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Topic: Microkeratome

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	[No title] (Site not responding. Last check: 2007-10-08)
		According to yet another aspect of the invention, the microkeratome includes a base having a main portion for engaging the eye and a hollow handle extending from the main portion, the handle housing a linkage that connects a control shaft to a cutting blade movable relative to the base.
		The microkeratome of claim 11, wherein the base includes a fixture having a passage extending therethrough and connected to the suction ring and the fixture is connectable to a vacuum source.
		A method for ophthalmic surgery, comprising connecting a control shaft to a microkeratome; axially shifting the control shaft to effect movement of a carriage relative to a base on which it is mounted; and rotating the control shaft to effect movement of a cutting blade relative to the carriage in which it is carried.
	www.wipo.int /cgi-pct/guest/getbykey5?KEY=02/17834.031030&ELEMENT_SET=DECL (6911 words)

	Encyclopedia - Microkeratome (Site not responding. Last check: 2007-10-08)
		A microkeratome is a surgical instrument used for shaving and/or reshaping the front surface of the cornea.
		In a LASIK procedure, the surgeon uses the microkeratome and the Excimer laser to produce a refractive correction.
		The microkeratome is sometimes used during a corneal transplant procedure to remove any severely diseased or damaged corneal tissue prior to the transplant.
	www.visionrx.com /library/enc/enc_microkeratome.asp (258 words)

	Your Eye Site
		The microkeratome is treated with pressurized air to blow away foreign debris that lie within the workings of the microkeratome that may cause it to malfunction.
		The microkeratome goes right from the surgeon's hand to be soaked in an alcohol or bleach solution and is then sent to an oven called an autoclave for sterilization.
		During the microkeratome procedure, the increased pressure placed on the eye by the microkeratome suction can close off a vein or artery and, if the pressure remains for too long, cause the vein or artery to leak into the retina.
	www.youreyesite.com /laserrisks.htm (4111 words)

	Millennium Laser Eye Centers
		As with a mechanical microkeratome, a small section of tissue at one edge of the corneal flap is left uncut, forming a hinge that allows the surgeon to fold back the corneal flap and reshape the corneal bed with the excimer laser as in traditional LASIK.
		Microkeratome use is also more difficult in people with prominent orbital rims and small eyes, and introduces sterility issues not posed by the laser, Thompson said.
		Replacing the mechanical microkeratome, the source of many LASIK complications, with a computer-guided laser may be a significant advance.
	www.millenniumlaser.com /news_0304_allaboutvision.asp (760 words)

	Refractive Surgery - Lamellar Refractive Keratoplasty (Keratomileusis)
		The microkeratome is equipped with a special blade which is oscillated at approximately 10,000 RPM and is controlled through a footswitch.
		The microkeratome is advanced across the cornea until the blade is clear.
		In this procedure, a predetermined diameter corneal disk of approximately 70% thickness is resected using the microkeratome and immediately resutured to the eye.
	www.e-sunbear.com /rs_mkm.html (1038 words)

	Microkeratome creates flaps for LASIK, LASEK procedures - Ophthalmology Times (Site not responding. Last check: 2007-10-08)
		"Since the blade of the pendular microkeratome is curved in one meridian when it is attached to the disposable blade holder, an equidistant space is maintained between it and the spherical moulding plate," Dr. Carriazo said.
		Carriazo is also evaluating his pendular microkeratome for the creation of epithelial flaps for LASEK, although further research is needed because it is not always possible to make the flap without using alcohol.
		Since its suction ring design is characterized by a larger vacuum chamber relative to rings found on conventional mechanical microkeratomes, there is improved suction with the pendular microkeratome and also the suction ring has a smaller diameter that allows its use in small and deep-set eyes.
	www.ophthalmologytimes.com /ophthalmologytimes/article/articleDetail.jsp?id=82710 (804 words)

	Burlington County Eye Physicians
		This suction ring stabilizes the position of your eye and increases the pressure to a level that is needed for proper functioning of the microkeratome.
		The microkeratome is a very precise instrument that is the "keystone" in the LASIK procedure.
		After the suction ring and microkeratome have been removed, the corneal flap is folded back on the hinge exposing the middle portion of the cornea.
	www.bceye.com /lasik.htm (320 words)

