advice needed on ophthalmic instruments

Re: advice needed on ophthalmic instruments

albatross — Mon, 30 Nov 2009 22:23:16 GMT

I've just placed the order for the instruments so hopefully we will have a small dental kit, a third general surgical kit (together with existing odds and ends of kit we had), and an ophthalmic kit.
Many thanks to everyone for all their input.

Now I just need to raise £100......

Re: advice needed on ophthalmic instruments

Maisy — Sat, 07 Nov 2009 14:46:12 GMT

Castroviejos are a little more pricey but vets I've worked with have always preferred using them when doing ophthalmic surgery. As you're a charity, could you contact local vets or put an ad in the Vet Times to see if anyone can donate spare instruments to you? Might be of some help hopefully.

Re: advice needed on ophthalmic instruments

albatross — Sat, 07 Nov 2009 14:43:22 GMT

thanks for everyone's help.
sisterscope I have sent you details via message conversation.

My draft plan is to order the following (but please advise me if I should change it):
ophthalmic hook
strabismus curved 4 1/2 scissors
strabismus straight 4 1/2 scissors
2 baby mosquito forceps 3 1/2
forceps iris 1in 2 teeth 4 1/2
bishop harman 1 in 2 teeth 3 1/2
suture needle holder castroviejo

the last two are the two most expensive ones but the total exc vat comes to £38

I'm also going to get two larger mosquitos to make up a third kit (we have plenty of ordinary artery forceps), and some dental elevators.
that keeps it to just under £100 with postage and VAT (although the charity claims the vat back)

Re: advice needed on ophthalmic instruments

sisterscope1 — Thu, 05 Nov 2009 22:18:04 GMT

As money is a real issue you need to consider versatility. From the list of instruments you've given I would order 2. Curved strabismus scissors (as they are blunt/blunt and curved) and 1x2th iris forceps - plain forceps are pretty much useless. A mayo-hegar 5 1/2" is too big for small needles but you could probably cope. Not sure why you need aural forceps? Confusing Hartmann aural and artery? Hartmann artery forceps are basically a very small mosquito, but you could do without if push comes to shove.

Cheap instruments are a false economy! (I think £14 is cheap but appreciate I'm not in your position) You'll find yourselves replacing them very quickly. Go for German instruments from a large supplier, they're not as expensive as you may think and will last a lifetime if looked after. Remember anything "veterinary" often comes at a premium!

If you send me your address, I'm sure I can find a bunch of out of date ophthalmic sutures - may be not in time for the kitten but may be of use in the future.

Re: advice needed on ophthalmic instruments

albatross — Thu, 05 Nov 2009 22:09:52 GMT

right:

I've found a site called GB medical.
They have got some dental elevators I was loooking at a while ago because we also needed to extract a toofy peg of a staffy but only had the pick tyep instruments.
They seem much cheaper.
They list the bishop harman forceps (wasn't sure whether they were meant to be hartman or harman before because NVS didn't show harman ones), so they are about £8.
they also list a plain end set of forceps.
I guess as well as what I call tweezers (sorry folks but calling them all forceps confuses me!), we need the artery clamping type. Or do I just use tiny mosquito ones?
do I need a hook as well as they're quite cheap?
Anyone used this site for purchasing equipment?

Re: advice needed on ophthalmic instruments

albatross — Thu, 05 Nov 2009 21:54:50 GMT

ok,

boss has given me the go ahead to order some bits:

If I go via NVS the choices are (maybe) :
Scissors Strabismus curved size 4 1/4
Scissors Excision straight 4 1/2
Scissors Metz curved 5 1/2
Scissors Metz straight 5 1/2
Scissors sharp point straight 5
Scissors iris curved 4 1/2
Scissors iris straight 4 1/2

needleholder olsen hegar 5 1/2

forceps mosquito artery 4
forceps iris 1/2 size 4
forceps iris 1/2 teeth straight 4 1/2
forceps iris diss straight 4 1/2
forceps hartman aural 5
forceps hartman aural matthew 5 1/2

I will go search for other suppliers, but the boss is worried that cheaper ones might rust quicker.
Anything I buy I will need to raise money for afterwards, but at least we can get something.

I'm thinking one pair of scissors, one needle holder, and two or three forceps???

