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

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.