Download MBBS Ophthalmology PPT 12 Ophthalmology Instruments Lecture Notes

CATARACT AND GLAUCOMA

INSTRUMENTS

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CATARACT

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WIRE SPECULUM

Uses. Eye speculums are used to keep the lids

apart

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?Any intraocular operation such as cataract

surgery and glaucoma surgery.

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?Any extraocular surgery e.g., squint surgery,

pterygium surgery.

?Enucleation and evisceration operation.

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?Removal of conjunctival and corneal foreign

bodies.

?Cauterization of corneal ulcer.

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?Examination of the eye in a patient with

blepharospasm.

SUPERIOR RECTUS HOLDING FORCEPS

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S-shaped double curve near the tip.
TOOTHED FORCEPS
Uses:
? hold the superior rectus muscle while

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passing a bridle suture under it;
? to stabilize the eyeball during any
operation such as cataract surgery,
glaucoma surgery, corneal surgery

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LIMS FORCEPS

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? to hold conjunctiva , cornea, or any structure
?Single tooth with a base
?Angulated

CONJUNCTIVAL SCISSORS

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To cut the conjunctiva to make flap for SICS
For other cutting purposes

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CRESCENT BLADE

blunt-tipped, bevel up knife having cutsplitting

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action at the tip and both the sides

USES:
It is used to make tunnel incision in the sclera
and cornea for phacoemulsification, manual

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small incision cataract surgery (SICS), and
sutureless trabeculectomy.

SIDE PORT

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straight knife with a sharp pointed tip and
cutting on one side.
Uses.
It is used to make a small valvular clear
corneal incision (commonly called as side

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port incision) in phacoemulsification and
other intraocular surgeries including pars
plana vitrectomy.

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VISCOELASTICS

CYSTITOME

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SMALL NEEDLE KNIFE with bent tip with

cutiing on both the sides.

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Disposable needle are prepared from the 26 G

or 30G hypodermic needles

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KERATOME

diamond-shaped blade with a sharp apex and

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two cutting edges.
USES:
? Valvular corneal incisions for entry into the

anterior chamber for all modern techniques of

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cataract extraction

? self-sealing incisions for phacoemulsification

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and manual SICS operation

IOL DIALER

Uses:

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(i) to manipulate the nucleus in

phacoemulsification surgery

(ii)to dial PMMA non-foldable IOL for proper

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Positioning in the capsular bag or ciliary sulcus.

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WIRE VECTIS

It is wire loop attached to a metallic handle.
Uses:

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It is used to remove dislocated or subluxated

lens. and nucleus in conventional ECCE and
SICS.

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SYMCOE CANNULA

Irrigation and aspiration of lens matter in

Conventional and SICS.

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POST SURGERY

To remove viscoelastic from the anterior

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chamber

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Kelman-McPherson forceps

These
are fine forceps with bent limbs. Uses:
(i)To hold the superior haptic of IOL during its

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placement.

(ii) To tear off the anterior capsular flap in

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ECCE.

(iii) Can be used for suture tying.

CHOPPER

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resembling sinskey hook in shape. The
inner edge of the bent tip is cutting and may
have different angles.
Uses.

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It is used to split or chop the nucleus into

smaller pieces

Nuclear manipulation in phacoemulsification

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surgery


CASTROVIEJO CALLIPER

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To make measurements for the scleral incision.
It is also used to measure corneal diameter

and visible horizontal iris diameter.

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It is used to take measurements during squint,

ptosis, retinal detachment and pars plana

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vitrectomy surgery.

Cornea scleral forceps

Uses: These are used to hold

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the cornea or scleral edge (of incision) for
suturing
during cataract, glaucoma, repair of corneal
and/or
scleral tears and keratoplasty operations.

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CAPSULORHEXIS FORCEPS

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After a flap lens capsule is raised used
For holding lens capsule

Corneal scissors or

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section enlarging scissors

Uses: (i) These are used to enlarge corneal or

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corneoscleral incision For conventional
intracapsular and extracapsular Cataract
extraction cataract surgery.

(ii) To enlarge corneal incision

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In keratoplasty operation.
(iii) To cut the scleral and trabecular
tissue in trabeculectomy.

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IRIS REPOSITOR

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Handle with blade & blunt end
Uses
? to reposit iris in AC during/after intra ocular
surgery

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? To break synechiae at pupillary margin

NEEDLE HOLDING FORCEPS

TO DO SUTURING DURING GLAUCOMA AND

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CATARCT SURGERY

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SUTURE-TYING FORCEPS

Lens expressor (hook)

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It is a flat metal handle with a rounded curve at

one end. Tip of the curve is knobbed. The plane

of the handle is at right angle to the curvature of

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the hook.

Uses: (i) To apply pressure on the limbus at the 6

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O'clock position During the delivery of lens in

intracapsular cataract extraction with Smith's

(tumbling) and capsule forceps techniques.

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(i ) To express the nucleus in extracapsular

cataract extraction.

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(i i) It can also be used as muscle hook if the

latter is not available.

(iv) Also used along with wire vectis to extract

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out the dislocated lens

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De wecker's scissors

They are fine scissors with small blades

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directed at right angles to the arms. The

blades are kept apart, making V-shape, by

spring action.

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Uses: It is used to perform iridectomy,
iridotomy and to cut the prolapsed formed
Vitreous and pupillary membrane.

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KELLY'S PUNCH

TO MAKE A CLEAN HOLE IN TRABECULECTOMY
WHICH ACTS AS THE INNER WINDOW

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Hydrodissection cannula

BP Handle

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Irrigating vectis