Duckworth & Kent. Ophthalmic Titanium Surgical Instruments at the Leading Edge. Graham D. Barrett, MD. CALIPER VIEW ON ARROW

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1 3 4 5 Duckworth & Kent Ophthalmic Titanium Surgical Instruments at the Leading Edge Graham D. Barrett, MD. Duckworth and Kent is the first and original manufacturer and supplier of titanium surgical instruments. Working in conjunction with Graham Barrett, MD Duckworth and Kent has produced this collection of the finest ophthalmic surgical instruments. We are meticulous in our designs and pride ourselves on the quality of our instruments, manufacturing a product with optimum function and efficiency. Featured in this collection... Calipers, Cannulas, Diamond Knives, Dissectors / Knives, Fixation Rings, Forceps, Irrigation and Aspiration Handpieces, Keratoscope, Lens Loops, Nucleus Expressors, Markers, Needle Holders, Nucleus Rotators, Dividers, Separators, Scissors, Spatulas, Specula, Utility Clamps Full Duckworth and Kent product range, refer to... Duckworth and Kent Catalogue 2002 Edition or visit us on the web at and see the extensive product range Barrett Diamond Caliper / Scissors (angled) CALIPER VIEW ON ARROW Double-sided 0.1mm diamond tips Adjustable thumb screw 2.5mm tip width caliper / scissors in closed position Barrett balanced set handle, length 112.0mm 30 angled shafts, tip to angle length 2.2mm Includes sterilising tray Measures 2.5mm to 5.0mm in 0.5mm increments Measurement from outside of tips The Barrett Diamond Caliper has all the benefits of the Barrett balanced handle combined with the precision provided by diamond blades. The central knurl can b adjusted to define the enlargement of an incision from 2.5mm to 5mm. The reverse cross-action design permits selective enlargement of the internal aspect of th wound to assist intra-ocular instrument manipulation. The two diamond blades provide for a precise enlargement to the original incision. Hydrodissection Barrett Hydrodissection Cannula CANNULA gauge Curved shaft, bevelled tip Facilitates hydrodissection and hydrodelineation. page 1

2 0.8mm Lance Barrett 0.8mm Lance DIAMOND KNIVES Four Position Handle (0.2, 0.3, 0.5, 5.0mm) Length 128.0mm Four position handle may be used to perform 0.2mm or 0.3mm depth external incisions for phacoemulsification, whilst full extension position provides a lance style blade for paracentesis incision. 1.0mm Lance Barrett 1.0mm Lance Four position handle (0.2, 0.3, 0.5, 5.0mm) Length 128.0mm LRI Blade Barrett LRI Diamond Knife Blade preset at 550 microns 8 facet vertical cutting blade This diamond knife has a unique double sided footplate for lateral support on the diamond knife and an opening behind the footplate to give good visibility. Barrett Micrometer LRI Diamond Knife VIEW ON ARROW Retractable long handle length 120.5mm Supplied with T7000 sterilizing tray Micrometer Handle 8 facet vertical cutting blade 2.0mm Round Barrett 2.0mm Round (vertical cutting edges; upper side faceted) Length 105.0mm Supplied with T7000 sterilizing tray Eleven facets Length 138.0mm Upper side faceted Angled retractable handle Designed for lamellar dissection, particularly for performing a scleral tunnel for phacoemulsification. 2.5mm Arrow Barrett 2.5mm Arrow (12 facets) Six facets per side Length 127.0mm Retractable long handle Designed as a multipurpose diamond blade used to perform external incision, lamellar dissection and enlargement of phacoemulsification incisions. Surface are of diamond is larger than conventional diamonds, which facilitates corneal and scleral incisions for ECCE, trabeculectomy and penetrating keratoplasty. 2.65mm Single Sided Spear Barrett 2.65mm Single-Sided Spear Angled retractable handle Length 138.0mm page 2

