c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Corneal Transplant: 7

A D V E R T I S E M E N T

   
 

Trephination of the donor cornea is performed here using a disposable donor punch with a sharp circular steel blade. The donor cornea is placed in the block endothelial side up, and the punch produces a round donor button with vertical edges and little endothelial trauma. The donor trephine is selected based on the size of the host trephine, usually 0.25 to 0.5 mm larger than the host.

After the donor button is cut, it should be protected with storage media and covered with a sterile cover such as a specimen cup while the recipient bed is prepared.    

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Corneal Transplant: 8

A D V E R T I S E M E N T

   
 

The host trephine is shown, in this case a Barron-Hessberg radial vacuum trephine. Note the circular blade is recessed within the cylindrical suction ring (inset). This suction ring is attached to a spring-loaded syringe which will create a vacuum when the obturator is placed in contact the the cornea. This vacuum will hold the trephine firmly in place while cutting the host cornea. Prior to trephination, size and centration on the host cornea can be checked by applying gentle pressure with the trephine to imprint the corneal surface. Once the host trephine size is determined, the cornea is protected with a moistened cellulose sponge while the donor button is cut.    

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Corneal Transplant: 9

A D V E R T I S E M E N T

   
 

The host trephine is centered over the cornea. Crosshairs in the central cylinder aid with centration. The dial is then turned manually. Each quarter turn advanced the blade 60 microns. Trephination can be carried out carefully until the first sign of aqueous indicated entry into the anterior chamber. Alternatively, trephination can proceed to an estimated 90% depth and the anterior chamber entered with a blade.     

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This page was last modified on 3/21/2001.