A study of the optical micrometer, the coin gauge, and the diamond knife micrometer in diamond knife calibration.

Reproducible results in refractive keratectomy are greatly influenced by an accurate setting of the diamond knife blade length. In this study, we evaluated the accuracy and reproducibility of three existing techniques of blade calibration: the KOI coin gauge, the KOI diamond knife handle micrometer, and the Magnum optical micrometer. Serial blade length measurements of three similarly designed KOI diamond knives were made using each of the above calibration methods. The three knife handle micrometers had the largest measurement error (3.55%, 2.83%, 1.82%), and therefore the sole reliance of the handle micrometer for blade calibration was not recommended. The measurements made by the coin gauge on the three knives had measurement errors of 1.03%, 1.64%, and 1.46%. The optical micrometer achieved an accuracy of 0.005 mm and an interobserver precision of 0.009 mm. We prefer using the optical micrometer because the potential for parallax error is eliminated; it has a lower risk of blade damage; it is easier to use; and it also allows detection of defects in the footplates, the diamond knife, and of the wobbling blade, which may contribute to calibration error.