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DR VINEET SEHGAL

MBBS MD (AIIMS)
FELLOWSHIP IN GLAUCOMA
CONSULTANT - INCHARGE
GLAUCOMA SUBSPECIALITY
SHARP SIGHT CENTRE
EX CONSULTANT- MEDANTA
MEDCITY
ASSISTANT EDITOR- DJO
(NTSE SCHOLAR, ASSISTANT EDITOR-
DJO)
Overview
Common Instruments
Instruments for lid surgery
Chalazion surgery
Entropion/ectropion surgery
Ptosis surgery

Evisceration/ Enucleation surgery


Dacryocystorhinostomy surgery
Orbitotomy surgery
Squint surgery
Ocular Speculum
Barraquers Eye Speculum
Most common eye speculum

Fenestrated blades

Light weight

Minimal pressure on the globe

Available in pediatric(14 mm)


and adult sizes( 16- 18 mm)
Universal Eye Speculum
(Williams)
Screw adjustment- holds
the speculum open

Controlled retraction

Used in corneal surgeries


like DALK, ALTK

Greater rise in IOP


Eye speculum with guard (Lancaster)

Solid blades

Keeps lashes away from the


field of surgery

Predominantly used in squint


surgery
Chalazion surgery
Chalazion Clamp
Has a solid plate like end
and a fenestrated ring

Fenestrated end on the


conjunctival side to aid
incision

Achieves localization,
support and hemostasis
Chalazion Scoop
Small round scoop like end

Helps in non traumatic


curetting of chalazion
Entropion/Ectropion Surgery
Snellens Entropion clamp
Right and left variety

Plate design supports the lid

Helps achieve hemostasis


Jaeger Lid Spatula

Slight convex surface

Lid surgeries- entropion ,


ectropion , ptosis

Protects globe

Provides support

Helps in creating dissection


planes during orbitotomy
Desmarres Lid Retractor
Retraction of soft tissues

Ptosis , orbitotomy, buckling,


DCR surgeries

Double eversion of eyelids

Used to unroll AMG over


corneal surface
Ptosis surgery
Berkes Ptosis Clamp
Used to support and clamp
the levator muscle during
levator resection

Helps achieve hemostasis


Crawfords Fascia Lata Stripper
Used in ptosis surgery
during autologous fascia lata
harvesting

Proximal slot for holding


fascia lata

Harvests fascia lata through a


small incision
Wrights Fascia Needle
Needle tip bent at 900

Large eye for passing


harvested fascia lata.
Castroveijos calipers
0-20 mm range

Used to measure exact


distances
Evisceration/Enucleation Surgery
Mules Evisceration Scoop
Used to scoop out the
intraocular contents i.e uveal
tissue

Has a gentle curve to slide


along corneal surface
Enucleation Spoon
Has a groove for the optic
nerve to pass through

Supports the globe and aids


in giving slight traction to
the optic nerve
Enucleation Scissors
Curved scissors- pass along
the orbital wall smoothly

Blunt end- non-traumatic


to the globe

Help to maximize the


length of the optic nerve
resected
DCR Surgery
Nettleships Punctum Dilator
Used to dilate the puncta
prior to any probing

Available in multiple sizes,


corresponding to probe sizes
Bowmans Probes
Available in sizes ranging from
0000 to 4

Size 0=1mm diameter, with


0.1mm gradation

Used for probing nasolacrimal


duct

DCR surgery

Therapeutic probing in pediatric


population
Freer Periosteum Elevator

Slight concavo-convex ends

Used to lift periosteum and


lacrimal sac from underlying
fossa
Mullers Self Retaining Retractor
Helps to retract the skin
incision in DCR surgery

Helps to achieve hemostasis

Self - retaining
Kerrison Bone Punch
Available in multiple sizes
Size 0=1mm
Size 4=5mm

Cutting end up or down


designs

Predominantly used to create


an ostium in DCR surgeries
Orbitotomy surgery
Bard Parker handle
with blade

Slot for attaching disposable


blades

Pen like grip

Used to make incisions


Kellys Malleable Retractor

Used to retract soft tissue


during orbitotomy

Increases the field of view

Helps to achieve hemostasis


Tenotomy Scissors
Fine blunt tipped scissors

Used to separate Tenons from


underlying sclera

Used in buckling surgery,


enucleation, eviseration,
squint surgery
Strabismus surgery
Strabismus/ muscle hook
Used to hook extra-ocular
muscles

Squint , buckling surgeries

Scleral perforation repairs

Jameson Muscle Hook

Green Muscle Hook


Serriphine
Used to clip long end of
sutures

Squint surgeries, ptosis


surgery
Castroveijos needle holder
Needle holder with or
without locking

Used to hold 4-0 to 7-0


sutures

Used to suture periocular


skin incisions, extraocular
muscles , explants in retinal
detachment surgery.
Ignacio Barraquer

Thank you