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Moria One disposable microkeratome is found to be reliable, simple and safe
Vacuum ring of clear plastic is visual aid for suctioning.
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ALBANY, N.Y. — The LSK-One disposable microkeratome from Moria SA (Antony, France) is reliable, flexible, easy to use and has an excellent safety profile, according to two surgeons who have had experience with the unit. The disposable components are a suction ring with vacuum tubing that is attached to a permanent control unit and a single-piece plastic head with a flap size up to 10 mm that oscillates up to 15,000 oscillations per minute.
“One of the problems I’ve encountered with many of the other disposable units is that they come across somewhat flimsy. They really lack the quality control that most surgeons are used to in a non-disposable unit,” said Michael W. Belin, MD, medical director of the TLC Laser Eye Center here. In contrast, the Moria One disposable unit “appears to function with the same quality control and reliability of a non-disposable unit.” In fact, “we have yet to return a single Moria One disposable unit for quality reasons. The unit appears to be very reproducible, and structurally it has a good feel to it. You’re not dealing with a toy.”
Dr. Belin has used the Moria disposable microkeratome since last fall and the Moria non-disposable unit for the past 3 years. To date, he estimates he has performed 100 laser in situ keratomileusis (LASIK) procedures with the disposable microkeratome. “Anyone who has used the Moria non-disposable unit should be comfortable with the Moria disposable unit after only three or four cases,” Dr. Belin said.
Easier suction
Suction also appears to be easier with the Moria disposable microkeratome. “One reason may be because it has two vacuum ports as opposed to the one port of the non-disposable unit,” Dr. Belin said. In addition, the vacuum ring in the disposable unit is clear plastic compared with stainless steel. “You can literally see when you have achieved 360° of suction on the sclera,” Dr. Belin said. “Obviously, we still check the readings and the pressure, but this provides you with a visual safety.”
Simplicity, though, may be the greatest benefit of the Moria non-disposable microkeratome. “It comes pre-assembled. There’s virtually nothing for the technician to do. You don’t have to touch the blades. The unit can literally be set up in probably less than 30 seconds,” said Dr. Belin, a clinical professor of ophthalmology at Albany Medical College. “When you’re done with the case, you dispose of the unit. There is no cleaning or sterilizing.”
From a safety point of view, “the more we turn to disposables, the less we have to be concerned about any type of infectious agents, some of which may not always be sterilized by standard means,” Dr. Belin said. And economically, “if you can cut turnaround time to only one additional patient per session, this will more than compensate for any possible increased cost associated with the disposable unit.”
Smaller profile
Jonathan B. Rubenstein, MD, an associate professor of ophthalmology at Rush Medical College in Chicago, likes the fact that the Moria One disposable microkeratome has a “smaller profile than the non-disposable. It is not as wide, so it fits into small eyes and eyes with narrow palpebral fissures. These eyes are too narrow to permit a normal suction ring from gaining access to the eye.”
Furthermore, the control unit is fully compatible without adaptation for both the Moria non-disposable and the Carriazo-Barraquer. In essence, “you can run three different types of microkeratomes using the same control unit,” Dr. Rubenstein said. And by being essentially pre-assembled, “your speed and efficiency are increased, as well as decreasing the chance of human error. The blade is already positioned correctly.” Overall, “it is a quick and easy setup, decreasing the chance of error in assembly.”
Still, surgeons retain a choice of flap size because of different sized suction rings. “You can control the diameter of the flap,” Dr. Rubenstein said. Currently, the Moria has two sizes of rings, permitting an optical zone diameter up to 10 mm. “You also can change the actual flap depth by using two different microkeratome cutting heads — 130 µm and 150 µm. It’s important to have that variability,” he said. Moreover, the unit has an adjustable stop pin that allows adjustment of the hinge size.
“The cuts also are very reliable and very high quality,” Dr. Rubenstein said. Another feature of the disposable microkeratome is a clean air turbine, weighing less than 50 g and only 8 cm in length. This new turbine has been specifically designed for better handling, while its power and blade speed continue to be one of the strongest available. The control unit also provides continuous automatic monitoring though visual and audible signals, as well as a built-in rechargeable power battery to prevent power fluctuation or failure.
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For Your Information:
- Michael W. Belin, MD, can be reached at Cornea Consultants of Albany, 1240 New Scotland Road, Ste. 205, Slingerlands, NY 12159-9222; (518) 475-1515; fax: (518) 475-0645. Dr. Belin has no direct financial interest in any of the products mentioned in this article, nor is he a paid consultant for any companies mentioned.
- Jonathan B. Rubenstein, MD, can be reached at Rush–Presbyterian–St. Luke’s Medical Center, 1725 W. Harrison St., Ste. 918, Chicago, IL 60612; (312) 942-2745; fax: (312) 942-2140; e-mail: jrubenst@rush.edu. Dr. Rubenstein has no direct financial interest in any of the products mentioned in this article, nor is he a paid consultant for any companies mentioned.
- For product information on the Moria One disposable microkeratome, contact Microtech Inc., 4030 Skyron Drive, Unit G, Doylestown, PA 18901; (800) 441-1314; fax: (215) 230-7670; e-mail: microtech@microtechnic.com.