Westcott E-30440 00 Titanium Super Soft Grip Scissor, 10 cm- Grey/Yellow

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Ehrenhaus M, D'Arienzo P. Improved Technique for Temporary Tarsorrhaphy With a New Cyanoacrylate Gel. Arch Ophthalmol. 2003;121(9):1336–1337. doi:10.1001/archopht.121.9.1336. In addition, the operating scissor includes fine serrations to improve grip. It also has small blades to shank ratio for better control. Our Westcott Tenotomy Scissor comes with rounded tips that are ideal for blunt dissection of tissues. Kasaee A, Musavi MR, Tabatabaie SZ, et al. Evaluation of efficacy and safety of botulinum toxin type A injection in patients requiring temporary tarsorrhaphy to improve corneal epithelial defects. Int J Ophthalmol. 2010;3(3):237-240. doi:10.3980/j.issn.2222-3959.2010.03.13. Allen, R. “Pillar tarsorrhaphy.” Oculoplastics Surgery Techniques. University of Iowa Health Care. Ophthalmology and Visual Sciences Video Library.

At OfficeStationery, we know a good quality pair of scissors is vital in any office or working environment. The best multi purpose scissors are titanium bonded scissors. These are strong but lightweight which makes them easier scissors to cut with. We have a huge range of these, as well as those with stainless steel blades. These are all manufactured by big brands including Scotch, Wescott, Leitz, Durable and more, which guarantees you the best quality every time. Especially includes narrow blades which increase precision. Moreover, the instrument has curved blades that contort to the surface of the eye for increased accuracy. Khairy H. Botulinum toxin A-induced ptosis: A safe and effective alternative to surgical tarsorrhaphy for corneal protection. Journal of the Egyptian Ophthalmological Society. 2014;107(1):20-22. doi:10.4103/2090-0686.134937. Neurotrophic corneal ulceration (CN V deficit, herpes simplex virus (HSV) or varicella zoster virus (VZV) keratitis) [1] The suture is then tied over the bolster to complete the tarsorrhaphy. The suture should be snug to prevent incomplete lid opposition when intraoperative edema resolves.Inadequate blinking secondary to reduced corneal sensation, Riley Day Syndrome/Familial Dysautonomia, severe brain injury, or prolonged sedation [1] The final step is to create the drawstring, the 2 suture arms are passed through the 3rd bolster (it is commonplace to make this smaller than the other ones) Stevens or Westcott scissors are used to dissect between the anterior and posterior lamella to a depth of 3-4 mm making sure to stay parallel to the tarsal plate. To retain a prosthesis, Boston Keratoprosthesis, or other device in patients with anophthalmia or after evisceration or enucleation

Two bolsters of the surgeon's choice of size and material (plastic tubing, red robin catheter, cotton wool balls, etc.) are prepared. If it is anticipated that the suture will be removed within 2 weeks and there is no skin compromise, bolsters may not be necessary. In summary: The suture is passed through the bolster, followed by the upper eyelid, then the lower eyelid, then the second bolster. Once the second bolster is engaged, the suture is turned around and placed through the second bolster, then the lower eyelid, then the upper eyelid, and the bolster. The suture is then tied to complete the tarsorrhaphy. [12] The upper eyelid is prepped with Betadine solution and the desired concentration is drawn up into a 1 mL insulin or tuberculin syringe. Introduce the needle tip of a 23 to 26-gauge needle just below the superior orbital rim along the mid-pupillary plane and passed against the orbital roof for 1 to 2 cm. The desired amount of botulinum toxin is injected, and the needle and syringe are discarded appropriately. The patient should then be monitored closely for appropriate healing and resolution of ptosis with return of levator function. [18] [19] Repeat injection may be necessary. Prior to the procedure, a full ophthalmic examination should be performed and documented. A thorough slit lamp biomicroscopic examination should document corneal pathology and the size and location of any defects or corneal ulcers. Careful examination of the palpebral conjunctiva using double eversion to look for foreign bodies or keratinization should also be performed. External examination of eyelid abnormalities, the degree of lagophthalmos, and assessment of corneal sensitivity are critical in determining what type of tarsorrhaphy is appropriate (permanent vs. temporary) and deciding on the extent of tarsorrhaphy (lateral vs. medial vs. central vs. total) to be performed. The length of tarsorrhaphy to be performed is determined by gently pinching the upper and lower eyelids together with forceps or manually to achieve desired closure. Trivedi D, McCalla M, Squires Z, Parulekar M. Use of cyanoacrylate glue for temporary tarsorrhaphy in children. Ophthalmic Plast Reconstr Surg. 2014 Jan-Feb;30(1):60-3. doi: 10.1097/IOP.0000000000000011. PMID: 24398490.

Scissor - Mayo, Straight, Length 12.5cm

Illustration of a Pillar tarsorrhaphy step-by-step approach. Image c reated by by Fabliha A. Mukit, MD using an iPad and the Procreate app. Technique

Steiner GC, Gossman MD, Tanenbaum M. Modified tarsal pillar tarsorrhaphy. American Journal of Ophthalmology. 1993 Jul;116(1):103-104. DOI: 10.1016/s0002-9394(14)71755-6. PMID: 8328528. Tzelikis PF, Diniz CM, Tanure MA, Trindade FC. Tarsorrafia: aplicações em um Serviço de Córnea [Tarsorrhaphy: applications in a Cornea Service]. Arq Bras Oftalmol. 2005 Jan-Feb;68(1):103-7. Portuguese. doi: 10.1590/s0004-27492005000100019. Epub 2005 Mar 30. PMID: 15824813. A #15 blade is used to make 2 parallel incisions that are connected at one end to develop two pillars of tarsoconjunctiva tissue, one corresponding to the medial limbus and one corresponding to the lateral limbus.After washing and preparing the eye thoroughly within the lid margins and fornices, the glue gel of choice is applied along closed lateral eyelid margins using the standard applicator tip supplied with the gel. Using the same applicator tip, the gel is spread medially along the eyelid margins to achieve the desired amount of closure. The glue is allowed to dry for 15 – 20 seconds. Once dry, the eyelids stay closed for approximately 2 weeks. [5] [16] Some report longer lasting closure with a recent study in a pediatric population reporting that cyanoacrylate glue tarsorrhaphies last an average of 4.5 weeks (range 0.5-13 weeks). [17] It can be reversed by cutting the eyelashes following the application of lidocaine gel. An absorbable or nonabsorbable double armed 4-0 to 6-0 suture is initially passed through the bolster material. The needle is then passed through the meibomian gland orifices of the upper lid margin and retrieved 3-4 mm above the upper lid margin and engages the upper bolster.