3 Barrett Lamellar Dissector / Knife DISSECTOR / KNIFE Dissector 4.0mm round blunt edge 55 angled shaft, tip to angle length 6.0mm Barrett LeClip Utility Clamp UTILITY CLAMP Knife 2.0mm sharp rounded tip 55 angled shaft, tip to angle length 6.0mm Barrett balanced set handle, length 121.0mm mm serrated cross action jaws Length 82.0mm Replaces need for a mosquito or artery forces. Holds sutures to drape without piercing plastic drapes. Barrett Fixation Ring with Flap Support FIXATION RINGS mm fixation ring with in 10 increments Pivot swivel round handle, length 140.0mm Barrett Fine Thornton Double Sided Fixation Ring /4 offset ring, 14.0mm diameter ring dual sided with 9 point fixation Pivot swivel round handle, length 137.0mm Barrett Fine Thornton Fixation Ring with Degree Marking /4 ring, 14.0mm diameter ring with 9 point fixation Mirrored degree markings in 10 increments Pivot swivel round handle, length 135.0mm page 3

4 Capsulorhexis Barrett Capsulorhexis Forceps FORCEPS Utrata style tips Iris stop platforms 8.5mm from tips Curved shafts, tip to curve length 13.0mm Cross section of jaws are flattened vertically providing a rectangular cross section which strengthens forceps in horizontal plane, minimizes incision gape and loss of viscoelastic during capsulorhexis. Jaws maintain consistent alignment of tips. Conjunctival Barrett Conjunctival Forceps cusps, 4.0mm diameter 0.3mm separated Slightly curved shafts Designed with series of small cusps to avoid crushing conjunctiva while holding tissue securely. Corneal Barrett Corneal Forceps Barrett balance set handle, length 120.0mm Distinctive identification labeling Pierse 0.25mm notched, tip length 2.0mm 20 angled shafts, plain tips without tying platforms Swan neck style shafts Pierse notched tip, rather than teeth provide atraumatic fixation. Angulation of slim swan neck style of jaws assists suture tying in conjunction with Barrett needle holder (3-245). IOL Barrett IOL Forceps mm smooth curved tips Slightly curved shafts Low profile tips grasp optic of lens securely. Curvature of jaws designed to facilitate insertion and placement of IOL into capsular bag. Barrett IOL Forceps (model II) mm triangular jaws with trough to fold IOL Straight shafts page 4

5 Barrett IOL Holding / Insertion Forceps mm curved jaws 30 angled shafts, tip to angle length 15.0mm Barrett balanced set handle, length 119.0mm Barrett IOL Folding Forceps Triangular jaws with trough to fold IOL 20 angled shafts, tip to angle length 10.0mm Standard cross action handle, length 104.0mm Barrett IOL Folding Forceps (model II) 2-778BT Triangular jaws with trough to fold IOL 20 angled shafts, tip to angle length 10.0mm Grooved jaws hold optic securely during folding. Low profile facilitates adequate purchase of folded optic with 2-781BT Barrett IOL holding / insertion forceps. TM Barrett balanced set handle allows closure as well as rotation by finger control. Maybe used with latest hydroview, acrylic and silicone lenses. Barrett IOL Folding Forceps (model I) Triangular jaws with trough to fold IOL Straight shafts Standard cross action handle, length 103.0mm Foldable IOL is initially folded with Barrett folding (2-779 or 2-747) held and inserted with Barrett lens holding / insertion forceps (2-780 or 2-748). Instrument's TM fine, low profile jaws minimize incision size, as well as provide controlled release of implant into capsular bag. Maybe used with latest hydroview, acrylic and silicone lenses. Barrett IOL Holding / Insertion Forceps (model I) mm highly curved jaws 30 angled shafts, tip to angle length 15.0mm Reverse standard cross action handle, length 115.0mm Reverse action holds optic securely during insertion process then releases by closure of handle in a controlled fashion. Both actions are required during insertion of a foldable lens and can be accomplished with greater control by reducing wrist and arm movement. Fine curved jaws of forceps are easy to introduce and TM minimize wound size required for insertion. Maybe used with hydroview, acrylic, and silicone lenses. page 5

