Customizing the Amadeus® II Microkeratome: Evaluation of Cut Quality with Various Settings Using Electron Microscopy

Abstract

Purpose

To evaluate the cut quality of keratectomy specimens created with the new Amadeus® II microkeratome (SIS, Ziemer Ophthalmic, Port, Switzerland) using scanning electron microscopy (SEM).

Methods

Corneal cuts were performed in 24 freshly enucleated porcine eyes using the Amadeus® II microkeratome with combinations of cutting-head depth, oscillation rate, head-advance speed, and reuse of the blade. For the cutting trials, a 140-μm and 160-μm cutting head with three oscillation rates of 8,000, 10,000, and 13,000 rpm and two head-advance speed rates of 1.5 and 3.5 mm/s were chosen. In each setting, the blade was reused for a second time. All eyes were included, resulting in 4 groups with 6 eyes for each configuration. The surface and edge of the corneal cut was examined using SEM.

Results

At fixed oscillation rates, an increase in head-advance speed led to lower quality cuts, higher surface roughness, and irregular cut edges for both cutting heads (140 μm/160 μm), especially when using the blade for a second time. At fixed head-advance speeds an increase in oscillation rates improved the cut quality for both cutting heads (140 μm/160 μm). This results in smoother surface characteristics and more regular cut edges, especially when using the blade for the first time.

Conclusions

Using the Amadeus® II microkeratome for laser in situ keratomileusis procedures, the optimum oscillation rate, the optimum head-advance speed, and a single use of the blade will produce a very smooth and regular surface and cut edge for safe, comfortable, and improved customized refractive surgery. (Eur J Ophthalmol 2009; 19: 743–7)