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Good news !      Patients, Doctors, and Surgical Team are all Happy with "KARTON SYSTEM."

:What can you do with Karton System?

:Karton System is a training method using butchered pig's eyes.  You can practice performing CCC and PEA on simulant cataract models exactly as in human cataract operations.  By practicing on these models beforehand, the necessary skills required for successful human cataract surgeries will be acquired in a short period of time.

:Is it easy to use Karton System?

:Karton agents are liquid gelation chemicals.  By injecting these agents into a butchered pig's eye with a syringe, you can induce a simulant cataract on which you can perform a simulated cataract operation and enhance your technique. There are, however, certain hints to learn in producing ideal models for your practice, so please be sure to read the procedures carefully.  Nevertheless, if you still have problems, feel free to contact us by email at any time.

:Karton-C agents stiffened in the syringe when left unused.  What do I do?

:The chemical reaction of Karton-C is relatively fast, so if you mix the two agents and let it sit for a while, it will stiffen inside the syringe.  Please try to use the mixture as soon as possible, approximately within 5 minutes at latest.  In addition, an appropriate amount of each agent is set for one dose.

:I can't inject Karton-C correctly into the pig's eye's lens.  Is there a knack in doing this?

:At first, when making a scleral side port, make a fairly large port with a stab knife or a slit knife.  That way, it is easier to insert the needle.  The area to pierce is from the limbus to the equator.  Then, confirming the location of the needle, pierce the posterior capsule of lens.

:Karton-C is injected into the pig's eye's lens, but the agent does not spread widely beneath the anterior capsule.  Also, the agent pours out into the anterior chamber.

:When injecting Karton-C beneath the anterior capsule, slightly raise the anterior capsule with the blunt needle before injecting the agent.  In case the agent pours out, it is a sign that the injecting amount is overdosed.

:When Karton-C gelled, it opacified perfectly, but then it was so white that I couldn't identify the edge of the anterior capsule.  What do I do?

:When Karton-C spreads out in the entire area of the pupil, the hardened nucleus of the cataract model resembles a mature human cataract.  At the same time, however, it becomes that much more difficult to perform CCC on it.  For the beginning surgeons especially, it is advised to stain the anterior capsule with an agent such as trypan-blue, then the practice will be much easier.

:I find it difficult to inject Karton-N.

:The point in injecting Karton-N, to prevent rupturing the posterior capsule, is to slowly advance the needle toward the equator of the empty bag.  You may find it difficult at first, but it's just a matter of practice.  When you get used to it, the prospects of success is 99%.  Inject the agent attentively and pour it in a doughnut shape.  Also, avoid overdosing.

:How long should I wait after injecting Karton-N into the empty bag?

:After injecting Karton-N into the empty bag, to prevent the anterior chamber from collapsing, inject a little amount of viscoelastic material and let it sit for 15 to 20 minutes.

:I find difficulty in performing PEA on the cataract models. What are the points to attend to?

:When Karton-N is left to harden for about 30 minutes, its consistency becomes almost equivalent to a human cataract emery grade 5.  It then becomes difficult to practice the 'divide & conquer' technique on the Karton-nucleus, and the practice of PEA will be time-consuming, too.  For beginners, we recommend to practice on a softer Karton-nucleus.

:While performing PEA on a cataract model, the posterior capsule was ruptured by mistake.

:Karton System was originally developed with the object of producing as real an artificial human cataract as possible.  Therefore, even a rupture of the posterior capsule may sometimes occur, which is quite rare during PEA on an untreated pig's eye.  Furthermore, even the motion of the Karton-nucleus after the rupture resembles that of a human eye.  In that sense, what you have just observed is a good simulation of the real situation, which helps you to tell the progress of your technique as well.

:Are Karton agents harmless when coming in contact with hands or eyes?

:The ingredients of Karton agents are mainly polyvalent alcohol, and the coloring matter is a plant pigment, therefore, they are all nonpoisonous.  They are, however, inflammable, so please keep them away from fire.

:I'd like to try Karton agents.  What do I do to purchase them?

:Thank you for your interest in our products.  Please contact us directly by E-mail.

:While trying to inject Karton-N into the bag, I can't seem to inject sufficient amount of it and fail to form a good model.  Are there any tricks to know about when injecting Karton-N?

:There are two points to be suggested.

1) The first is when applying viscoelastic material, avoid spreading it over the central pupillary area, but try to inject it onto the iris root area only and limit the spread within the iris.  Generally, viscoelastic material is transparent, so it is hard to tell its status while injecting it.  A hinting sign to observe here is the condition of the iris, which should stretch out as the viscoelastic material invades into the area.

2) Secondly, you should be able to see some wrinkly transparent membrane right under the anterior capsular edge, which is the posterior capsule.  Insert a blunt 27-G needle into the space between the two capsules, and while advancing the needle carefully, slowly inject Karton-N.  At first, the agent will spread about the equator of the bag, then penetrate over the central pupillary area.  As mentioned in the manual of our homepage, you may find it difficult at first, but once you've acquired the feel of it, it should be easy from the second time.

:In order to inject Karton-N more quickly, is it possible to use a broader needle?

:For such a request, our suggestion is to make a homemade blunt 23-G needle.

Pinch off the tip of a 23# needle and then smooth its surface with a whetstone or sandpaper.  With this handmade needle, you can draw in 1 ml of Karton-N into the syringe directly.  Also, with this needle, it is easier when injecting into the capsule than using a blunt 27-G needle.  Try it once.