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New Forceps and Cutting Block for Donor Corneas
744
AMERICAN JOURNAL OF OPHTHALMOLOGY
MAY, 1980
preserved in McCarey-Kaufman medium. It consists of a hydraulic system, which creates a positive pressure of 60 mm Hg or more. An added rotating ring serves as a base to the microkeratome's tracks and varying diameters of lamellar sections can be obtained. This device allows the surgeon to use readily available corneas with scleral rims preserved in McCarey-Kaufman medium rather than whole eyes to obtain precise lamellar sections. REFERENCES 1. Ward, D. E., and Nesburn, A. B.: An artificial anterior chamber. Am. J. Ophthalmol. 82:796, 1976. 2. Barraquer, J. I.: Keratomileusis. Int. Surg. 48:103, 1967. 3. McCarey, B. E., and Kaufman, H. E.: Improved corneal storage. Invest. Ophthalmol. 13:365, 1974.
NEW FORCEPS AND CUTTING BLOCK FOR DONOR CORNEAS FREDERICK S. BRIGHTBILL, M.D., AND BRAD CALKINS, B.S.
Fig. 1 (Brightbill and Calkins) Left, Cross-action angled media' forceps with 20-ml media storage bottle. Right, Media forceps engaging edge of corneoscleral tissue stored in media.
the surgeon's gloves while the cornea is removed from a 20-ml solution bottle (Fig. 1, left). The cross-action design combined with 0.12 mm doublepronged, opposing teeth allows positive closure over the scleral edge and sure first-attempt retrieval of the donor tissue (Fig. 1, right). Variable-curved wells are a new con-
Madison. Wisconsin
We designed 0.12-mm media forceps" for removal of the corneoscleral rim when stored in short-term solutions such as McCarey-Kaufman medium. A 7.0-cm length shaft is sufficiently long to minimize the possibility for contamination of
From the Department of Ophthalmology, University of Wisconsin Center for Health Sciences, Madison, Wisconsin. Reprint requests to Frederick S. Brightbill, M.D., University of Wisconsin Center for Health Sciences, 600 Highland Ave., Madison, WI 53792. "Both instruments are available from Storz Instrument Co., St. Louis, Missouri.
Fig. 2 (Brightbill and Calkins). Variable-curved wells (15 mm, 16.5 mm, and 18 mm) with centering targets in a Teflon block.
VOL. 89, NO.5
NOTES, CASES, INSTRUMENTS
745
well when used in conjunction with any new 0.25-mm stepped disposable trephine blade. SUMMARY
We designed two new instruments to faciliate the handling and cutting of donor corneal buttons: 12-mm media forceps and a varible curved Teflon block with centering targets. REFERENCES Fig. 3 (Brightbill and Calkins). The surgeon uses the corneal trephine to punch the corneoscleral tissue by using the endothelial-side maneuver with the Teflon cutting block.
cept in the design of a block for use with handheld trephines using the endothelial punch technique'f for cutting donor buttons. * The block (Fig. 2) incorporates three wells per side (total of six) with three different base curves manufactured by using one half circle end mills of 15 mm, 18 mm, and 20 mm (we have omitted the 20-mm well [flattest] in newer blocks while inserting a 16.5-mm diameter well for improved corneoscleral rim fitting). This allows the surgeon to choose the well that is the best fit before punching out the donor button (Fig. 3). Eight-millimeter red centering targets assure improved centering of the punching trephine. Made from Teflon, the block's dimensions (58 X 58 X 20 mm) were designed for easy use either in the palm of the surgeon's hand or on the instrument table top. Whenever a punching maneuver is used over a Teflon surface, the edges of the donor button must be carefully inspected for adherence of small fragments of Teflon. We have observed that the punched button will always remain in the
1. Brightbill, F. S., Polack, F. M., and Slappey, T.: A comparison of two methods for cutting donor corneal buttons. Am. J. Ophthalmol. 75:500, 1973. 2. Vannas, M.: A study of corneal transplantation and operative technique. Albrecht von Graefes Arch. Klin. Exp. Ophthalmol. 140:709, 1939.
ENHANCEMENT OF RETINAL FLUORESCEIN BIOMICROSCOPY JERRE K. CHAMBERS, M.D. Charleston, South Carolina
Visualization of fluorescein through a slit lamp and contact lens can be enhanced through proper selection of exciting and barrier filters.l" We devised an optical bench model of the American Optical 11666 slit lamp to test filter combinations of theoretical value. We compared clinically selected filter combinations to determine effectiveness when mounted in a slit lamp. MATERIAL AND METHODS
An optical bench model of the American Optical 11666 slit lamp was conFrom the Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina and the Veterans Administration Hospital, Charleston, South Carolina. Reprint requests to Jerre K. Chambers, M.D., Department of Ophthalmology, 171 Ashley Ave., Charleston SC 29401.
