Amadeus II microkeratome: optimizing microkeratome settings for high flap accuracy using optical low coherence...

Area of Science:

• Ophthalmic surgery
• Refractive surgery technology
• Corneal flap microkeratome analysis

Background:

• Accurate corneal flap thickness is critical for refractive surgery outcomes.
• The Amadeus II microkeratome (SIS, Ziemer Ophthalmic) is a new device requiring parameter optimization.
• Blade reuse and its impact on flap accuracy need thorough investigation.

Purpose of the Study:

• To evaluate the influence of Amadeus II microkeratome settings on corneal flap thickness accuracy.
• To assess the effect of Surepass blade reuse on flap thickness precision.
• To identify optimal experimental settings for consistent flap creation.

Main Methods:

• Prospective study involving 120 porcine eyes using the Amadeus II microkeratome.
• Tested 140 and 160-micrometer cutting heads with Surepass blades, reusing each blade twice.
• Varied head advance speed (1.5, 3.5 mm/s) and oscillation rates (8000, 10000, 13000 rpm); measured flap thickness via optical low coherence reflectometry (OLCR).

Main Results:

• With the 140 µm head, optimal accuracy (132.1±10.0 µm) was achieved at 1.5 mm/s advance and 10,000 rpm oscillation; blade reuse yielded best results at 8000 rpm (130±6.9 µm).
• With the 160 µm head, optimal thickness (162.4±7.7 µm) occurred at 3.5 mm/s advance and 13,000 rpm oscillation.
• Blade reuse with the 160 µm head required adjusted settings (3.5 mm/s, 10,000 rpm) for accuracy (157.4±7.7 µm).

Conclusions:

• Optimized microkeratome settings are essential for minimizing flap thickness deviation and improving flap accuracy.
• Specific settings are required for different cutting heads and when reusing blades.
• Optical low coherence reflectometry (OLCR) is an effective method for verifying individualized settings.