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:What can you do with Karton System? |
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: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.
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:Is it easy to use Karton System? |
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: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.
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:Karton-C agents stiffened in the syringe when left unused. What
do I do? |
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: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.
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:I can't inject Karton-C correctly into the pig's eye's lens. Is
there a knack in doing this? |
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: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.
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: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. |
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: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.
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: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?
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: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.
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:I find it difficult to inject Karton-N. |
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: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.
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:How long should I wait after injecting Karton-N into the empty bag? |
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: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.
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:I find difficulty in performing PEA on the cataract models. What are
the points to attend to? |
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: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.
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:While performing PEA on a cataract model, the posterior capsule was ruptured
by mistake. |
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: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.
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:Are Karton agents harmless when coming in contact with hands or eyes? |
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: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.
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:I'd like to try Karton agents. What do I do to purchase them? |
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:Thank you for your interest in our products. Please contact us
directly by E-mail.
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: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? |
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: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.
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:In order to inject Karton-N more quickly, is it possible to use a broader
needle? |
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: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.
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