6 Barrett IOL Holding / Insertion Forceps (model II) mm curved jaws 30 angled shafts, tip to angle length 15.0mm Reverse standard cross action handle, length 115.0mm Barrett IOL Holding / Insertion Forceps (model II) 2-781BT Graham D. Barrett, MD. 10.0mm curved jaws 30 angled shafts, tip to angle length 15.0mm Muscle, Superior Rectus Barrett Rectus Fixation Forceps mm notched tip with 0.25mm slot for suture passage Barrett balanced set handle, length 122.0mm 20 angled shafts, tip to angle length 4.0mm Colibri style shafts Designed as a rectus and general fixation forcep to hold globe securely, atraumatic. Large cusp avoids need for toothed forceps and notched tip facilitates passage of fixation suture beneath forceps. Tying Barrett Tying Forceps mm tying platforms 30 angled shafts, tip to angle length 15.0mm Assists where a fine, non-toothed tying forceps is required. Forceps may be used as a second instrument to help stabilize IOL when inserting with Barrett IOL forceps (2-745). Barrett Miniature I/A Tip 8-620, * IRRIGATION AND ASPIRATION 23 gauge, 0.3mm aspiration port Curved shaft *(23 Gauge, 0.3mm aspiration port with silicone tubing and luer fitting supplied, specify , reorder for silicone tubing, specify B-0926) Designed to facilitate removal of cortex at 12 o'clock. Miniature I/A Tip may be used in conjunction with a syringe to dislodge cortex from 12 o'clock with a push, pull manoeuvre. Miniature I/A Tip may also be connected to aspiration line and used with simultaneous irrigation through a side port. Barrett I/A Handpiece gauge, 1.63mm tube diameter, 0.8mm irrigation ports, 0.3mm aspiration port Curved shaft, tip to handle length 20.0mm Round handle, length 134.5mm page 6

7 Barrett Irrigation Axe IRRIGATION gauge, 1.0mm tube diameter, 0.8mm bore diameter Irrigation port on top and bottom of tube, 1.2mm x 0.8 size Curved shaft, tip to handle length 17.0mm Barrett Irrigation Axe 0.75 x 0.75mm Axe angled to the left Flow rate of 70cc/min* Round handle, length 106.0mm Barrett Irrigating Handle gauge, 1.0mm tube diameter, 0.8mm bore diameter Irrigation port at front of tube, 0.8mm diameter Curved shaft, tip to handle length 17.0mm 0.7 x 0.6mm Axe angled to the left Flow rate of 75cc/min* Round handle, length 106.0mm *Flow Rate Conditions One litre head of water, gravity fed over a vertical distance of one metre through an Irrigation line (diameter 2.5mm), figures are for guidance only. Used with 8-730, and series DK I/A tips Irrigation only, through tip and silicone sleeve Silicone sleeve not included Round handle, length 88.0mm Barrett Keratoscope KERATOSCOPE (reorder for ring, specify B-0806) Quantitative keratoscope assists with detection of astigmatism at end of procedure. Microscope light provides a bright reflective image. Surgeon selects which of three ring images is most circular to determine a quantitative estimation of astigmatism. Handle contains an engraved scale to facilitate determination of astigmatism. Barrett Modified Lens Loop LENS LOOP VIEW ON ARROW 4.0mm x 12.0mm loop (outside dimension), 3.0mm x 10.0mm loop (inside dimension) Barrett balanced set handle, length 121.0mm Smaller diameter allows use in phacoemulsification through a relatively small wound. Lens loop also used to apply pressure superiorly in conjunction with pressure applied inferiorly by Barrett nucleus expressor (6-630) during manual ECCE. Corneal Barrett Corneal Marker MARKERS blade radial marks, 12.0mm diameter ring One concentric ring Barrett balanced set handle, length 118.0mm Package insert certification page 7

8 LASIK Barrett LASIK Marker MARKERS Two 5.0mm long blades, lowest profile with 3.0mm separation Two offset blades, 5.5mm x 1.0mm separation Barrett balanced set handle, length 117.0mm Limbal Barrett Limbal Ruler mm and 5.5mm markings Distinctive identification labeling Measured outside line, outer diameter Package insert certification Designed for measurements of external incision for cataract surgery, 3.5mm for Foldable IOLs, 5.5mm for PMMA IOLs. Barrett Limbal Marker mm arc with radius of 6.0mm marking Two 2.0mm side markings Anodized gold Flat handle, length 114.0mm VIEW ON ARROW Barrett Limbal Marker mm arc with radius of 8.0mm marking Two 2.0mm side markings Anodized blue Flat handle, length 114.0mm VIEW ON ARROW Barrett Nucleus Expressor NUCLEUS EXPRESSOR mm bulbous tip, curved shaft page 8

