Instructions: Donor Cornea Punches

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Donor Cornea Punch
   
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Instructions for Barron Donor Cornea Punches

Donor Punch As Received 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. Donor Cornea Punch Parts

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.  

  1. 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.
  2. 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.
Punch with number 
  Marking before cornea
  1. 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.  
  1. 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.
  1. 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. 
Inserting Top into Block
Markning from bottom
  1. 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.
  1. 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.
Punch being pressed
  1. 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 - Get Adobe Reader

 

Instructions in English INSTRUCTIONS FOR USE - In English
Instructions in French MANUEL D'UTILISATION - en Français
Instructions in German GEBRAUCHSANWEISUNG - auf Deutsch
Instructions in Italian GEBRAUCHSANWEISUNG - in Italiano
Instruction in Spanish INSTRUCCIONES DE USO - en Español