Year : 1983 | Volume
: 31 | Issue : 5 | Page : 502--504
Make your own disposable stainless steel blade
Daljit Singh1, Jan Worst2, Hampton Roy3,
1 Department of Ophthalmology, Medical College, Amritsar, India
Department of Ophthalmology, Medical College, Amritsar, (Punjab)
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Singh D, Worst J, Roy H. Make your own disposable stainless steel blade.Indian J Ophthalmol 1983;31:502-504
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Singh D, Worst J, Roy H. Make your own disposable stainless steel blade. Indian J Ophthalmol [serial online] 1983 [cited 2020 Oct 1 ];31:502-504
Available from: http://www.ijo.in/text.asp?1983/31/5/502/29531
A number of ophthalmologists in developed and developing countries are using breakable razorblade pieces for eye surgery. Blue Gillets and many other good varieties of breakable blades are a dwindling species and are difficult to find. The world wide popularity of cheap, good quality stainless steel blades makes it inevitable that breakable blades will be extinct in the near future.
The Advantages and Disadvantages of Breakable Blades
The making of a razor blade fragment is very easy. The blade is broken into two halves, inside its paper wraping. Slivers are made by twisting the blade with a blade breaker or with a well-closing needle holder. Sufficiently long slivers are made for an optimum grasp. Not every razor fragment thus made is of good quality, so that many of them have to be discarded after making a trial on the eye. If the razor fragments are kept in the open, or sterilised in spirit or boiling water, their points seem to loose some of their sharpness. This is due to inherent weakness of their point and rust formation. To get a fair degree of sharpness, the razor fragments are to be freshly prepared and quickly sterilised. For some unknown reasons, there are days when most razor fragments are sharp and good, while on other days a large number of blunt-pointed, blades may spoil the mood of the surgeon.
A number of firms in the West have come out with custom-made uniform quality, presterilised, "Use and throw away" blades. Such blades are generally rust-prone, like the breakable razor blades.
One of the authors (J.W.) introduced Superblade' in 1977. It is made from stainless steel blades with highly sophisticated technology. They are available in sterile packs and are popular in the affluent West. Even though the blade is reusable after re-sterilisation, few surgeons in the West would take that trouble.
A third development has been the making of a Diamond knife which is so costly that most surgeons would hesitate to buy one. The cost is around one thousand U.S. dollars. The cutting quality of Super-blades' and diamond knife are so great that there is hardly any sensation of touch or pressure and the incision has to be guided by sight. Slightest mishandling will lead to the loss of knife-point.
Stainless steel blade making
One of the authors (J. W) has been experimenting with the use of a shearing rose cutter for cutting stainless steel blade slivers. This procedure tended to curl the sharp point of blade-sliver. The curled point could then be finished by carefully tapping between a convex jeweller's hammer and a polished jeweller anvil to provide an excellent working blade. Recently, however, one of the authors (D.S.) has simplified the preservation of blade-tip by simply wrapping the blade with cello tape prior to cutting with a rose-cutter. This utter simplification of the process has thus brought stainless steel knife-making within the reach of every ophthalmologist.
1, A good quality shearing rose-cutter or a shear.
2, A good quality stainless steel shaving blade.
3, Cellotape role 2.5 cm wide.
1, Cut the razor blade length wise into two parts.
2, Stick one-half of the razor blade on an appropriate length of cello tape.
3, Role the cello tape over the edge of blade and stick it firmly [Figure 2].
4, Cut fragments with the rose-cutter, The angle of cut should be between 25 and 45 degrees. The cut fragment will remain attached to the cello tape [Figure 3].
5, The cello tape containing the knives may be stuck to a card board for storage and transport or even posting. Sterilisation procedures
The stainless steel razor fragment prepared 'as' above can be sterilised by any of following; means:
1) Acetone Sterilisation
Pure acetone is used for this purpose. Some cellotapes do not dissolve in acetate. If that is the case the tape should be peeled off with small forceps before sterilisation. Great Care should be taken to avoid even slightest touch to the tip of the blade:
(a) A small dish containing a pad of cotton is filled with acetone. Either individual bald,- fragments or the whole pack contained within the Sellotape covering is dipped in acetone for about 5 minutes. The cello tape covering is `dissolved and sterilised blade fragments are left on the cotton pad.
(b) Alternately, an individual razor fragment within the cello tape covering is held by 'a blade holder and this instrument is kept in the acetone. As soon as cello tape is dissolved the instrument is ready for use.
The use of cotton pad in (a) and pre-fixation with razor blade holder in (b) assures that' the razor blade is not damaged in handling.
2) Dry Heat Sterilisation
Before dry heat sterilisation, the cello tape covering should be peeled off with fine forceps. A dip in the boiling water makes cello tape. thick and its peeling off becomes easier, A temperature of 160° C for five minutes is sufficient for dry heat sterilisation of razor blades.
Stainless steel blade vs. breakable blades
The practical stainless steel blades as described above are far superior to the breakable blades for two reasons:
1. Stainless steel blades are almost 50 thinner than the breakable blades.
2. The stainless bevel at the edges is almost two times wider than the bevel of breakable blades.
In actual use the practical stainless steel slivers come equal to Super-blades R. A well made blade will need no effort to cut through scleral or cornea. [Figure 4] shows the tips of Supe-blade and practical stainless steel blade as described above as seen under polarised microscope at magnification X 300.
One stainless steel razor blade can provide roughly 10-12 knives (slivers). Each sliver need to be used only once. Thus the cost per surgery for a sharp ocular knife will be infinitely small.
A practical method for making stainless steel razor blades for eye surgery is described. This method provides a sharp, inexpensive and readily available ocular knife. Two easy methods of sterilisation are described.