Rail-Roading Technique Using 18 Gauge Intravenous Catheter and Silicon Rod for Frontalis Suspension in Blepharophimosis Syndrome

Ruchi Goel*, 1, Apoorva A.G1, Sparshi Jain 1, Malik K.P.S2, Smriti Nagpal 1, Divya Kishore 1
1 Gurunanak Eye center, Maulana Azad Medical College, New Delhi, India
2 Subharti Medical College, Meerut, Uttar Pradesh, India

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© Goel et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the 513/514, First Floor, Double Storey, New Rajinder Nagar, New Delhi-110060, India; Tel: 9811305645; E-mail:


Silicon rods are widely employed for frontalis sling suspension. However, on passing through the tissues, at times, the silicon rod gets detached from the stainless steel needle. This occurs more commonly in patients of blepharophimosis syndrome, in which hypoplasia of superior orbital rim with deficiency of skin between lid and brow, causes difficulty in passage of the needle when it is manipulated upwards from lid towards the brow. To overcome these problems we describe the use of an 18 G intravenous catheter to railroad the needle with the silicon rod, obviating the blind upward maneuvers with the needle and protecting against the damage to the silicon rod –needle assembly. The technique is easily reproducible, safe and can be used in all silicon rod suspensions.

Keywords: Blepharophimosis syndrome, intravenous catheter, ptosis, silicon sling, technique. .