘sScissors

For Iridectomy and other delicate Intraocular Procedures

Dastoor Pupil and Iris Repositor Two-

limbed instrument

Pupil Repositor: Forked at the tip; To reposition PupillaryMargin

Iris Repositor: Flattened and rounded at the tip; To move or reposition the Iris during Intraocular Maneuvers

Utrata Capsulorhexis Forceps Removes

central portion of Anterior Capsule of Lens in continuous curvilinearfashion ( Continuous Curvilinear Capsulo-rhexis(CCC))

Fine, Non-toothed, Sharp-tipped, slightly forward-hooked Forceps Forward hook mimics a Cystitome

Kelman-McPherson IOL Forceps Fine sharp-

tipped non-toothed forceps

Angulated Tip

For holding and inserting Intraocular Lens (IOL) in Capsular bag

Phaco Chopper / Sinskey Hook IOL Dialer Chopper

Tip: Very sharp curve, used along with PhacoProbe for cutting Cataract Lens

Sinskey Hook Dialer Tip: Curved round hook; Fits in IOL Dialer Holes or at IOL Haptic-Optic Junction, for Positioning the IOL in Capsular bag

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