When the punch is
received it will be in a
sterile tray sealed with a Tyvek
lid. The sealed tray is
housed in a cardboard carton
along with printed instructions
and a gentian violet marking
pen.
The tray contains a vacuum
syringe, the cutting block
and top blade assembly, and a
seating ring.
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The punch top and
cutting block are
separated by a ring that
prevents the blade from
contacting the block
during shipment. The
parts are held together
with an elastic silicone
band that should be
removed after the
components are taken out
of the tray. |
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The instructions below will refer to the components
as identified in the photo.
CAUTION:
Before clinical use, the surgeon
should thoroughly understand all
aspects of the surgical
procedure and the use of the
Vacuum Donor Cornea Punch.
The Barron Vacuum Donor Cornea Punch is
packaged in a hermetically-sealed
tray that has been gas
sterilized with ethylene oxide. It is a disposable
unit designed
for single-use and
should not be resterilized or reused. The
punch has been
carefully
checked before packaging and is
ready
for use when it is received.
The Barron Vacuum 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.
Suggestions for Use
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The size of the
punch blade is
stamped on both the
top 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
it 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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- To mark the four
quadrants on the
epithelial side of
the donor cornea,
first open
the sterile pouch
that contains the
surgical marking pen
that comes with the
punch assembly. Then
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.
- Push in the plunger of the syringe all the way
and hold. (It is helpful to have a surgical assistant do this).
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- Place the donor cornea, endothelial surface
up, in the well of the cutting block. Center
the donor cornea in the well with a fine-toothed
forceps.
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- Place the cutting block
on a solid, flat
surface. Insert the
four steel guide
posts of the seating
ring housing into
the corresponding
holes in each corner
of the cutting block and press down gently.
- Release the plunger of the syringe abruptly.
- While holding the cutting block with
one hand, pull the seating ring housing
upward with the other hand and discard
it.
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- With the cutting
block on a solid, flat
surface, insert the four steel guide posts of
the punch top into the corresponding
holes in each corner of the cutting block. Place the thumb directly over the
trephine blade and press down firmly with enough pressure to cut through the
cornea..
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- While
holding the
cutting
block with
one hand, pull the punch top upward with
the other hand to remove the trephine
blade.
- Grasp the scleral rim with a fine-toothed
forceps and
remove the
rim from the
cutting
block. This
releases the
vacuum and
leaves the
donor cornea
button in
the well of
the cutting
block.
- Leave
the cutting
block with
the donor
corneal
button
undisturbed
until the
button is to
be used.
Prolonged
contact of
the button
with the
inked holes
in the well
of the
cutting
block
enhances the
epithelial
marks.
Dessication
may be
prevented by
the
application
of a few
drops of the
corneal
storage
medium on
the button.
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A demonstration of the
Barron Vacuum Donor Cornea
Punch being used by a
cornea surgeon is shown in the
Flash video at the
right.
If
you don't have Flash
installed as a plug-in
for your browser, you
can download an mpeg
version of the clip by
clicking on the
thumbnail below.
Mpeg Download:
12.2MB
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The instructions for the
Barron Vacuum 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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