Abstract:
PURPOSE:Today, for the preparation of donor and recipient cornea during keratoplasty either single-use or reusable metal trephines are commonly used although excimer and femtosecond laser systems are available. Due to the surgical techniques as well as the configuration of metal trephine's cutting edge irregular corneal surfaces may be induced. These will result in a postoperative astigmatism. Contemporary manufacturing processes do allow for the production of minimal cutting edge diameters (400 nm -- 1 microm), however, this is related with a reduced mechanical stability of such delicate cutting edges. It has been observed that the cutting edge of metal blades is immediately bent with the first exposure to tissue. As a result, the cutting forces are increasing and the wound configuration is negatively effected. Due to the complex geometry of trephine cutting edges, no diamond trephines are currently available. We are investigating the cutting performance of conventional trephines that were modified using nanotechnology. METHOD:Different metal trephines were characterised using a scanning electron microscope (SEM). The diameter of the cutting edge was measured. Pig cornea were studied histologically after trepanation. Selected trephines were ion-forged in a modified PVD (physical vapour deposition) reactor using highly accelerated ions which are concentrated by magnetic fields at low temperature. The consecutive processing steps were controlled by SEM analysis of the cutting edge diameters. Randomly chosen areas of treated trephines were analysed. After processing the trephines, pig cornea were cut and analysed by histological and SEM examination. Additionally, the relevant mechanical cutting parameters of untreated as well as treated trephines were measured when penetrating into a PU (polyurethane) foil. RESULTS:Preliminary microscopic analysis already reveals differences in the quality of the cutting edges. The nanotechnological modification of the cutting edges does not result in larger diameters. Compared with the initial cutting edges, the optical analysis of the modified trephine cutting edges reveals subjectively smoother surfaces. The force measurements prove a reduction of cutting forces for the treated trephines compared to the untreated ones. The SEM analysis show for the cornea treated with the modified trephines a subjectively smoother surface. Histology reveals that the surfaces of the treated cornea do not exhibit a smooth and unidirectional structure. This divergence became larger when untreated trephines were used. The mechanical characterisation of the treated trephines resulted in harder and longer-lasting surfaces. DISCUSSION:The newly developed ion-forging of trephines in combination with nanostructured carbon coatings yield complex cutting edges of higher stability with diamond-like properties. This study shows that the performance of laser trepanation cannot be reached; however, the use of nanotechnology can further improve manual trephine techniques.
journal_name
Klin Monbl Augenheilkdjournal_title
Klinische Monatsblatter fur Augenheilkundeauthors
Lingenfelder C,Kupferschmid S,Grabowy U,Kleinen L,Spraul CWdoi
10.1055/s-2005-858661subject
Has Abstractpub_date
2005-09-01 00:00:00pages
709-16issue
9eissn
0023-2165issn
1439-3999journal_volume
222pub_type
杂志文章abstract::It has been shown by a series of 127 dacryocystorhinostomies using the Toti technique, that this operation, which is independent of age or aethiology, can be performed using a simple procedure and a short hospitalization time. The success rate of over 90% indicates that this operation should be used as a standard proc...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::Binocular perimetry with Aulhorn's Phase difference haploscope is described. Of 62 patients with primary micro-squint, 21 patients showed no scotoma, 15 patients showed a fixation or zero point scotoma of 0.5-1 degrees, 26 patients showed a larger scotoma (average: 3.7 degrees). In addition, 15 patients with larger an...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
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更新日期:2007-06-01 00:00:00
abstract::By means of a new optical device developed by Reiner, an "optical implantation" of 6 different bi- and multifocal intraocular lenses (MIOLs) was performed in 20 young healthy subjects, and results were compared with those of a monofocal reference IOL. The following parameters were investigated: distance and near visua...
journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1046005
更新日期:1991-05-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-06-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045527
更新日期:1994-11-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
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更新日期:2015-01-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1057639
更新日期:1980-01-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0041-111801
更新日期:2016-04-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract::124 lowgrade hypermetropic pupils aged from 6 to 9 years, with normal I.Q. showed exophoria for near vision combined with weakness of convergence and school difficulties in several disciplines. These were treated as follows: training of the physiological diplopy, training of convergence, and surgical treatment by unil...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-11-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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更新日期:2001-09-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1057741
更新日期:1980-12-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
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更新日期:2008-09-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
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更新日期:2012-01-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1057477
更新日期:1980-03-01 00:00:00
abstract::This case report describes a rare fibrous histiocytoma at the corneoscleral limbus in a 10-year-old boy. In our patient the tumour was histologically classified as benign, however, it presented with an invasive growth pattern and recurrency, so that a penetrating sclerokeratoplasty became necessary. This case is set i...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1027125
更新日期:2008-01-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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更新日期:1982-11-01 00:00:00