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When the punch is
received it will be in a
sterile pouch that is
housed in a cardboard
carton along with instructions and a marking pen. The punch top
and bottom cutting block
are separated by a ring
that prevents the blade
from contacting the
block during shipment.
The parts are held
together with a silicone
band. |
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Suggestions for Use
CAUTION:
Before clinical use, the surgeon
should thoroughly understand all
aspects of the surgical
procedure and the use of the
Donor Cornea Punch.
The Donor Cornea Punch is
packaged in a
hermetically-sealed pouch that
is gas
sterilized with ethylene oxide. It is a disposable
unit designed
for single-use and
should not be resterilized or reused. The Donor
Cornea Punch has been
carefully
checked before packaging and is
ready
for use when it is received.
The Barron Donor Cornea Punch should
be used only by a licensed physician who is
familiar with corneal transplant surgery and
with the use of this instrument. The following
instructions do not include all of the procedural
steps required to perform corneal
transplant surgery.
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The size of the
punch blade is
stamped on both the
top surface of the
punch top and the
side of the cutting
block as indicated
in the photo at the
right (the stamped
numbers are circled
in red).
Verify the blade
diameter and remove
the elastic silicone
band from the
instrument.
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While holding
the cutting block
with one hand, use
the other hand to
pull the
punch top straight
upward, turn it over and place
the top on a sterile
tray. Discard
the white blade
protector
ring that is used to
separate the punch top
from the cutting
block.
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- There are two
ways that can be
used to mark the 4
quadrants on the
epithelial side of
the donor cornea.
One is to mark the
cutting block prior
to placing the
cornea in the
block. Open
the sterile pouch
that contains the
surgical marking pen
that comes with the
punch assembly, and
place the tip of the
pen into each of the
four holes in the
well of the cutting
block. Rotate
(twist) the pen
until the sides of
each hole are evenly
coated with gentian
violet ink.
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- Place the donor cornea in the base with
endothelial side facing up. Remove all scleral tissue protruding beyond the
cutting block well. Center the graft in
the cutting block using a fine- toothed forceps.
- Place
the four guide posts
of the punch top into the
corresponding corner
holes of the cutting
block. Press
the top down gently
until the blade
comes into contact
with the cornea.
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- If the
cornea was not
marked using the
procedure as
outlined in step
3 above, then
hold the punch top
in place against
the cornea and mark
the four
cardinal suture
points by
inserting the
tip of the
marking pen into
the four holes
in the bottom of
the block as
shown in the
photo on the
left.
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- Place the block (with
top in place) on a flat
surface, place a thumb
directly over the center
hole of the punch top and
press down firmly with
enough force to cut through
the cornea.
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- Remove the blade by pulling the
punch top upward. The corneal
button will usually remain in the well of
the cutting block, while the peripheral corneoscleral
rim remains on the blade. If
the button remains in the blade, it may
be dislodged by dripping Balanced Salt
Solution (BSS) or viscoelastic substance
on the endothelial side of the
button through the center of the
punch blade.
The instructions for the
Donor Punch are available
in pdf format in English,
French, German, Italian, and
Spanish. The files require
Adobe Reader which can be
downloaded if your browser
doesn't currently have a version
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