Behrens A, Seitz B, Langenbucher A, Kus M M, Rummelt C, Küchle M
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany.
J Refract Surg. 2000 Jan-Feb;16(1):83-9. doi: 10.3928/1081-597X-20000101-12.
To evaluate flap dimensions and cut deterioration with repeated blade use in an automated microkeratome.
The Automated Corneal Shaper (Chiron-Adatomed, Munich, Germany), 160-microm plate attached, was used to make a corneal flap in 90 pig cadaver eyes, reusing blades up to five times. Flap diameter was measured by planimetry and thickness was calculated by ultrasound pachymetry. Scanning electron microscopy of stromal beds and blade cutting edges was performed to assess cut deterioration after repeated blade use.
Mean flap central thickness was 125 +/- 32 microm. Mean vertical flap diameter was 7.6 +/- 0.4 mm. No correlation was found between thickness and diameter (r = 0.15, P = .45). Progressive thinning of the flap was observed in the direction of the flap hinge. Smooth cuts (using new blades) with periodic chatter lines at the keratectomy edge and in the stromal bed were observed with scanning electron microscopy. Increasing tissue remnants on the stromal bed and decreasing cut quality occurred with repeated blade use. Blades showed larger tissue remnants, nicks, and even folds on the cutting edge proportional to the number of times blades were used.
Satisfactory cut quality and reproducibility were obtained after a single use of stainless steel blades in the Automated Corneal Shaper microkeratome. Cut quality was degraded dramatically by repeated use of blades.
评估在自动微型角膜刀中重复使用刀片时瓣片尺寸及切割质量的恶化情况。
使用配备160微米刀片的自动角膜成型仪（Chiron-Adatomed，德国慕尼黑），在90只猪尸体眼上制作角膜瓣，刀片重复使用次数最多达5次。通过平面测量法测量瓣片直径，通过超声角膜测厚法计算瓣片厚度。对基质床和刀片切割边缘进行扫描电子显微镜检查，以评估刀片重复使用后切割质量的恶化情况。
瓣片中央平均厚度为125±32微米。垂直瓣片平均直径为7.6±0.4毫米。未发现厚度与直径之间存在相关性（r = 0.15，P = 0.45）。在瓣片铰链方向观察到瓣片逐渐变薄。扫描电子显微镜观察到，使用新刀片时切割面光滑，但角膜切除术边缘和基质床有周期性震颤线。随着刀片重复使用，基质床上的组织残留增加，切割质量下降。刀片切割边缘出现的组织残留、缺口甚至褶皱与使用次数成正比。
在自动角膜成型仪微型角膜刀中单次使用不锈钢刀片后可获得令人满意的切割质量和可重复性。刀片重复使用会使切割质量显著下降。
