A microkeratome is a handheld medical device used in LASIK (laser-assisted in situ keratomileusis) eye surgery to surgically cut a flap in the cornea. This hinged corneal flap is then folded back to expose the underlying corneal stroma before laser ablation corrects refractive errors like myopia, hyperopia and astigmatism. The instrument consists of an oscillating stainless steel blade mounted on a disposable head that is attached to a sterile handle. Different blade designs and settings allow surgeons to cut corneal flaps of precise thickness.

Types of Microkeratomes

There are two main types of Microkeratome - mechanical and femtosecond lasers. Mechanical instruments utilize a sharp oscillating blade to cut the corneal flap with precise control over the depth and area of the incision. Older generation instruments used a circular blade while newer models feature a single-use oscillating plate with a hinged blade designed for improved safety and accuracy. In contrast, femtosecond lasers use ultrafast infrared laser pulses to dissect the corneal tissue, providing even smoother cuts without applying pressure to the eye. This bladeless technique reduces risks of irregular flaps and other complications compared to mechanical instruments.

Corneal Flap Creation Process

To create the corneal flap, surgeons first secure the patient's head with a suction ring to stabilize the eye. The instrument head is then thoroughly sterilized and mounted on the handles. After numbing the eye, the laser-guided instrument is gently placed on the central cornea and advanced across the eye using controlled vacuum suction. As the oscillating blade moves forward, it cuts a thin hinged flap of corneal tissue around 140-160 microns thick. Modern instruments cut with nanometer precision using advanced optical guidance. Within seconds, the engineered flap is completely isolated from the underlying stroma. It can then be gently folded back to access the treatment area.

Ensuring a Safe, Effective Procedure

Proper use and calibration of the instrument is critical to obtain a smooth, complete flap and avoid any complications. Surgeons carefully select instrument blades based on the patient's corneal thickness and visual needs. Before every case, they perform calibration and testing to guarantee the device is functioning within specified tolerances. Advanced optical tracking and feedback enables consistent, custom flap creation tailored to each individual. High-quality instruments from trusted manufacturers also incorporate multiple safety features to minimize any risks of flaws or inadvertent contact with other ocular tissues. With experience, surgeons have excellent control over factors like suction ring placement, blade angle and speed to optimize outcomes.

Advantages of Microkeratome Assisted LASIK

The introduction of instruments revolutionized LASIK by enabling highly accurate and controlled flap creation. Some key benefits include:

- Thin, hinged flaps prevent postoperative pain and promote rapid visual recovery compared to previous flap cutting techniques.

- Precise flaps allow for extremely customized laser ablation profiles and greater correction of refractive errors.

- Minimally traumatic incisions reduce risks of infections, disrupted wound healing and other ocular surface problems.

- Automated and standardized flap dimensions between patients increases procedural consistency and long-term predictability of results.

- Advancements like bladeless lasers further minimize complications from uneven pressure or imperfect blade contact during dissection.

- High flap strength and elasticity facilitates easy re-lifting if enhancements are needed in future without risk of additional trauma.

In summary, the precise instrument methodology has become the gold standard approach for initial flap creation in LASIK thanks to its safety, accuracy and benefits over previous techniques. Consistently producing high quality flaps is integral to achieving optimal refractive outcomes.

Continued Development of New Technologies

While modern instruments provide excellent results, ongoing research continues to improve laser and blade technology. Scientists work to develop even more advanced optical tracking capabilities, ablation profiles and guided cutting systems. Femtosecond lasers now offer additional customizable incision patterns beyond simple planar flaps. With computer-guided instruments of the future, it may one day be possible to achieve perfect flap geometry customized to thousandths of a micron for each unique cornea. Automated calibration and onboard diagnostics could further increase procedural consistency. As technology progresses, new generation instruments aim to maximize precision and optimize outcomes for more complex refractive cases and customized corneal procedures.

Ever since its introduction instrument surgery has established the gold standard for flap creation in LASIK. Continuous improvements to laser, blade and guidance systems now enable flap incisions that are increasingly precise and customized. As technology advances, the evolving instrument methodology will remain integral for achieving the best visual outcomes through maximally precise corneal surgery.

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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)