McPherson Forceps - Precision Instruments for Delicate Eye Surgery

What are McPherson Forceps?

McPherson forceps, named after ophthalmologist William F. McPherson, are specialized surgical forceps used in delicate eye surgery. With angled shafts and fine, curved tips, McPherson forceps allow surgeons to grasp and manipulate eye tissue with precision during procedures like cataract surgery or corneal transplants.

The Unique Design of McPherson Forceps

McPherson forceps feature an elongated shaft with a gently curved section along the middle. This offset design improves visibility and access to the surgical site. The tips are ultra-fine, with delicate jaws or platforms suited for grasping the thin membranes within the eye without causing trauma.

Most McPherson forceps have serrated jaws or platforms to ensure a secure, no-slip grip on slick, delicate tissues. Some feature one serrated side and one smooth side for versatility. The serrations are very fine to avoid tearing.

Common Variations of McPherson Forceps

Many types of McPherson forceps are available for different purposes during ophthalmic surgery, including:

• Corneal McPherson forceps - For manipulating donor corneas
• Capsulorhexis forceps - For tearing the lens capsule in cataract surgery
• Intraocular forceps - For manipulating tissues inside the eye
• Tying forceps - For suturing during wound closure

These forceps vary in tip shape, size, and angle based on their intended use, but all share the same delicate McPherson design.

Using McPherson Forceps in Ophthalmic Surgery

Cataract Surgery Applications

One common application of McPherson forceps is during cataract extraction surgery. The most critical step of this surgery is called capsulorhexis:

1. The surgeon uses special capsulorhexis McPherson forceps to grasp the front of the cloudy lens capsule.
2. They tear a circular opening in the capsule by making a continuous rip around its circumference.
3. This opening allows them access to the old lens so they can break it up and remove it.

Other McPherson forceps help manipulate tissues and position implants within the eye after the old lens is extracted.

Corneal Transplant Surgery Applications

McPherson forceps also assist corneal transplant surgery by enabling the following steps:

1. Grasping and properly positioning the donor cornea graft
2. Manipulating host eye tissue for access and visibility
3. Placing anchoring sutures to attach the donor cornea

The delicate jaws provide the control necessary to handle such thin, sensitive membranes without causing damage.

Proper Care and Handling of McPherson Forceps

As precision surgical instruments, McPherson forceps must receive conscientious care both during usage and sterilization/storage:

Intraoperative Care Guidelines

• Grasp tissue gently with only enough pressure to maintain control
• Use the appropriate size/type for each application
• Keep tissues moist with irrigation to avoid sticking
• Pass instruments via neutral zones to maintain visibility

Cleaning and Sterilization Protocol

Follow these crucial steps every time after use:

1. Rinse gross soil from jaws under running water
2. Gently brush debris away from hinges/serrations if needed
3. Clean ultrasonically and rinse before sterilizing
4. Double-wrap and cycle autoclave according to facility policy
5. Store in a designated, limited-access area to prevent damage

Are McPherson Forceps Required for Eye Surgery?

While eye surgeons can manipulate tissue manually with other instruments, McPherson forceps vastly improve safety, efficiency, visibility and outcomes during delicate procedures. Their specialized design makes complex maneuvers like capsulorhexis much simpler.

Attempting eye surgery without McPherson forceps would pose significant difficulties even for the most skilled surgeon. These instruments are considered indispensable equipment in any ophthalmic OR.

The Takeaway

With fine, angled tips perfectly contoured for accessing tight eye anatomy, McPherson forceps allow eye surgeons to manipulate tissue with extraordinary finesse and safety. They also minimize procedure length, fatigue and complication rates. While novice surgeons require practice to master their nuances, McPherson forceps remain essential for even simple anterior segment procedures.

FAQs

What procedures are McPherson forceps used for?

McPherson forceps are designed specifically for delicate ophthalmic surgeries like cataract removal, corneal transplants, glaucoma surgery, and oculoplastic procedures. Their precision allows eye surgeons to grasp and manipulate tissue safely.

Why are McPherson forceps angled?

The gentle curve along the shaft of McPherson forceps serves an important purpose. It improves visibility and accessibility to tight surgical sites since the surgeon's hands and instruments don't completely obstruct the view. The angle also reduces hand fatigue.

How should McPherson forceps be sterilized?

McPherson forceps should be gently scrubbed free of debris, ultrasonically cleaned, and then bagged and autoclaved according to the manufacturer's recommendations. This prevents tissue buildup and corrosion over repeated uses.

How often do McPherson forceps need replacing?

With proper care and maintenance, McPherson forceps can last for years. But over time, the precise alignment of the tips may suffer from small dents or bends that affect grip and control. Forceps should be replaced at the first sign of damage, stickiness or poor performance.