9 Barrett Needle Holder / Scissors (curved) NEEDLE HOLDERS 10.0mm heavy curved jaws, inbuilt cutting edge, distal jaw Length 120.0mm Barrett balanced set handle, tag spring Designed for large sutures with an inbuilt edge at distal end of jaw to allow surgeon to cut suture without changing instruments. Jaws of needle holder are large enough to bend a 26 gauge needle for capsulorhexis. Barrett Needle Holder / Scissors (curved with lock) mm heavy curved jaws, inbuilt cutting edge, distal jaw Barrett balanced set handle with lock, tag spring Length 120.0mm Barrett Needle Holder (curved) mm medium curved jaws Length 120.0mm Barrett balanced set handle, tag spring Designed for suturing with fine 10-0 needles. Jaws are curved proximately but straight distally providing a unique bi-curve which facilitates suture placement, suture tying in conjunction with Barrett corneal forceps (2-181) or Barrett angled tying forceps (2-181) or Barrett angled tying forceps (2-193). Barrett Needle Holder (curved with lock) mm medium curved jaws Barrett balanced set handle with lock, Tag Spring Barrett Duo Nucleus Rotator / Manipulator / Splitter Length 120.0mm NUCLEUS ROTATORS, DIVIDERS, SEPARATORS 6-085, * Nucleus Splitter Rotator / Manipulator Straight, sharp inner / outer sides of tip, tip length 1.25mm 0.65mm mushroom tip Cutting Edge 90 to Axis 45 angled shaft, tip to angle length 10.0mm 45 angled shaft, tip to angle length 10.0mm Barrett balanced set handle, length 123.0mm *(Duo nucleus rotator / manipulator / splitter, round handle, length 120.0mm, specify ) Smooth tip manipulator is useful as a nucleus rotator / manipulator in four quadrant nucleo fractis techniques. End of manipulator is ideal for retracting iris during phacoemulsification and inserting IOLs. Nucleus splitter used during phacoemulsification techniques such as phaco chop and modified phaco chop procedures. page 9

10 Barrett Phaco-Axe (Right Handed Surgeon) Graham D. Barrett, MD. NUCLEUS ROTATORS, DIVIDERS, SEPARATORS , * Highly polished mushroom rotator 0.75 x 0.75mm Axe *Barrett Phaco axe (Left Handed Surgeon) specify Phaco-Axe tip end anodized gold for easier identification Length 122.0mm Barrett Double Ended Phaco-Axe x 0.75mm Axe & 0.75 x 1.10mm Axe Length 123.5mm Barrett Nucleus Rotator / Manipulator 6-472, * 0.65mm mushroom style tip Angled shaft, tip to angle length 10.0mm *(0.65mm Mushroom style tip, round handle, length 120.0mm, specify ) Multipurpose, eliminates need for multiple hooks and second instruments. Used as a second instrument to facilitate rotation and manipulation of nucleus as cracking. Mushroom style tip minimizes chance of inadvertent damage to capsule while manipulating nuclear quadrants. Used to rotate and dial IOL within capsular bag. In presence of a small capsulorhexis, two manipulators are used in a two handed manoeuvre allowing retraction of capsule or pupil with one manipulator and rotation and dialling with a second manipulator. Manipulator is well suited to retracting iris in an atraumatic fashion, and two manipulators can stretch a small pupil prior to phacoemulsification. The phaco axe is a wedge shaped instrument designed to produce a quick vertical crack of the nucleus during phacoemulsification. The wedge produces a fracture in the vertical plane of the nucleus along fault lines that exist in alignment with the lens sutures. The axe manoeuvre consists of 4 steps, which occur in rapid sequence so that it appears as one fluid movement. Step 1 The initial step is to engage the nucleus deeply to at least 50 % of the nuclear thickness. A small amount of phaco energy is required to embed the nucleus, whic is then held with vacuum alone. The phaco tip should not advance significantly beyond the centre of the nucleus so that there is sufficient space to place the axe in front of the tip. Step 2 The axe is then moved vertically downwards just in front of and adjacent to the phaco tip to initiate a vertical cleft in the nucleus. Step 3 The phaco tip moves in an upward and outward motion separating the segment of nucleus away from the axe, which holds the remainder of the lens in position and extending the vertical cleft created by the axe into a crack. Step 4 The final motion is to separate the axe and the phaco tip to propagate the crack through the full thickness of the lens. The initial crack tends to propagate along the entire lens and is not confined to one quadrant as tends to occur with initial sculpting and cracking associated with divide and conquer techniques. After the quick vertical crack, the segment is engaged on the phaco tip and is removed with the application of ultrasound energy. The axe is well suited to rotating the nucleus for the next vertical crack. The entire axe manoeuvre is performed within the margins of the capsulorhexis, unlike horizontal chopping procedures where access to the lens equator requires manipulation under the capsule anterior. High vacuum levels are therefore not necessary to engage the nucleus as in conventional chopping procedures where the chopper tends to displace the segment of nucleus from the phaco tip. A mushroom manipulator is better suited for manipulating epinuclear material and this is provided on the other end of the phaco axe. The technique is well suited to Dual Linear systems where the linear control of phacoemulsification and aspiration allows the surgeon to simultaneously control these parameters, thereby using just the required energy and aspiration to embed the phaco tip and remove each segment of nucleus. The phaco-axe produces a quick vertical crack of the nucleus, allowing the surgeon to rapidly fracture and remove a cataract with less energy than conventional nucleofractis techniques which rely on sculpting. This procedure also provides greater safety and precision than other chopping manoeuvres. page 10

