Moshirfar Majid, Calvo Charles M, Kinard Krista I, Williams Lloyd B, Sikder Shameema, Neuffer Marcus C
University of Utah, Department of Ophthalmology and Visual Sciences, Salt Lake City, UT, USA;
Clin Ophthalmol. 2011;5:1121-5. doi: 10.2147/OPTH.S23898. Epub 2011 Aug 12.
This study analyzes the characteristics of donor and recipient tissue preparation between the Hessburg-Barron and Hanna punch and trephine systems by using elliptical curve fitting models, light microscopy, and anterior segment optical coherence tomography (AS-OCT).
Eight millimeter Hessburg-Barron and Hanna vacuum trephines and punches were used on six cadaver globes and six corneal-scleral rims, respectively. Eccentricity data were generated using measurements from photographs of the corneal buttons and were used to generate an elliptical curve fit to calculate properties of the corneal button. The trephination angle and punch angle were measured by digital protractor software from light microscopy and AS-OCT images to evaluate the consistency with which each device cuts the cornea.
The Hanna trephine showed a trend towards producing a more circular recipient button than the Barron trephine (ratio of major axis to minor axis), ie, 1.059 ± 0.041 versus 1.110 ± 0.027 (P = 0.147) and the Hanna punch showed a trend towards producing a more circular donor cut than the Barron punch, ie, 1.021 ± 0.022 versus 1.046 ± 0.039 (P = 0.445). The Hanna trephine was demonstrated to have a more consistent trephination angle than the Barron trephine when assessing light microscopy images, ie, ±14.39° (95% confidence interval [CI] 111.9-157.7) versus ±19.38° (95% CI 101.9-150.2, P = 0.492) and OCT images, ie, ±8.08° (95% CI 106.2-123.3) versus ±11.16° (95% CI 109.3-132.6, P = 0.306). The angle created by the Hanna punch had less variability than the Barron punch from both the light microscopy, ie, ±4.81° (95% CI 101.6-113.9) versus ±11.28° (95% CI 84.5-120.6, P = 0.295) and AS-OCT imaging, ie, ±9.96° (95% CI 95.7-116.4) versus ±14.02° (95% CI 91.8-123.7, P = 0.825). Statistical significance was not achieved.
The Hanna trephine and punch may be more accurate and consistent in cutting corneal buttons than the Hessburg-Barron trephine and punch when evaluated using elliptical curve fitting models, light microscopy, and AS-OCT.
本研究通过使用椭圆曲线拟合模型、光学显微镜和眼前节光学相干断层扫描（AS-OCT），分析了赫斯堡-巴伦系统与汉纳环钻和环锯系统在供体和受体组织制备方面的特点。
分别在六个尸体眼球和六个角膜巩膜缘上使用8毫米的赫斯堡-巴伦和汉纳真空环锯及环钻。利用角膜片照片测量数据生成偏心率数据，并用于生成椭圆曲线拟合，以计算角膜片的特性。通过数字量角器软件从光学显微镜和AS-OCT图像测量环锯角度和环钻角度，以评估每个器械切割角膜的一致性。
汉纳环锯与巴伦环锯相比，在制作受体角膜片时更趋向于形成圆形（长轴与短轴之比），即1.059±0.041对比1.110±0.027（P = 0.147）；汉纳环钻与巴伦环钻相比，在制作供体切口时更趋向于形成圆形，即1.021±0.022对比1.046±0.039（P = 0.445）。在评估光学显微镜图像时，汉纳环锯的环锯角度比巴伦环锯更一致，即±14.39°（95%置信区间[CI] 111.9 - 157.7）对比±19.38°（95% CI 101.9 - 150.2，P = 0.492）；在评估OCT图像时，也是如此，即±8.08°（95% CI 106.2 - 123.3）对比±11.16°（95% CI 109.3 - 132.
