GLOBE

NEWS FOR OPHTHALMIC PROFESSIONALS VOLUME 11 NUMBER 1 Controlled IOL Explantation

PHACO CHOICES Katena iterally hundreds of phaco Soft IOL K4-5570 manipulators, rotators and horizontal Lchoppers have been developed Cutter handle since the introduction of phacoemul- K4-5571 vertical sification for by Dr. handle (shown) Charles Kelman in the late nineteen sixties. As more and more surgeons learned to use , new surgical techniques were devel- oped along with new instruments to atena introduces a new soft the strength to cut even the thickest help implement those techniques. IOL cutter for explanting lenses. soft IOLs without twisting. The One of the first instruments for rotat- KIt features a fixed lower blade round shank easily fits through a ing the nucleus and feeding it into for insertion under the IOL and an 3mm incision. The instrument is the phaco tip was upper movable blade for cutting so offered with two different handle designed by Dr. that the blade movement can be visu- mountings to suit the surgeon’s pref- Charles “Skip” alized by the surgeon. The 6mm long erence. The vertically mounted K3-2410 Bechert of Fort blades have serrated edges to grasp handle (K4-5571) points upward, in Lauderdale, and he named it the IOL surface and prevent it from line with the blades, while the hori- the Bechert Nucleus Rotator. It fea- slipping away during cutting. The zontally mounted handle (K4-5570) is tures a Y-shaped tip for rotating rongeur style mechanism provides offset 90˚ to the right. and manipulating the nucleus. Dr. Norman Jaffe modified the Bechert rotator, increasing its length to 9mm Flap Manipulator for LASIK Enhancements so that it could easily be used olive shaped tip which is used to through a sideport incision. Some gently depress the cornea to locate 30 years later, the Jaffe-Bechert rota- the flap edge. Once located, Dr. K3-2540 tor is still as popular as ever with Durrie engages the edge with the phaco surgeons. During his AAO 2000 presentation smoothly polished tip and slides it In this issue we will illustrate some of of “Surgical Technique Pearls for around the rim to partially open the the instruments that have become the LASIK Enhancements”, Dr. Daniel S. flap. The flap is then lifted with a for- mainstay for phaco surgery. Durrie of Overland Park, KS ceps to expose the stromal bed for introduced a new LASIK Flap laser retreatment. See Phaco Choices, page 3 Manipulator. It features a delicate, Free technique video supplied with each instrument. Ginsberg Eye Speculum Grandon Eye Speculum

controls redundant lid tissue

K1-5679 Ginsberg Eye Speculum K1-5076 Grandon Wire Speculum Dr. Stephen P. Ginsberg of Kensington, Maryland has designed a new speculum to address the problem of new wire speculum has redundant lid tissue and lashes entering the surgical field. The been designed by Stanley C. speculum features solid, non-reflective blades with flared ends to AGrandon, M.D., of Dear- control lid skin folds. The lower blade is shorter than the upper blade to born, Michigan. It features gently facilitate easy insertion and removal. Both blades are fenestrated to curled back tips to atraumatically minimize pressure exerted on the globe. Strongly angled shanks allow the retain redundant lid tissue. The opening and closing mechanism to lie flat along the patient’s temple and heavy gauge coiled fulcrum completely out of the way. provides strong spring tension to completely retract and control the Dr. Ginsberg states that this speculum is ideal for most ocular procedures patient’s lids. Dr. Grandon uses including laser and cataract surgery, as well as pterygium, strabismus, this speculum for both LASIK and corneal transplant and posterior segment surgery. cataract surgery. (Ref: “Ginsberg Lid Speculum provides a clear operating field”, Stephen P. Ginsberg, MD, Ocular Surgery News, March 15, 2001) Rasch Cartridge Helveston Fixation Forceps Holding for globe fixation during strabismus procedures Forceps

K5-2556 Helveston Fixation Forceps This new instrument was designed by Eugene M. Helveston, M.D., of Indianapolis, Indiana for fixating and retracting the K5-8185 Rasch Cartridge Holding Forceps globe during strabismus procedures. It has 0.6mm 1x2 teeth and a r. Volker Rasch of Potsdam, thumb activated slide catch for locking. The instrument features a unique Germany has designed a curved handle for stabilizing the forceps after affixing it to the globe. forceps for grasping and A suture may be placed through the hole in the end of the handle and D ® stabilizing the Staar IOL cartridge attached to the drape for additional traction. while placing the IOL into the cartridge channel. The forceps Christensen Punctum Punch (K5-8185) is designed to securely grasp the rectangular holding for opening stenotic punctums tab without blocking the surgeon’s view while placing the into the plastic cartridge. The IOL Loading Forceps (K5-8184) is used to place the lens K5-8184 into the open cartridge channel and K2-9525 Christensen Punctum Punch features concave tip surfaces for Dr. Frank Christensen of Chapel Hill, NC has developed a punch for pushing the lens forward into the opening a stenotic punctum. The punch features a thin tapered tip which can cartridge channel. The combination be inserted into the punctum to excise a 1mm wide section of tissue in a single of these instruments permits the action. There is no need for multiple cuts, as with a scissors, thereby surgeon to comfortably work with minimizing the amount of bleeding. The instrument can be used in the 45˚ hand positions. office or during DCR procedures for stenotic punctums. Staar ® is a trademark of Staar Surgical Company, Inc. Phaco Choices

