Combined microkeratome, alcohol cone avoids intraoperative eye movement in LASEK

NICE, France — A combined microkeratome and alcohol cone is an improvement in LASEK instrumentation, according to a presentation given here.

“There are some patients who have heavy eye movement or who are very nervous, and so you really can’t sit the alcohol cone on the corneal surface,” said Chris Lohmann, MD, here at the European Society of Cataract and Refractive Surgeons meeting. “The problem with this is that the alcohol can leak. When the alcohol leaks, this usually leads to irritation of lids and conjunctiva. Additionally, the patient could also experience burning 3 to 4 hours after the procedure.”

Dr. Lohmann and colleagues at the University Eye Clinic in Regensburg, Germany, and St. Thomas Hospital in London developed the combination system to address this issue.

With the combined microkeratome and alcohol cone, surgeons can place the hinge of the LASEK epithelial flap wherever they choose. The device can be used with or without vacuum, and 70-µm incision depth is possible. Patient eye movement is significantly reduced, not only due to the size of the device, but because the device is designed in a way that it will stick onto the cornea, Dr. Lohmann said. The instrument is disposable and there is no alcohol leakage.

The new combined instrument is placed on the corneal epithelium and can be stabilized with vacuum, although Dr. Lohmann does not think vacuum is necessary. Suction is applied to the eye without increasing IOP. He said the device has been clinically evaluated in 30 myopic eyes. Epithelial trephination was possible in all 30 eyes, he said.

The instrument will become commercially available soon from the German company Geuder, Dr. Lohmann said.