	Shiley Eye Center: Cornea and Refractive Surgery
		The microkeratomes then have an applanation plate which flattens the cornea while an oscillating blade is advanced through the tissue with an offset of 130, 160, 180, or 200 microns.
		This microkeratome is made of molded high strength plastic, and various designs are available to produce smooth cuts at 160, 180 or 200 micron depths.
		These microkeratomes are marketed by Moria as the Barraquer Coriazo microkeratome; and by Chiron as the Hansatome, cause the oscillating blade to rotate on a temporal axis producing an incision that begins at the inferior portion of the cornea.
	medicine.ucsd.edu /cornea/microkeratomes.html (498 words)

	Ophthalmology Management
		The blades for the new microkeratome, however, are not interchangeable.
		Further enhancing the safety of the microkeratome, the blade does not oscillate in reverse; there is an audible sound if the blade fails; and the microkeratome automatically stops if the translation is too fast or too slow.
		The average hinge length is 5 mm; the flap diameter ranges from 8 mm to 11 mm; and heads are available in 130 µm, 160 µm or 180 µm.
	www.ophmanagement.com /article.aspx?article=86169 (1107 words)

	Chapter 6
		In the older procedure, a special device called a microkeratome was used to remove a section of the cornea which was then frozen by placing it on a cryolathe and lathed into a new shape.
		This pass is smaller in diameter, and the resected disk of tissue usually measures between 4 to 6 mm in diameter.
		In LASIK for myopia, a microkeratome is used to elevate a hinged lamellar corneal flap approximately 7.2 mm in diameter and 130 to 160 microns in thickness (see Figure 10-1, Step 1).
	www.elliseye.com /chapter_6.html (1958 words)

	Surgeons Discover that Microkeratomes Leave Plastic Particles in Corneas (Hagele in deep denial)
		The chemical composition of the metal and plastic parts of the microkeratome blade was identified using energy dispersive x-ray fluorescence (metal part), and Raman and infrared spectroscopy (plastic part).
		Only a few particles were observed on the unused microkeratome motor head and blade, whereas numerous fluorescent particles were detected after oscillation in air, the amount of particles increasing with oscillation time.
		This plastic (polyetherimide) emitted fluorescence identical to that of the observed particles, whereas all metal parts of the microkeratome blade and motor head were nonfluorescent.
	www.talkaboutsupport.com /group/alt.lasik-eyes/messages/42395.html (552 words)

	Ophthalmology Management
		With a microkeratome, the flap diameter is a function of suction ring thickness and corneal diameter and curvature.
		I also found that the mechanical microkeratomes were 10 times more likely to produce a seriously thin flap and 1,000 times more likely to create extremely thick flaps (see "Flap Thickness Distribution").
		Several studies strongly suggest this is because of the IntraLase flap's planar architecture, compared to a microkeratome flap that's deeper in the periphery than in the center (meniscus-shaped).
	www.ophmanagement.com /article.aspx?article=&loc=archive\2004\may\intralase\0504intralase.htm (1166 words)

	Quality Eye Care, P.C. - LASIK
		A flap-making device called a microkeratome is then attached to the ring and activated, to create a flap of corneal tissue.
		This flap of tissue is thin, approximately 160-180 microns (the center of the cornea averages about 550 microns), and remains attached to the rest of the cornea by a hinge.
		The ring and microkeratome are removed from the eye.
	www.laserforyou.com /lasik_steps.html (387 words)

	AORN Journal: LASIK Surgery
		The microkeratome suction ring fixates to the cornea with 25 mm Hg pressure at the same time the microkeratome is engaged.
		While the cornea is slightly elevated and fixated, the microkeratome glides across the corneal surface, incises a corneal flap, returns to its original position, and is removed.
		After the microkeratome passage, the photoablation is performed on the corneal periphery to increase corneal curvature.
	www.findarticles.com /p/articles/mi_m0FSL/is_5_71/ai_64424110/pg_5 (1470 words)

