ALIE

1. Lacrimal Cannula : Long bent metallic cannula with blunt tip. It is fitted with any hypodermic syringes.

Use: To test patency of lacrimal passages. (syringing)

2. Bowman’s Lacrimal Probe (broken) : A long wire with round tip and a holding flat plate in the middle.

Use: To probe nasolacrimal passage in –

• Congenital Dacryocystitis
• During DCR/DCT to identify the lacrimal sac
• During canalicular anastomosis in case of eyelid injury involving canaliculus.

3. Nettleship’s Punctum dilator : Long narrow instrument with cylindrical corrugated metal handle and a conical pointed tip.

Use: To dilate the lacrimal punctum and proximal (vertical) canaliculus during syringing, probing, DCT, DCR, in punctal stenosis.

4. Muscle Hook : It is a long narrow limb with 90 degree bend in the tip and a solid handle. The handle and curvature of limb is in same plane. Handle is smooth. Tip maybe sharp or knobbed.

Use: To hold extraocular muscles (tip placed under the belly of muscle and drawn up to insertion) during Enucleation, Strabismus and RD Surgery.

Can be used to punch the nasal bone in DCR.

5. Rougine: Instrument with a Rectangular small stout blade attached by a narrow neck to a handle. Distal end is sharp.

Use: In DCT/DCR

• To dissect and disinsert medial palpebral ligament.
• To create cleavage between lacrimal sac and lacrimal fossa.
• To elevate periosteum.

6. Citeli’s Bone Punch : A stout instrument with spring handle and two blades. The upper blade has a small hole with a sharp cutting edge. The lower blade has a cup like depression. The number imprinted in handle (1/2/2.5/3) denotes length of desired punch in mm.

Also called as Kerrison’s Bone Nibbler.

Use: To break lacrimal / nasal bone / frontal process of maxilla during DCR to create bony osteum.

For knowledge only–

Citelli’s bone punch and Kerrison bone nibbler has some structural differences.

Kerrison’s Nibbler has simple configuration. Citelli has a hole in the upper aspect of the end, which throws cut bone parts out.

7. Cat’s Paw Lacrimal Retractor: Fork like instrument with inward bent fork ends.

Use: To retract incised skin and subcutaneous tissue in DCR and DCT and eyelid surgery.

8. Artery Forceps: It is a forceps with long beaks/jaws with parallel grooves and A Locking ratchet.

Use: To clamp artery to stop bleeding during surgery. The locking ratchet helps the forceps to be kept in place to keep it tight and keep bleeding stopped.

9. Muller’s Self Retaining Adjustable Hemostatic Lacrimal Retractor : Two limbs with 3 curved pins, fixing screw present. The two limbs with 3 pins on each for engaging the edges of the skin incision. The limbs are kept retracted by making the screw tight after retracting the limbs to desired positions.

Use : To retract incised skin and subcutaneous tissue in DCR & DCT. Hemostatic effect is due to the angled hooks pressing the blood vessels.

10. Castroviejo’s Needle Holder : Medium sized limbs with spring action. Narrow fine curved/straight tips, with S shaped locking system.

Use: Holding fine needle (5-0, 6-0, 8-0, 10-0) during suturing, mostly in extra ocular surgeries, can also be used in intraocular surgeries.

11. Sclerocorneal /Corneal Scissors : Curved scissors, cutting blades present, spring action present.

Available as Universal, right curved and left curved. Holes are present in the body to make the instrument lighter. (Holes are absent in Vannas scissors)

Use:

• To enlarge corneoscleral incision during Keratoplasty.
• To cut sutures
• Iridectomy

Vannas Scissors : Very fine scissors with small blades (straight or curved), with spring action. Looks similar to Corneal scissors, but much smaller, finer and lighter.

Use:

• Cut anterior capsular tag
• Cut sutures
• Cut inner scleral flap in trabeculectomy
• Iridectomy