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Forceps
(This page looks at the basic principles of forceps and the next page shows some commonly used forceps in ophthalmic surgery.)

Forceps are designed for seizing or holding tissues or sutures.  Many different designs of  forceps are available in ophthalmic surgery. 

Forceps used in ophthalmic surgery can be broadly divided into two types: 

      • tooth 
      • smooth forceps. 
In general, the tooth forceps are used for holding tissues whereas the smooth forceps are for holding and tying sutures. Some forceps are designed for both purposes by adding a tying platform to the tooth forceps (such as colibri forceps).

An ophthalmic forcep has three parts (see the St.Martin forceps below):

      • working ends (tips) connected to
      • shaft which is connected to
      • handle

The working ends determines the function of the forceps and  may be tooth or smooth. With tooth forceps, the teeth may be interdigitating or opposing (see picture below).
 


opposing flat surface seen
in Pierse forceps

Teeth at right angle see in Harmon-Bishop forceps

Forward-angled teeth seen
in Castroviejo forceps

The opposing type causes less trauma to the tissue but provides less fixation of the tissue compared with the interdigitating type. The standard interdigitating type for the anterior segment surgery  is of the one-into-two pattern (see picture above). The teeth may be set at right angle (Bishop-Harmon) or are forward-angled (Castroviejo). The forward-angled forcep allows greater ease in gasping and manipulation of  tissues. 

The shaft connects the tips to the handle. A narrow and thin shaft is ideal as it does not obstruct the surgical view.

The handles in the ophthalmic forceps are designed to be held like pencils to provide ease for manipulation and stability. The handles may be round or flat. A round handle allows easy rotation with the fingers only; whereas a flat handle requires pronation of the wrist for rotation. However, a flat handle gives a convenient reference point by feel as the surgeon knows the alignment of the working end of the instrument relative to the flat aspect of the handle. 
 
 
 

Examples of forceps for different tissues
Conjunctiva Moorfield's forceps
Cornea and sclera Colibri's forceps
Skin Adson's forceps
Lens capsule Utrata's forceps
Common forceps in Ophthalmic Surgery