Evaluation of corneal flap dimensions and cut quality using the SKBM automated microkeratome

Arne Viestenz, Achim Langenbucher, Carmen Hofmann-Rummelt, L. Módis, Anja Viestenz, Berthold Seitz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: To evaluate flap dimensions and cut quality with repeated blade use of the automated Summit Krumeich-Barraquer microkeratome (SKBM® [LadarVision]). Setting: Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen, Germany. Methods: The SKBM (160 μm plate, intended flap diameter 9.0 mm) was used to perform a corneal hinged flap in 35 pig cadaver eyes. Seven blades were reused 5 times each. The flap diameter was measured by planimetry, and the thickness was assessed by ultrasonic pachymetry. Scanning electron microscopy (SEM) of blades and stromal beds was performed. Results: With single use of the blade, the mean central flap thickness was 145 μm ± 25 (SD). The vertical/horizontal flap diameter was 9.0 ± 0.03 mm/ 8.6 ± 0.03 mm. No thickness gradient was observed from the incision (138 ± 31 μm) to the flap hinge (130 ± 30 μm). If the blade was used more than 2 times, the flap was thinner at the incision (157 ± 34 μm versus 124 ± 20 μm; P = .003) and the hinge (143 ± 24 μm versus 122 ± 31 μm; P = .04), but the central thickness remained unchanged. With multiple use of the blade, SEM analysis showed increasing cut irregularity, more tissue remnants on the blade surface, and a progression in blade irregularities (up to 9.3 μm). Conclusions: Reproducible flap size and thickness can be obtained with single use of stainless steel blades in the SKBM. With multiple use, the quality of the blades and the stromal bed deteriorates and the peripheral thickness of the flaps decreases. Thus, single use of blades is recommended.

Original languageEnglish
Pages (from-to)825-831
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume29
Issue number4
DOIs
Publication statusPublished - Apr 1 2003

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Electron Scanning Microscopy
Stainless Steel
Ophthalmology
Cadaver
Ultrasonics
Germany
Swine

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Evaluation of corneal flap dimensions and cut quality using the SKBM automated microkeratome. / Viestenz, Arne; Langenbucher, Achim; Hofmann-Rummelt, Carmen; Módis, L.; Viestenz, Anja; Seitz, Berthold.

In: Journal of Cataract and Refractive Surgery, Vol. 29, No. 4, 01.04.2003, p. 825-831.

Research output: Contribution to journalArticle

Viestenz, Arne ; Langenbucher, Achim ; Hofmann-Rummelt, Carmen ; Módis, L. ; Viestenz, Anja ; Seitz, Berthold. / Evaluation of corneal flap dimensions and cut quality using the SKBM automated microkeratome. In: Journal of Cataract and Refractive Surgery. 2003 ; Vol. 29, No. 4. pp. 825-831.
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abstract = "Purpose: To evaluate flap dimensions and cut quality with repeated blade use of the automated Summit Krumeich-Barraquer microkeratome (SKBM{\circledR} [LadarVision]). Setting: Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen, Germany. Methods: The SKBM (160 μm plate, intended flap diameter 9.0 mm) was used to perform a corneal hinged flap in 35 pig cadaver eyes. Seven blades were reused 5 times each. The flap diameter was measured by planimetry, and the thickness was assessed by ultrasonic pachymetry. Scanning electron microscopy (SEM) of blades and stromal beds was performed. Results: With single use of the blade, the mean central flap thickness was 145 μm ± 25 (SD). The vertical/horizontal flap diameter was 9.0 ± 0.03 mm/ 8.6 ± 0.03 mm. No thickness gradient was observed from the incision (138 ± 31 μm) to the flap hinge (130 ± 30 μm). If the blade was used more than 2 times, the flap was thinner at the incision (157 ± 34 μm versus 124 ± 20 μm; P = .003) and the hinge (143 ± 24 μm versus 122 ± 31 μm; P = .04), but the central thickness remained unchanged. With multiple use of the blade, SEM analysis showed increasing cut irregularity, more tissue remnants on the blade surface, and a progression in blade irregularities (up to 9.3 μm). Conclusions: Reproducible flap size and thickness can be obtained with single use of stainless steel blades in the SKBM. With multiple use, the quality of the blades and the stromal bed deteriorates and the peripheral thickness of the flaps decreases. Thus, single use of blades is recommended.",
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AU - Viestenz, Anja

AU - Seitz, Berthold

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N2 - Purpose: To evaluate flap dimensions and cut quality with repeated blade use of the automated Summit Krumeich-Barraquer microkeratome (SKBM® [LadarVision]). Setting: Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen, Germany. Methods: The SKBM (160 μm plate, intended flap diameter 9.0 mm) was used to perform a corneal hinged flap in 35 pig cadaver eyes. Seven blades were reused 5 times each. The flap diameter was measured by planimetry, and the thickness was assessed by ultrasonic pachymetry. Scanning electron microscopy (SEM) of blades and stromal beds was performed. Results: With single use of the blade, the mean central flap thickness was 145 μm ± 25 (SD). The vertical/horizontal flap diameter was 9.0 ± 0.03 mm/ 8.6 ± 0.03 mm. No thickness gradient was observed from the incision (138 ± 31 μm) to the flap hinge (130 ± 30 μm). If the blade was used more than 2 times, the flap was thinner at the incision (157 ± 34 μm versus 124 ± 20 μm; P = .003) and the hinge (143 ± 24 μm versus 122 ± 31 μm; P = .04), but the central thickness remained unchanged. With multiple use of the blade, SEM analysis showed increasing cut irregularity, more tissue remnants on the blade surface, and a progression in blade irregularities (up to 9.3 μm). Conclusions: Reproducible flap size and thickness can be obtained with single use of stainless steel blades in the SKBM. With multiple use, the quality of the blades and the stromal bed deteriorates and the peripheral thickness of the flaps decreases. Thus, single use of blades is recommended.

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