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 punch parts are held together with a silicone band that should be removed after the assembly is emptied from the pouch onto a sterile field. The carton and outside of the pouch are not sterile, so they should be handled by an assistant and not be allowed to touch the sterile working area. The pouch should be opened by the assistant, and the punch assembly should be deposited onto a sterile tray.
SuggesTions For USe
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 re-sterilized 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 the procedural steps required to perform corneal transplant surgery.
- The size of the punch blade is marked on both the top of the punch top and the side of the cutting block as indicated in the photo (the marked numbers are circled in red). Verify the blade diameter, remove the elastic silicone band from the instrument, and discard the band.
- 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.
- To mark the 4 quadrants on the epithelial side of the donor cornea 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.
- 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 guideposts of the punch top into the corresponding corner holes of the cutting block. Press the top down gently until the blade contacts the cornea.
- 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.
- 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.