Cut edges and surface characteristics produced by different microkeratomes

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Surgical Technology

Background:

• Microkeratomes are crucial surgical instruments for lamellar keratectomy.
• Optimizing microkeratome parameters is essential for achieving high-quality corneal cuts.
• Variations in microkeratome design and settings can significantly impact surgical outcomes.

Purpose of the Study:

• To assess and compare the cutting characteristics of seven distinct microkeratomes.
• To evaluate corneal cut edges and surface regularity based on microkeratome parameters.
• To investigate the influence of blade oscillation frequencies and keratome speed on cut quality.

Main Methods:

• Lamellar keratectomies were performed on porcine corneas using eight different microkeratomes.
• Scanning electron microscopy (SEM) was employed to examine the freshly cut corneal beds.
• A standardized scoring system assessed cut edge serration and corneal wound bed regularity.

Main Results:

• Serrated cut edges were observed with the Microtech, Automatic Corneal Shaper, Draeger rotor, and Schwind microkeratomes.
• Most devices produced smooth cut edges, with the Schwind microkeratome yielding particularly regular wound surfaces.
• Smooth and regular wound beds were achieved with the Schwind, Automatic Corneal Shaper, Microtech, and MKM devices.

Conclusions:

• The interplay between keratome speed, oscillation frequency, and blade material is critical for microkeratome cut quality.
• A lower advancement-to-oscillation ratio is recommended for automated microkeratomes to enhance surgical precision.
• These findings aid in selecting optimal microkeratome settings for superior corneal tissue preparation.