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  To our valued customer:

Thank you very much for your interest in our titanium pegging system. We think you will find this universal titanium pegging system easy to use. We are excited about the results we believe you will see with your patients.

We hope that this information from our Medical Director, Arthur Perry, M.D., will assist you when you begin to use this system. The following is Dr. Perry's experience with this procedure:

I do this in my office, as a sterile procedure, using retrobulbar anesthesia.

To use the threaded sleeve and the flat headed peg, simply create the hole with gradually larger hypodermic needles which are also enclosed (20g, 18g, 16g, 14g). Mark the conjunctiva with a marking pen. I use a template made by the ocularist to locate the spot. Use the Implant Ring Stabilizer, or any other appropriate instrument, to stabilize the implant. Make the first hole with the 20g needle slowly and carefully so that you get it very straight (perpendicular to the frontal plane of the patient). I generally make this hole completely through the implant to allow more vessel ingrowth. The other needles will easily follow the first hole and simply enlarge it. Keep your eye carefully on the entry and exit spot on the conjuntiva so that you can easily find the same hole. After using the 14g needle, I irrigate the hole with injectable gentamycin (40mg/cc). The threaded sleeve easily screws into the hole using the titanium driver. Place the open end of the sleeve at a depth so that it will be just below the conjuntiva when the conjunctival edema has resolved. Place the flat headed peg into the shaft of the threaded sleeve. I put antibiotic ointment into the socket, put the artificial eye in betadine and then rinse it with sterile saline, place it back in the socket and patch the eye overnight. I place the patient on oral antibiotics for 7 days and on topical antibiotics until I see them back in one month.

After rechecking the patient at one month, I send them to the ocularist to have the implant coupled to the prosthesis. The ocularist will determine the technique for coupling (ball peg, locking socket peg, direct attachment, etc.) and he will order the appropriate titanium attachment. I continue the patient on topical antibiotics for 2 weeks post coupling and then have the patient use the medication at bedtime only if they find that it decreases their secretions. About 50% of patients use a drop every night. In these cases, the antibiotic (or antibiotic/steroid) will need to be changed periodically.

We hope this information has been of assistance. Should you have any further questions please do not hesitate to contact our office at 858-259-4355 (or US only: 800-424-6537).

All of us at IOI wish you great success.