History and Development of Microkeratome

The epikeratome was first developed in the late 1980s as surgeons were looking for better ways to perform refractive surgery to correct vision without glasses or contact lenses. The earliest epikeratomes were basic cutting devices that used a blade to slice off the front part of the cornea. However, they proved unreliable and unpredictable in controlling the depth and evenness of the cut.

Throughout the 1990s, major advances were made to improve the precision and safety of epikeratomes. Newer designs used an oscillating microblade driven by a precise motor and vacuum system. This allowed for more consistent, thinner flaps to be cut with much less variation in depth between patients. Microkeratom technology continued to advance well into the 2000s with improved blades, motors and suction rings for an even smoother, safer cutting process.

Today, modern epikeratomes provide an incredibly precise and reproducible cut almost every time. The latest designs incorporate advanced optics, controls and digital imaging to ensure the thinnest, most uniform flaps possible. This enables laser eye surgeons to achieve much better results for their patients through procedures like LASIK and LASEK.

How a Epikeratome Works

At its core, a epikeratome is a sophisticated automated microsurgery device used to cut the initial hinged flap in the cornea before laser treatment. Here is a brief overview of how it works:

First, the suction ring is placed on the surface of the eye to gently secure the cornea. This evens out the cornea and prevents any movement during cutting. Next, the oscillating microblade, which is essentially a very small ultra-sharp blade driven by a precise high-speed motor, is advanced to the desired depth on the cornea.

As the microblade moves at incredibly high speed, it slices a very thin disc of corneal tissue in a smooth, consistent motion. Strict controls ensure the blade only cuts to the programmed depth without any variation. This leaves behind a perfectly hinged flap of corneal tissue that can be gently folded back.

The laser surgeon can then reshape the underlying corneal stroma as needed before the flap is replaced. The strength and integrity of the corneal tissue means it heals back into the correct position on its own, without stitches. The end result is a precisely reshaped cornea for improved vision.

Advantages of Using a Epikeratome

Besides enabling laser eye procedures like LASIK, epikeratomes provide several advantages over older blade techniques:

- Precision - Modern epikeratomes cut with micron-level accuracy, creating ultra-thin and consistent flaps that optimize outcomes. Manual blades were far less precise.

- Control - Digital controls allow laser surgeons to program the exact flap depth and diameter needed. There is very little room for human error compared to manual techniques.

- Safety - The automated cutting process with forceps and oscillating blade is far safer than any handheld device. Risks of complications are dramatically reduced.

- Thinness - Thinner flaps mean less corneal tissue is disrupted and healing is smoother. Thinner flaps also expand the range of refractive corrections possible.

- Speed - The automated process is much faster than manual cutting, enhancing operating room efficiency without compromising precision.

- Reliability - When properly maintained, epikeratomes provide predictable, reproducible cuts for every single patient, day after day.

In Summary, microkeratome have truly revolutionized corneal refractive surgery since their introduction. They enabled new procedures like LASIK to become commonplace by providing a precise, safe and reproducible method for creating corneal flaps. Their innovative design is what continues to deliver outstanding outcomes for laser vision correction worldwide.