	LASIK technique (Site not responding. Last check: 2007-10-08)
		Next, the microkeratome is placed into the groves on the ring, and the gears are lined up.
		The microkeratome is similar to a carpenter's plane.
		After the microkeratome has passed over the cornea a thin flap (F) is created with a "hinge".
	www.wfubmc.edu /eye/cornea/keratome.htm (373 words)

	LASIK Eye Surgery in San Diego, California - Shiley Eye Center in La Jolla
		Traditionally this step was done by using a microkeratome, however recent technology allows Dr. Schanzlin to create the flap using the precision of a laser.
		Microkeratomes work in a fashion similar to that of a carpenter's plane.
		Microkeratome have a plate that flattens the cornea while an oscillating blade incises the flap at a predetermined depth.
	www.shileylasik.com /html/lasik.html (2084 words)

	Review of Optometry May 1999 Optometric Study Center
		After the surgeon removes the microkeratome and suction ring, he gently pulls the flap back to expose the stromal bed.
		With certain types of microkeratomes that were incompletely or incorrectly assembled (e.g., plate depths set too deep), perforation of the eye with loss of intraocular contents occurred.
		The microkeratome suction ring and flap manipulation may cause a patch of epithelium to slough off.
	www.revoptom.com /archive/issue/ro05f8.htm (2563 words)

	Maddox Laser Eye Center LASIK Brochure -- The LASIK Experience
		This microkeratome was used to correct large degrees of myopia by reshaping the front surface of the eye and has been used for that purpose since 1963.
		The most common reason for this incomplete microkeratome resection would be poor suction with the suction ring or a break in suction, for whatever reason, during the micro-keratome pass.
		Next, the microkeratome will be placed into position onto the suction ring track and groove, and is then driven across 90% of the cornea, resecting approximately 160 microns of cornea tissue, creating a corneal flap, and then is reversed off the suction ring.
	www.excimernet.com /MLASIKbody.htm (7560 words)

	EyeNet Magazine Online \| April 2000 \| Refractive Surgery
		I prefer the Hansatome microkeratome (Bausch & Lomb) because I believe it is associated with a very low rate of flap complications and provides a 9 to 10.5 mm diameter flap (depending on the corneal curvature) that is already the appropriate size for hyperopic enhancement, should that become necessary.
		Get in the habit of carefully examining the blades as the microkeratome head is assembled to detect notches in the blade edge and other abnormalities that could lead to a severe flap complication.
		The suction ring of a microkeratome may migrate when suction is applied despite posterior pressure being applied to the ring by the surgeon's hand.
	www.aao.org /aao/news/eyenet/archive/04_00/refract.html (2554 words)

	LASIK in Denver Colorado (Site not responding. Last check: 2007-10-08)
		The anterior section of the cornea became known as the "cap" and it is approximately 1/3 of the thickness of the cornea.
		This was done with the microkeratome performing refractive curvature change to the surface of the intact portion of the cornea.
		When lamellar surgeons started to use the laser rather than the microkeratome to create the curvature change, they proclaimed many advantages over their present method of in-situ keratomileusis and noted advantages over photorefractive keratectomy where the epithelium was manually removed by scraping.
	www.personavitamins.com /technical-explanation-lasik-surgery.html (737 words)

	Automated Lamellar Keratoplasty (ALK) (Site not responding. Last check: 2007-10-08)
		uses a device called a microkeratome to remove a thin slice of the cornea from the eye to reshape it for corrected vision.
		The microkeratome is then makes a small incomplete flap across the cornea by cutting across it.
		At this point, the microkeratome is precisely readjusted to match the calculated cut depth for the patient's vision correction.
	www.oregoneyecenter.com /ALK.htm (217 words)

	The Raleigh Eye Center, PA - LASIK & Refractive Surgery (Site not responding. Last check: 2007-10-08)
		It is a combination of two proven procedures, using the microkeratome and the Excimer laser.
		The microkeratome is used to make a flap in the cornea, the front clear surface of the eye.
		The microkeratome was first used in 1963 by Jose’ Barraquer, M.D. He performed keratomileusis using a keratome very similar to the one used today.
	www.raleigheyecenter.com /lasik_&_refractive_surgery.html (949 words)

