[Rise in intraocular tension in microkeratome sections (LASIK) and with the GTS trephine system for keratoplasty].
Microkeratome systems are being increasingly applied in lamellar corneal surgery (e.g., LASIK). The results of the few studies on intraocular pressure changes during the microkeratome cut vary widely. In this study, we examined the intraocular pressure pattern (IOP) in relation to the initial pressure.


METHODS
We performed lamellar corneal cuts on freshly enucleated porcine bulbs with three different microkeratome systems and different setting for the initial pressure (10, 20 and 30 mm Hg). The bulbs were cannulated, and the IOPs were recorded online with a two-chamber measuring system. In addition, we examined the GTS trephine system applied for corneal transplantation.


RESULTS
It became obvious that there were significant differences between systems (significance level, P = 0.05). With an initial pressure of 10 mm Hg the measured values of the Schwind system are significantly lower than with the Polytech system, and these values are again significantly lower than with the Chiron microkeratome. With 20 mm Hg the Chiron system shows significantly higher values than both other systems. With 30 mm Hg initial pressure, the pressure values with the Schwind system and with the Chiron microkeratome are significantly higher than with the Polytech system. Thus with all microkeratome systems the middle and maximum pressure values rise in correlation with the initial pressure levels. This effect was not seen with the trephine system. With the same initial pressure, the standard deviation of the measured data of different mikrokeratomes was low (range 3.1-9.0 mm Hg).


CONCLUSIONS
The pressure values shown are higher than the data published by the manufacturers. There is current discussion as to whether these pressure values are dangerous (e.g. bleeding) or not. The pressure values reached intraocularly during the microkeratome cut depend on the system and also on the present initial intraocular pressure values. Only with the same initial pressure can reproducible applanation and cutting conditions be obtained, which guarantee stable quality of the cut.
Wachtlin
J
J
Augenklinik und Poliklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin.
Schründer
S
S
Pham
D T
DT
Hoffmann
F
F
Hartmann
C
C
D000818:Animals; D003315:Cornea / Q000601:surgery*; D016039:Corneal Transplantation / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D053685:Laser Therapy / Q000295:instrumentation*; D008866:Microsurgery / Q000295:instrumentation*; D009862:Online Systems / Q000295:instrumentation; D013552:Swine
Intraokularer Tensionsanstieg bei Mikrokeratomschnitten (LASIK) und bei der Verwendung des GTS-Trepansystems zur Keratoplastik.