Any preferences?
Price obviously is an issue, so if the iris forceps are only a couple of pounds but the toothed version is nearly £14, would it still be recommended to go for toothed ones?

I guess for vicryl etc we tend to use either round needle or cutting so if anyone has useful W codes for these in whatever is cheapest type that would be good. NVS list surgicryl as well, is this the equivalent, although the descriptions seem to be reverse cut or taper cut but not round?

Re: advice needed on ophthalmic instruments

Sal the 1st — Thu, 05 Nov 2009 21:03:56 GMT

you can get vicryl equivalents on a needle a lot cheaper than buying vicryl - may be something to bear in mind in future (just trying to save you a few pennies) dont know if Benkat instruments are still on the go but they used to sell reasonable instruments at a reasonable price.

oops sorry just read previous post properly

Re: advice needed on ophthalmic instruments

christinam — Thu, 05 Nov 2009 01:06:50 GMT

It would be worth asking local practice if you can get suture material from them, as comes in packs of 12/ 36 normally. Also look at brand names, same material dearer than other brand names.

Also,prob a slap in the face here (as you have a lack of money), but would be good investment to get smaller instruments as could be used for future surgeries in small furrries and kittys/ pups.

Re: advice needed on ophthalmic instruments

Vicky RVN — Wed, 04 Nov 2009 23:22:55 GMT

Have you tried vet direct for instruments etc? They are often cheaper than other places.

Re: advice needed on ophthalmic instruments

sisterscope1 — Tue, 03 Nov 2009 23:40:51 GMT

Wells or Hartmann's artery forceps are smaller, but wouldn't worry too much if money an issue. In a small kitten, best advice would be get it out, get it closed and get it awake!

For a small kitten enucleation we'd prob use 6/0. Sometimes you just have to make the best of what you've got. The W ethicon code would depend on what needle type you wanted...

Lyostypt is a useful collagen based haemostatic agent, although shouldn't be left in direct contact with CNS, we use it occasionally for enucleations and brain surgeries.

I think approaching local practice for supplies may be the way forward!

Re: advice needed on ophthalmic instruments

Fiona Leathers — Tue, 03 Nov 2009 23:34:07 GMT

can't think off the top of my head but I'll check at work tomorrow

Re: advice needed on ophthalmic instruments

albatross — Tue, 03 Nov 2009 23:31:51 GMT

thanks for advice so far>
it's now begged another question regarding suture material.
We tend to use 3.0 and 2.0 vicryl or catgut for most things. I take it then that 5.0 would be useful? If so, can anyone give me the W code on them because we have to order by that rather than the actual item.

We have some mosquito forceps in our two kits but the vet thought we needed smaller ones, unless they just come in different sizes?
Migt be able to beg some haemostatic foam from somewhere.....great idea.

Re: advice needed on ophthalmic instruments

Fiona Leathers — Tue, 03 Nov 2009 23:12:13 GMT

We don't have particular ophthalmic instruments but we did get very small sharp scissors from Veterinary Instrumentation, which only cost £6. These are the ones we would use for the enucleations, but they also get used for lots of other ops. As for forceps, we use the ones out of our cat/rabbit spay kit - they're just small mosquito forceps. We do use haemostatic foam to pack the eye, which makes a huge difference, but it can be a bit pricey, cos you have to buy a box, unless there's a practice near you which you could buy it from.

Re: advice needed on ophthalmic instruments

sisterscope1 — Tue, 03 Nov 2009 23:12:01 GMT

The ophthalmic instrument sets we use run into thousands of pounds, but for an enucleation you don't really need anything fancy. Enucleation = eye death! Supplementing what I suspect would be your usual sets I would recommend (for an enucleation):

Metzenbaum scissor 5 3/4" curved or small curved blunt/blunt iris scissor.

Bishop Harman 1 x 2 tooth 0.5mm dissecting forceps

normal Halstead mosquito's fine for haemostasis, remember optic chiasm is short in cats so clamping behind the globe can result in blindness of the other eye.

For needleholders, depends what suture size your surgeon is planning on. A Ryder needleholder will deal with 5/0 and below and shouldn't cost a lot.

Have you looked at Ark Surgical? They are doing a new range of surgical instruments that are very competitively priced and very good quality.