Microkeratome offers easy assembly, reliable flap thickness

Raleigh, NC-Simplicity is the key word to James Kiley, MD, when he describes the MK-2000 microkeratome (Nidek).

"What we like primarily about the MK-2000 is its simplicity. The instrument is very tech-friendly and easy to assemble, maintain, and clean. We continue to use the instrument because it is so reliable and it has performed consistently as we want it to," Dr. Kiley told Ophthalmology Times.

In his practice, he began doing refractive surgery using the Automated Corneal Shaper (Bausch & Lomb), one of the original microkeratomes, and eventually switched to a Hansatome microkeratome (Bausch & Lomb).

Dr. Kiley, who is in private practice at the Raleigh Eye Center, Raleigh, NC, has had more than 5 years of experience with the MK-2000, which was part of a package deal when he bought a Nidek laser.

The microkeratome comes equipped with 8.5-mm and 9.5-mm suction rings and 130-µm and 160-µm plates. The heads, according to Dr. Kiley, are reliable in that the resultant flap thicknesses are close to the desired size.

Dr. Kiley and his practice colleagues use the MK-2000 for all their patients undergoing refractive surgery, even those with small eyes.

"In fact," he pointed out, "being able to do refractive surgery on patients with small eyes is one of the instrument's advantages over a machine such as the Hansatome. The MK-2000 is easy to place on a small eye. I have never had a patient with an eye that was too small for the microkeratome."

Pearls for use

Two screws hold the head in place, and Dr. Kiley advised that the screws be checked to ascertain that they are tightly secured.

There is also a wedge that should be placed correctly to ensure that the plate remains fully closed. He explained that the wedge was developed after a surgery outside of the United States during which the head was not closed tightly, resulting in a gap between the head and the instrument.

"If the instrument is assembled properly, there is minimal risk of flap complications," he said.

Dr. Kiley examines, runs, and returns the microkeratome prior to performing every surgery to make sure it is functioning properly, which is something he advises.

"The MK-2000 is a reliable workhorse. It does the job it is intended to do and I have never had an instrument-related flap complication," he said. However, he does have one request on his wish list, namely, that the microkeratome would be especially useful for surgeons if it were redesigned to perform epi-LASIK.

"It would be nice if it could be set to a lower suction level to perform epi-LASIK," he said.