11 Conjunctival Barrett Conjunctival Utility Scissors (angled) SCISSORS Blunt tips, angled blades Cut length 12.0mm, tip to pivot length 20.0mm Designed to cut and undermine conjunctival tissue, cut sutures, as well as incise plastic drape. Corneal and Corneal Section Barrett Micro Scissors (curved) 1-221, * Sharp tips, slightly curved blades Cut length 5.0mm, tip to pivot length 12.0mm *(Blunt tips, slightly curved blades, ION treated tips, cut length 5.0mm, Barrett Balanced Set Handle, specify ) Fine blades, designed with sufficient length, suitable for iridectomy, iridotomy, sphincterotomy as well as cutting 10.0 nylon suture. Barrett Corneal Scissors (curved) Blunt tips, curved blades Universal cutting blades Cut length 5.0mm, tip to pivot length 11.0mm Designed for penetrating keratoplasty, or for surgeons who may require Scissors for enlargement of cataract incision. Barrett Double Ended Spatula SPATULA Flattened tip 0.2mm x 0.5mm highly polished 45 angled shaft, tip to angle 8.0mm Barrett Adjustable Speculum SPECULA Rounded tip 0.6mm tip 45 angled shaft, tip to angle 8.0mm Round handle, length 121.0mm Open blades Open blades Angled to rest temporally Angled to rest nasally Adjustable with thumb screw Adjustable with thumb screw Profile is similar to a wire type Speculum; locking mechanism allows Speculum to resist eyelid squeezing etc., especially during procedures with topical anaesthesia. Construction of Speculum allows maximum exposure, resists eyelid compression and avoids any compression of globe. page 11

12 Barrett Adjustable Speculum SPECULA Open blades Adjustable with thumb screw Solid blades Angled to rest nasally Adjustable with thumb screw Barrett LASIK Duo Adjustable Speculum Open blades Thin blade thickness Dual action opening to give parallel movement Suitable for LASIK surgery Rigid design Adjustable with thumb screw Duckworth & Kent Ltd Terence House 7 Marquis Business Centre Royston Road, Baldock Herts SG7 6XL England Tel: +44 (0) Fax: +44 (0) Web: info@duckworth-and-kent.com Duckworth & Kent USA Ltd 9100 Watson Road Suite 100 St. Louis, MO USA Tel: (314) Tel: (800) Fax: (314) sales@dkusa.org April 2002 Duckworth & Kent Ltd Revised page 12