Evaluation of cut quality using the Amadeus microkeratome with different settings.

PURPOSE

To evaluate the quality of keratectomy specimens created with the Amadeus microkeratome (AMO) using scanning electron microscopy (SEM).

SETTING

Johannes Gutenberg-University Hospital, Department of Ophthalmology, Mainz, and the Department of Anatomy, Justus Liebig-University, Giessen, Germany.

METHODS

Corneal cuts were performed in freshly enucleated pig eyes using the Amadeus microkeratome with 9 combinations of oscillation rate and head-advance speed. For the cutting trials, oscillation rates of 8000, 13,000, and 18,000 rpm and head-advance speeds of 1.0, 2.5, and 4.0 mm/s were chosen. Fifty-four eyes were included, resulting in 9 groups of 6 eyes for each configuration. The surfaces and edges of the flaps were 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. At fixed head-advance speeds, an increase in oscillation rates improved the cut quality, resulting in smoother surface characteristics.

CONCLUSIONS

Smooth and regular surfaces and cut edges can be achieved by choosing high oscillation rates and low head-advance speeds. Microkeratomes that enable the user to adjust the oscillation rate and head-advance speed can be used to maximize surface smoothness and improve customized refractive surgery.