AMERICAN JOURNAL OF OPHTHALMOLOGY
MAY, 1980
preserved in McCarey-Kaufman medium. It consists of a hydraulic system, which creates a positive pressure of 60 mm Hg or more. An added rotating ring serves as a base to the microkeratome's tracks and varying diameters of lamellar sections can be obtained. This device allows the surgeon to use readily available corneas with scleral rims preserved in McCarey-Kaufman medium rather than whole eyes to obtain precise lamellar sections. REFERENCES 1. Ward, D. E., and Nesburn, A. B.: An artificial anterior chamber. Am. J. Ophthalmol. 82:796, 1976. 2. Barraquer, J. I.: Keratomileusis. Int. Surg. 48:103, 1967. 3. McCarey, B. E., and Kaufman, H. E.: Improved corneal storage. Invest. Ophthalmol. 13:365, 1974.
NEW FORCEPS AND CUTTING BLOCK FOR DONOR CORNEAS FREDERICK S. BRIGHTBILL, M.D., AND BRAD CALKINS, B.S.
Fig. 1 (Brightbill and Calkins) Left, Cross-action angled media' forceps with 20-ml media storage bottle. Right, Media forceps engaging edge of corneoscleral tissue stored in media.
the surgeon's gloves while the cornea is removed from a 20-ml solution bottle (Fig. 1, left). The cross-action design combined with 0.12 mm doublepronged, opposing teeth allows positive closure over the scleral edge and sure first-attempt retrieval of the donor tissue (Fig. 1, right). Variable-curved wells are a new con-
Madison. Wisconsin
We designed 0.12-mm media forceps" for removal of the corneoscleral rim when stored in short-term solutions such as McCarey-Kaufman medium. A 7.0-cm length shaft is sufficiently long to minimize the possibility for contamination of
From the Department of Ophthalmology, University of Wisconsin Center for Health Sciences, Madison, Wisconsin. Reprint requests to Frederick S. Brightbill, M.D., University of Wisconsin Center for Health Sciences, 600 Highland Ave., Madison, WI 53792. "Both instruments are available from Storz Instrument Co., St. Louis, Missouri.
Fig. 2 (Brightbill and Calkins). Variable-curved wells (15 mm, 16.5 mm, and 18 mm) with centering targets in a Teflon block.
VOL. 89, NO.5
NOTES, CASES, INSTRUMENTS
745
well when used in conjunction with any new 0.25-mm stepped disposable trephine blade. SUMMARY
We designed two new instruments to faciliate the handling and cutting of donor corneal buttons: 12-mm media forceps and a varible curved Teflon block with centering targets. REFERENCES Fig. 3 (Brightbill and Calkins). The surgeon uses the corneal trephine to punch the corneoscleral tissue by using the endothelial-side maneuver with the Teflon cutting block.
cept in the design of a block for use with handheld trephines using the endothelial punch technique'f for cutting donor buttons. * The block (Fig. 2) incorporates three wells per side (total of six) with three different base curves manufactured by using one half circle end mills of 15 mm, 18 mm, and 20 mm (we have omitted the 20-mm well [flattest] in newer blocks while inserting a 16.5-mm diameter well for improved corneoscleral rim fitting). This allows the surgeon to choose the well that is the best fit before punching out the donor button (Fig. 3). Eight-millimeter red centering targets assure improved centering of the punching trephine. Made from Teflon, the block's dimensions (58 X 58 X 20 mm) were designed for easy use either in the palm of the surgeon's hand or on the instrument table top. Whenever a punching maneuver is used over a Teflon surface, the edges of the donor button must be carefully inspected for adherence of small fragments of Teflon. We have observed that the punched button will always remain in the
1. Brightbill, F. S., Polack, F. M., and Slappey, T.: A comparison of two methods for cutting donor corneal buttons. Am. J. Ophthalmol. 75:500, 1973. 2. Vannas, M.: A study of corneal transplantation and operative technique. Albrecht von Graefes Arch. Klin. Exp. Ophthalmol. 140:709, 1939.
ENHANCEMENT OF RETINAL FLUORESCEIN BIOMICROSCOPY JERRE K. CHAMBERS, M.D. Charleston, South Carolina
Visualization of fluorescein through a slit lamp and contact lens can be enhanced through proper selection of exciting and barrier filters.l" We devised an optical bench model of the American Optical 11666 slit lamp to test filter combinations of theoretical value. We compared clinically selected filter combinations to determine effectiveness when mounted in a slit lamp. MATERIAL AND METHODS
An optical bench model of the American Optical 11666 slit lamp was conFrom the Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina and the Veterans Administration Hospital, Charleston, South Carolina. Reprint requests to Jerre K. Chambers, M.D., Department of Ophthalmology, 171 Ashley Ave., Charleston SC 29401.