Project B: Corneal Suture Removal
Proposed by Bradley Sacher, Resident in Opthamology
Summary of Project Submission:
The field of ophthalmology is overflowing with new devices, new technology and advancements that
seem to make functioning in clinic and surgery easier each day. However, one aspect of daily clinical
practice that is in need of improvement is a means for a more efficient suture removal. Sutures are
placed after corneal transplants, open globe repair, and frequently after cataract surgery. With an
estimated 3,000,000 cataract surgeries per year, 40,000 corneal transplants per year and countless
other surgeries that require permanent suture placement and subsequent removal, the need is great
for an efficient and effective means for suture removal. Currently, the most common means to
remove sutures in the clinic involves using two instruments – one to cut the suture (often a bent
disposable needle) and one to remove the suture and pull it from the cornea or globe (often a
Jewelers or other type of forceps). This can be a somewhat cumbersome and time consuming process
taking out sutures in clinic. Additionally, there is a need to sterilize the forceps after each use and
dispose of the needle. My solution is to create a single, disposable instrument that could both cut and
pull/remove the suture in one quick movement. The device for which I have some sketches and
design ideas, has a handle with a thin plate that can slide under each suture on the globe. Attached is
a simple mechanism that that will grasp the suture and cut at the same time allowing one to
approach the suture, cut/grasp the pull-out all in one motion. There are many variations and possible
design ideas, but a similar instrument is what I envision as a solution.
MBA Student’s Initial Market Analysis, Submitted by Shanti Elangovan
Market size and growth potential – could be based on number of procedures, number of
patients having this issue, etc.

3,000,000 cataract surgeries per year
o Has been steadily increasing and projected to continue to grow because
of (http://www.mayoclinic.org/medical-professionals/clinicalupdates/ophthalmology/incidence-cataract-surgery-continues-increasesteadily):
 Improved access to surgery
 Number of cataract surgeons has increased 27 percent since 2002
 Shift from hospital-based surgery to outpatient procedure
 Adoption of widening indications for surgery causing a larger
surgical population and an increase in second-eye surgery
 Increase in potential patients due to aging baby boomers
Current solutions – what are the current solutions being used in the market today to
address this problem.

Two tools used:
o One to cut the suture – bent disposable needle
o One to remove the suture – forceps

Both tools come in various sizes and are manufactured by several companies
o Specific tool choice dependent on both hospital, surgeon, and surgery
Competition – products, companies and nature of competition.


No tool seems to be available that can perform both functions (cut and remove)
o However, other tools used for several different uses so may be difficult
for hospitals to justify purchase of ‘one-use’ tool
(http://www.optometricmanagement.com/articleviewer.aspx?articleid=7
0418)
Blacksmith Surgical makes a stitch removing kit:
o http://blacksmithsurgical.com/stitch-removing-set/
Trends – what is happening in the market and/or technology that could impact any
potential solution and IMIG team would identify.

Market growth in cataract surgeries definitely makes this market very appealing
but would need to consider value proposition of a tool that only has one purpose
in surgery – may need to challenge design team to think of other uses for the
tool
Other
 Would also need to consider time value for hospital – i.e. while the current
process may be ‘time-consuming,’ could not find information on how long the
actual procedure takes. If the time lost is minimal, purchase of a disposable,
one-use tool may not seem like an efficient use of hospital funds