Amadeus microkeratome: experience with the first 2000 cases and lessons learned.
BACKGROUND
To assess the safety and efficacy of the Amadeus microkeratome and to report on lessons learnt in optimizing results from its use.


METHODS
A retrospective review of the flap-related complications of 2000 laser in situ keratomileusis (LASIK) procedures performed by one surgeon using the Amadeus microkeratome (AMO, Irvine, CA, USA) was conducted. One hundred consecutive cases had preoperative and intraoperative pachymetry to evaluate the relationship between flap thickness, corneal thickness and reuse of the blade.


RESULTS
There were 35 cases of minor epithelial defects (1.8%) and four eyes with major epithelial defects (0.2%). There were no cases of suction loss, buttonholes, or incomplete or damaged flaps. There were four free caps (0.2%). Twenty-five cases had minor wrinkles and two cases had significant folds requiring relifts. Thinner corneas resulted in thinner flaps (P < 0.0001). Reuse of the blade resulted in thinner flaps (P = 0.0001).


CONCLUSIONS
The Amadeus is a safe and reliable microkeratome. Although short, there is a learning curve with use of the instrument. Corneal thickness and reuse of the blade affect flap thickness.
Chan
Colin Ck
CC
Department of Ophthalmology, Concord Hospital, Sydney, New South Wales, Australia.
Moshegov
Con N
CN
D003319:Corneal Stroma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation / Q000379:methods*; D009216:Myopia / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety; D013524:Surgical Flaps; D016896:Treatment Outcome; D014463:Ultrasonography