	LASIK Surgery - IntraLase: FAQs (Site not responding. Last check: 2007-10-08)
		IntraLase delivers micron-level accuracy 100 percent greater than that of a microkeratome, giving the surgeon more control during the procedure and the ability to establish precise dimensions and thickness of the corneal flap, factors which are critical to a successful LASIK outcome.
		This is a result of the superior precision provided by the computer-guided IntraLase laser, as compared to that of a hand-held microkeratome, which houses a metal blade that cuts across the cornea to create the flap.
		Contrary to popular belief, LASIK is not an “all-laser” procedure, due to the use of the microkeratome blade.
	www.intralase.com /patient/faq/index.php (1054 words)

	(WO 00/56222) DISPOSABLE MICROKERATOME BLADE HOUSING [Repub: 08.03.2001] (Site not responding. Last check: 2007-10-08)
		The disposable microkeratome blade housing apparatus (7) securely attaches to the surgical devices but remains independent of the motor (3), gearing and cutting head (5) components.
		In a second embodiment, the blade housing (57) and cutting head are integral and include a knife edged blade (61), a blade holder (59), and a plaque.
		As the microkeratome advances over the eye, the plaque portion of the housing partially compresses the corneal just ahead of the blade.
	www.wipo.int /ipdl/IPDL-CIMAGES/view/pct/getbykey5?KEY=00/56222.010308 (294 words)

	Review of Ophthalmology
		Refractive surgeons agree that careful evaluation of all microkeratome blades is vital for outcomes.
		“Run the blades on the microkeratome and listen for any changes in the pitch of the motor, and any slowing of the oscillations,” he suggests.
		He says he used a company’s microkeratome on a patient with the company’s own blades and he had a blade malfunction due to poor tolerances for that particular lot of blades.
	www.revophth.com /index.asp?page=1_151.htm (1477 words)

	Optometric Management
		This instrument has redefined lamellar corneal surgery by replacing the mechanical blade of a microkeratome with an ultra-fast laser to create the corneal flap for the LASIK procedure.
		It does, however, reduce the incidence of epithelial ingrowth, increase the security of the flap and may protect the patient from flap slippage with minor trauma as well as possibly preserving corneal strength and reducing the risk of iatrogenic ectasia.
		The incidence of DLK with IntraLase is similar to the mechanical microkeratome both in our experience and in the published studies.
	www.optometric.com /article.aspx?article=71162 (1188 words)

	Dishler Laser Institute, Dr. Jon Dishler, Lasik, Denver, LiteTouch IntraLASIK, Laser Vision Correction, Bausch & Lomb ...
		microkeratome is regarded around the world as the gold standard of microkeratomes.
		microkeratome was designed for precision, ease of use and reliability.
		microkeratome and we currently have five units on hand for the convenience and safety of our patients.
	www.dishler.com /op_blhansatome.cfm (351 words)

	LASEK or LASIK
		Gholam Peyman, MD adapted the microkeratome to the excimer procedure.
		The microkeratome was never designed for what it is asked to do today.
		microkeratome to be the most dangerous part of the procedure.
	www.asiteforeyes.com /PhysicianResource/lasek_or_lasik.htm (456 words)

	California Eye Surgery, CA Ophthalmalogy, Los Angeles Laser Surgery, Orange County LASIK Surgery
		This device must fit properly upon the eye and perform without mechanical or technical errors in order to create a perfect corneal cut or "flap." Not all microkeratomes fit every eye, however, and differences in size or shape of ones cornea may limit the use of this device or affect its performance.
		These aspects of the microkeratome plus the experience level of the surgeon using the device are factors in what is known as "flap complications" which are seen in traditional LASIK.
		Also, unlike the microkeratome, the IntraLase laser is easily programmed to create a corneal flap of any size, shape or thickness, thereby making it truly individual for each patient.
	dantranmd.com /news.htm (817 words)

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