The four microkeratome comparison

Article

Published in the September/October 2005 edition of Journal of Refractive Surgery, Thomas Hammer and colleagues compared the quality and reproducibility of cuts produced by four automatic microkeratomes, and found that each performed similarly on overall quality of cut surface, with one out of the four, performing exceptionally better than the rest on quality of cut edge.

Published in the September/October 2005 edition of Journal of Refractive Surgery, Thomas Hammer and colleagues compared the quality and reproducibility of cuts produced by four automatic microkeratomes, and found that each performed similarly on overall quality of cut surface, with one out of the four, performing exceptionally better than the rest on quality of cut edge.

High quality of cut surface and a clean sharp cut edge are the results required by today's refractive surgeon when using a microkeratome in their surgical practice as both have been found to reduce the risk of corneal erosion, epithelial cell growth and scarring during wound healing.

Hammer, of Martin-Luther-University, Halle-Wittenberg, Germany, and co-workers studied the quality and reproducibility of cut edge and cut surface of the following microkeratomes: Amadeus, Hansatome, Summit-Krumeich-Barraquer (SKBM) and Supratome. The effects of oscillation frequency and blade feed rate were determined for both adjustable models - Amadeus and SKBM.

According to the researchers, each microkeratome performed similarly on overall quality of cut surface, with the Hansatome scoring the highest (88% of theoretical maximum), followed by SKBM (86%; 1.0 mm/s blade feed and 7000 rpm oscillation), Amadeus (84%; 2.5 mm/s, 8000 rpm), Supratome (84%; 16.6°/s, 12,500 rpm), Amadeus (81%; 3.0 mm/s and 13,000 rpm) and SKBM (78%; 1.5 mm/s, 14,000 rpm).

The Amadeus produced by far the highest quality of cut, seen in 62.5% of cases (at both settings), compared with the Supratome (25% of cases), SKBM (25% of cases; 1.0 mm/s, 7000 rpm), Hansatome (12.5% of cases) and in no cases with the SKBM at 1.5 mm/s and 14,000 rpm.

The authors concluded that a high frequency with low blade feed rate were characteristics desired in a microkeratome in order to reproduce sharp areas and maintain cut area quality. The study did, however, demonstrate that elevated levels of frequency could be detrimental as displacement of tissue and uneven cut area were demonstrated with the SKBM at 14,000 rpm. The authors recommended oscillation/feed quotients of 2000 to 4000 (rpm/mm-s ).

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