equis - Articles
Eyelid: canthotomy
Introduction
- To provide good exposure and easy manipulation of globe for ocular surgery by:
- Lateral canthotomy.
- Eyelid stabilization.
- Globe stabilization.
Uses
- All ocular surgery but especially corneal, scleral and intra-ocular surgery.
Advantages
- Simple to perform.
- Minimal equipment - avoids need for eyelid speculum during surgery.
- Minimal complications.
- Ease of access for primary surgery.
Disadvantages
- General anesthesia Anesthesia: general - overview required.
- Additional time on top of primary surgery.
Alternative techniques
- Use of effective eyelid speculae especially in minor procedures or where non-perforation of globe - speculae may increase intraocular pressure.
- Less invasive cataract surgery techniques such as phacoemulsification decrease need for surgical exposure.
Time required
Preparation
- 10 min.
Procedure
- Canthotomy - 10 min.
- Eyelid stabilization - 5 min.
- Globe stabilization - 5 min.
Decision taking
Criteria for choosing test
- Whether increased exposure and globe control is required and to what degree:
- Lateral canthotomy.
- Eyelid fixation - may be performed with or without canthotomy.
- Globe stabilization - usually placed after lateral canthotomy and eyelid fixation.
- Two techniques:
- Forceps stabilization - used only for brief, external operative procedures as cause excess tension on eye when manipulated and can create excessive trauma from repeated grasping of the conjunctiva with forceps.
- Fixation sutures - equine conjunctiva tears easily so fixation sutures are usually preferred.
Risk assessment
- Increased surgical time.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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