The Lieberman MicroFinger fea- The Knolle Nucleus Spatula fea- choppers tures a curved, hourglass shaped tures a 0.5mm wide, flat, stainless tip for controlling, manipulating steel spatula which is completely The Rosen Phaco Splitter was and cracking the nucleus during malleable. This allows the surgeon designed for the “phaco chop” tech- phaco surgery. to angle or curve it to suit his or her nique. It features a 1.1mm long blunt personal preference. Lieberman MicroFinger tip with a blunt superior edge to pro- K3-2360 for use in right hand tect the capsule and a wedge shaped K3-2361 for use in left hand inferior edge for splitting the nucleus. Knolle Lens Nucleus Spatula The Rosen Splitter is also available K3-2350 with the wedge offset 60˚ for use through a paracentesis. manipulators Rosen Phaco Splitter crackers K3-2395 original model For the “divide and conquer” tech- K3-2396 60˚ model nique, the Drysdale Nucleus Manipulator is preferred by many For surgeons who prefer a single surgeons. It features a smoothly pol- handed technique of cracking the The double end Chang Combination ished, paddle shaped tip, which is nucleus, Katena offers the Dodick Chopper features a modified Lieber- used to divide, split, and control Nucleus Cracker with thin paddle man MicroFinger and a pointed the nucleus. shaped jaws. The longitudinal serra- Maloney “quick chop” tip. The Drysdale Nucleus tions on the outside surface of the MicroFinger tip is used for horizon- Manipulator jaws engage the grooved nucleus, tal chopping of soft to K3-2418 while gentle pressure on the medium nuclei and the handle opens the jaws to “quick chop” tip is used crack it. for vertical chopping of The Pisacano Nucleus Manipulator Dodick Nucleus Cracker hard nuclei. features a lightly concave, round shaft K5-7244 Chang Combination with a 0.75mm wide disc shaped tip Chopper for engaging the nucleus and guiding The Ernest Nucleus Cracker features it toward the phaco probe. It is also K3-2368 for use in right hand a patented cross-action mechanism K3-2369 for use in left hand well suited for the “divide and con- which allows the surgeon to crack quer” technique. the nucleus through a 2.5mm Pisacano Nucleus incision without stretching the Dodick-Kammann Chopper The Manipulator wound. Its delicate paddle shaped was designed for bimanual nucleus K3-2420 horizontal flat tip jaws have serrated outer surfaces chopping. It features a 2mm long tip K3-2421 vertical flat tip to engage the nucleus and with a wedge shaped inferior edge beveled corners for ease and a smooth, rounded posterior tip. of extraction through Using two of these instruments to The multi-purpose Anis Nucleus the small incision. chop the nucleus into small pieces Manipulator features a delicate ball can substantially reduce phaco time. Ernest Nucleus Cracker shaped tip mounted on the end of a K5-7240 Dodick-Kammann Chopper curved, thin shank, which is designed K3-2384 straight for exerting counter pressure while K3-2385 angled cracking the nucleus. With the Akahoshi Phaco PreChopper Anis Nucleus Manipulator sculpting of the nucleus is eliminated K3-2426 straight and phaco time is reduced. After This instrument was designed for K3-2427 angled inserting the sharp tipped jaws into the Fukasaku “snap & split” phaco the core of the nucleus, the forceps technique. The short, wedge shaped handle is gently squeezed to spread tip is used to crack the nucleus in The Tennant Nucleus Manipulator the jaws and divide the nucleus. The the “safe central area” while the features a ball shaped tip for rotating patented cross-action mechanism smoothly polished, notched superior and splitting the nucleus. The allows the jaws to fully open for edge is used to push back the iris for 0.6mm diameter ball tip is ideal for cracking without stretching the small better visibility. controlling soft nuclei. incision. Akahoshi Phaco Fukasaku Snapper Hook Tennant Nucleus PreChopper K3-2393 Manipulator K5-7230 K3-2428 Double Sterilizing Case

r. Daniel B. Drysdale of Blacksburg, Virginia has his lightweight aluminum D designed a new 19 gauge Tcase is ideal for sterilizing cannula (K7-5084) for closure of and transporting 30-50 oph- clear corneal cataract wounds by thalmic surgical instru- predictably pressurizing the eye ments. It features one after removal of all residual vis- removable upper tray and coelastic. He attaches the cannula a large side compartment to the irrigation tubing with the for handling bulky bottle at maximum height (78cm). items. The upper and With irrigation on, the tip of the lower trays are lined cannula is advanced to the inter- with soft silicone finger nal lip of the wound then slowly mats to securely hold and protect withdrawn without hesitation. instruments. For additional protec- K9-2350 Sterilizing Case, double tion of extra delicate hooks, manip- K9-2355 Instrument Rack (not shown) 3 1 5 Outside dimensions: 12 ⁄4'' x 10 ⁄2'' x 1 ⁄ 8'' ulators and cannulas, an optional (325 x 265 x 42mm) rack insert is available.

K7-5084 Drysdale Closure Cannula

Connect your mouse Dr. Drysdale suggests that the sur- geon’s first few cases be closed in to our catalog the usual manner, and that TonoPen® pressure be taken with a www.katena.com sterile tip cover in place just before and after pressurizing with the Drysdale Closure Cannula. Once the results are acceptable, occa- sional post-op tonometry may be performed in complicated cases or Copyright 2001, Katena Products, Inc. Copyright 2001, Products, Katena

when wound competence is in © question for any reason.

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